H.R.6386 - To amend title XVIII of the Social Security Act to extend and revise incentive payments for physician scarcity areas under part B of the Medicare Program.110th Congress (2007-2008)
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Shown Here: Introduced in House (06/26/2008)
110th CONGRESS 2d Session
H. R. 6386
To amend title XVIII of the Social Security Act to extend
and revise incentive payments for physician scarcity areas under part B of the
Medicare Program.
IN THE HOUSE OF REPRESENTATIVES
June 26, 2008
Mr. McCarthy of
California introduced the following bill; which was referred to the
Committee on Energy and
Commerce, and in addition to the Committee on
Ways and Means, for a
period to be subsequently determined by the Speaker, in each case for
consideration of such provisions as fall within the jurisdiction of the
committee concerned
A BILL
To amend title XVIII of the Social Security Act to extend
and revise incentive payments for physician scarcity areas under part B of the
Medicare Program.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1.Extension and revision of
Medicare incentive payments for physician scarcity areas.
(a) 5-year
extension.—Paragraph (1) of
section 1833(u) of the Social Security Act (42 U.S.C. 1395l(u)) is amended by
striking “2008” and inserting “2012”.
(b) Change in
eligibility criteria.—Such
section is further amended—
(1) in paragraph (1)(A)—
(A) by inserting
“or paragraph (8), as the case may be” after “paragraph
(4)”; and
(B) by inserting
“(or 2.5 percent in the cases specified in paragraph (8))” after
“5 percent”;
(2) in each of clauses
(i) and (ii) of paragraph (2)(C), by inserting “and paragraph (8)”
after “in this paragraph”;
(3) in paragraph (3),
by striking “The Secretary” and inserting “For years before
2009, the Secretary”;
(4) in paragraph (4)(A), by striking “The
Secretary” and inserting “For years before 2009, the
Secretary”; and
(5) by adding at the end the following new paragraph:
“(8) NEW RULES FOR
SCARCITY AREAS.—
“(A) IN
GENERAL.—Subject to
subparagraph (B)(ii), in applying paragraph (1) in the case of physicians’
services furnished on or after July 1, 2008—
“(i) the term
‘primary care scarcity county’ means a county (or equivalent area)
which the Secretary identifies as having a primary care ratio (as determined
under paragraph (2)(C)(i)) of less than 1 to 150;
“(ii) the term ‘specialist care scarcity
county’ means a county (or equivalent area) which the Secretary
identifies as having a specialist care ratio (as determined under paragraph
(2)(C)(ii)) of less than 1 to 150;
“(iii) for physicians’ services furnished by a
primary care physician in a primary care scarcity county (as defined in clause
(i)) which the Secretary identifies under such clause as having a primary care
ratio of more than 1 to 300, ‘2.5 percent’ shall be substituted
for ‘5 percent’ in paragraph (1); and
“(iv) for physicians’ services furnished by a
physician, who is not a primary care physician, in a specialist care scarcity
county (as defined in clause (ii)) which the Secretary identifies under such
clause as having a specialist care ratio of more than 1 to 300, ‘2.5
percent’ shall be substituted for ‘5 percent’ in paragraph
(1).
The
provisions of subparagraphs (B) through (D) of paragraph (4) shall apply to
identification of counties under this subparagraph in the same manner as they
apply to the identification of counties under subparagraph (A) of paragraph
(4).
“(B) REVIEW OF
RATIOS.—
“(i) STUDY.—The
Secretary, in consultation with the Medicare Payment Advisory Commission and
the Comptroller General of the United States, shall conduct a study to better
determine whether the primary and specialist care ratios applied under
subparagraph (A) are appropriate to provide the proper incentive payments for
physician scarcity areas.
“(ii) AUTHORITY TO
APPLY DIFFERENT RATIOS.—In the
case of physicians’ services furnished on or after such date (no earlier than
January 1, 2012) as the Secretary may specify, if the Secretary determines
based on the study conducted under clause (i) that other ratios should be
substituted for the 1-to-300 and 1-to-150 ratios specified in subparagraph (A),
the Secretary may substitute such other ratios in applying such
subparagraph.”.