To amend title XVIII of the Social Security Act to establish a minimum geographic cost-of-practice index value for physicians' services furnished under the medicare program of 1.

February 12, 2003

Mr. DOMENICI (for himself, Mrs. LINCOLN, Mr. ROCKEFELLER, and Mr. THOMAS) introduced the following bill; which was read twice and referred to the Committee on Finance

To amend title XVIII of the Social Security Act to establish a minimum geographic cost-of-practice index value for physicians' services furnished under the medicare program of 1.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE; FINDINGS.

(a) SHORT TITLE- This Act may be cited as the `Medicare Access Equity Act of 2003'.

(b) FINDINGS- Congress makes the following findings:

(1) Americans have paid taxes in to the medicare program equally across the country and every American should have access to quality health care.

(2) There is a national market for health care providers.

(3) Increasingly, private insurance companies tie their reimbursement rates to those paid by medicare.

(4) The physician fee schedule formula for medicare currently includes several adjustments for variable costs throughout the nation. While it is appropriate for the cost of running a practice to reflect overhead differences, physicians should not be compensated for their time differently based on where they live.

(5) Medicare beneficiaries pay the same part B premium regardless of location which forces subsidization of higher reimbursement areas by seniors in lower reimbursement areas without any corresponding benefit.

(6) Areas of the country that currently receive the lowest reimbursement from medicare are often the same areas that are experiencing the greatest shortage of physicians. Attracting more physicians to these areas cannot be achieved without greater equity in medicare reimbursement.

SEC. 2. ESTABLISHMENT OF FLOOR ON WORK GEOGRAPHIC ADJUSTMENT.

Section 1848(e)(1) of the Social Security Act (42 U.S.C. 1395w-4(e)(1)) is amended by adding at the end the following new subparagraph:

`(E) FLOOR AT 1.0 ON WORK GEOGRAPHIC INDICES- After calculating the work geographic indices in subparagraph (A)(iii), for purposes of payment for services furnished on or after January 1, 2004, the Secretary shall increase the work geographic index to 1.00 for any locality for which such geographic index is less than 1.00.'.

END