S.Amdt. 2979

SA 2979. Mr. BEGICH submitted an amendment intended to be proposed to
amendment SA 2786 proposed by Mr. Reid (for himself, Mr. Baucus, Mr.
Dodd, and Mr. Harkin) to the bill H.R. 3590, to amend the Internal
Revenue Code of 1986 to modify the first-time homebuyers credit in the
case of members of the Armed Forces and certain other Federal
employees, and for other purposes; which was ordered to lie on the
table; as follows:

After title IX, insert the following:

TITLE X--INCREASING ACCESS TO PRIMARY CARE SERVICES

SEC. 10001. STATE GRANTS TO HEALTH CARE PROVIDERS WHO PROVIDE
SERVICES TO A HIGH PERCENTAGE OF MEDICALLY
UNDERSERVED POPULATIONS OR OTHER SPECIAL
POPULATIONS.

(a) In General.--A State may award grants to health care
providers who treat a high percentage, as determined by such
State, of medically underserved populations or other special
populations in such State.
(b) Source of Funds.--A grant program established by a
State under subsection (a) may not be established within a
department, agency, or other entity of such State that
administers the Medicaid program under title XIX of the
Social Security Act (42 U.S.C. 1396 et seq.), and no Federal
or State funds allocated to such Medicaid program, the
Medicare program under title XVIII of the Social Security Act
(42 U.S.C. 1395 et seq.), or the TRICARE program under
chapter 55 of title 10, United States Code, may be used to
award grants or to pay administrative costs associated with a
grant program established under subsection (a).

SEC. 10002. INCENTIVE PAYMENTS FOR PRIMARY CARE PHYSICIANS
WHO TREAT A CERTAIN PERCENTAGE OF NEW MEDICARE
PATIENTS.

(a) In General.--Section 1833 of the Social Security Act
(42 U.S.C. 1395l), as amended by section 5501, is further
amended by adding at the end the following new subsection:
``(z) Incentive Payments for Primary Care Services Provided
to New Medicare Patients.--
``(1) In general.--In the case of primary care services
furnished on or after January 1, 2011, and before January 1,
2016, by an eligible primary care practitioner in a calendar
year, in addition to the amount of payment that would
otherwise be made for such services under this part,
including any payment available under subsection (x), there
also shall be paid (on a monthly or quarterly basis) an
amount equal to 5 percent of the payment amount for the
service under this part.
``(2) Definitions.--In this subsection--
``(A) the term `eligible primary care provider' means a
primary care practitioner for whom, of all patients for whom
such practitioner provides primary care services in a
calendar year and for whom such practitioner did not provide
such services in the previous calendar year, 10 percent of
such patients are enrollees under this part;
``(B) the terms `primary care practitioner' and `primary
care services' have the meanings given such terms in
subsection (x)(2).
``(3) Coordination with other payments.--The amount of the
additional payment for a service under this subsection and
subsections (m) and (x) shall be determined without regard to
any additional payment for the service under subsection (m),
subsection (x), and this subsection, respectively.
``(4) Limitation on review.--There shall be no
administrative or judicial review under section 1869, 1878,
or otherwise, respecting the identification of primary care
practitioners under this subsection.''.
(b) Conforming Amendments.--
(1) Section 1834(g)(2)(B) of the Social Security Act (42
U.S.C. 1395m(g)(2)(B)), as amended by section 5501(b)(2), is
further amended by striking ``(x) and (y)'' in the last
sentence and inserting ``(x), (y), and (z)''.
(2) Section 1834(x)(3) of such Act, as added by section
5501, is amended--
(A) by striking ``subsection (m)'' the first place it
appears and inserting ``subsections (m) and (z)''; and
(B) by striking ``subsection (m) and'' and inserting
``subsection (m), subsection (z), and''.

SEC. 10003. FACULTY LOAN REPAYMENT FOR PHYSICIAN ASSISTANTS.

Section 738(a)(3) of the Public Health Service Act (42
U.S.C.293b(a)(3)) is amended by inserting ``schools offering
physician assistant education programs,'' after ``public
health,''.

SEC. 10004. ACCOUNTABLE CARE ORGANIZATION DEMONSTRATION
PROGRAM.

Section 1899(b)(2)(D) of the Social Security Act, as added
by section 3022, is amended by adding at the end:
``Notwithstanding the preceding sentence, the Secretary may
approve for participation in the program any ACO, with any
number of Medicare fee-for-service beneficiaries assigned to
such ACO, that proposes a plan that would improve
efficiencies and provide cost savings.''

SEC. 10005. AMERICAN PRIMARY CARE CORPS.

(a) In General.--The Secretary of Health and Human Services
(referred to in this section as the ``Secretary'') shall
establish an American Primary Care Corps (referred to in this
section as the ``program'') for the purpose of encouraging
health care practitioners who are recent graduates of a
health care program to enter into primary care practice, by
providing incentive payments to eligible primary care
practitioners.
(b) Definitions.--In this section:
(1) Primary care practitioner.--The term ``primary care
practitioner'' means a health care provider, including a
physician, dentist, nurse practitioner, and physician
assistant, who primarily provides primary health services.
(2) Primary care services.--The term ``primary health
services'' has the meaning given such term in section
331(a)(3)(D) of the Public Health Service Act (42 U.S.C.
254d(a)(3)(D)).
(c) Program.--
(1) In general.--The Secretary shall select recipients of
the incentive payment awards under this section from among
eligible primary care practitioners. Each recipient of such
an award shall receive incentive payments, as described in
paragraph (2), for a period of 3 years, provided such
recipient continues to maintain active employment as a
primary care practitioner.
(2) Incentive payments.--The Secretary shall award
incentive payments, on a competitive basis, to eligible
primary care practitioners as follows:
(A) In the first year that a practitioner receives an award
under the program, such practitioner shall receive an
incentive payment in an amount that is equal to 75 percent of
the salary for such year received by such practitioner for
employment as a primary care practitioner.
(B) In the second year that a practitioner receives an
award under the program, such practitioner shall receive an
incentive payment in an amount that is equal to 50 percent of
the salary for such year received by such practitioner for
employment as a primary care practitioner.
(C) In the third year that a practitioner receives an award
under the program, such

[[Page S12635]]

practitioner shall receive an incentive payment in an amount
that is equal to 25 percent of the salary for such year
received by such practitioner for employment as a primary
care practitioner.
(d) Eligible Primary Care Practitioners.--To be eligible to
receive an incentive payment under this section, an
individual shall--
(1) be actively employed as a primary care practitioner, or
have arrangements to commence active employment as a primary
care practitioner;
(2) have graduated, not more than 2 years after the date on
which such individual would begin receiving incentive
payments under this program, from an accredited program that
qualifies such individual to maintain employment as a primary
care practitioner; and
(3) submit to the Secretary an application, at such time,
in such manner, and containing such information as the
Secretary may require.
(e) Duration of Program.--The Secretary shall make awards
under this section for each of fiscal years 2011 through
2015. Each such recipient shall remain in the program for a
3-year period, as described in subsection (c), provided such
recipient continues to maintain active employment as a
primary care practitioner.
(f) Authorization of Appropriations.--To carry out this
section, there are authorized to be appropriated $50,000,000
for each of fiscal years 2011 through 2015, and such sums as
may be necessary for fiscal years 2016 and 2017.
______