S.Amdt. 434

SA 434. Mr. BURR submitted an amendment intended to be proposed to
amendment SA 98 proposed by Mr.

[[Page S1741]]

Inouye (for himself and Mr. Baucus) to the bill H.R. 1, making
supplemental appropriations for job preservation and creation,
infrastructure investment, energy efficiency and science, assistance to
the unemployed, and State and local fiscal stabilization, for fiscal
year ending September 30, 2009, and for other purposes; which was
ordered to lie on the table; as follows:

On page 698, after line 25, insert the following:

SEC. 4204A. MINIMUM UPDATE FOR PHYSICIANS' SERVICES FOR 2010
AND 2011.

(a) In General.--Section 1848(d) of the Social Security Act
(42 U.S.C. 1395w-4(d)) is amended by adding at the end the
following new paragraphs:
``(10) Update for 2010.--
``(A) In general.--The update to the single conversion
factor established in paragraph (1)(C) for 2010 shall not be
less than 3 percent.
``(B) No effect on computation of conversion factor for
2011 and subsequent years.--The conversion factor under this
subsection shall be computed under paragraph (1)(A) for 2011
and subsequent years as if subparagraph (A) had never
applied.
``(11) Update for 2011.--
``(A) In general.--The update to the single conversion
factor established in paragraph (1)(C) for 2011 shall not be
less than 1 plus the Secretary's estimate of the percentage
change in the value of the input price index (as provided
under subparagraph (B)(ii)) for 2011 (divided by 100).
``(B) Input price index.--
``(i) Establishment.--Taking into account the mix of goods
and services included in computing the medicare economic
index (referred to in the fourth sentence of section
1842(b)(3)), the Secretary shall establish an index that
reflects the weighted-average input prices for physicians'
services for 2010. Such index shall only account for input
prices and not changes in costs that may result from other
factors (such as productivity).
``(ii) Annual estimate of change in index.--The Secretary
shall estimate, before the beginning of 2011, the change in
the value of the input price index under clause (i) from 2010
to 2011.
``(C) No effect on computation of conversion factor for
2012 and subsequent years.--The conversion factor under this
subsection shall be computed under paragraph (1)(A) for 2012
and subsequent years as if subparagraphs (A) and (B) had
never applied.''.
(b) Premium Transition Rule.--Notwithstanding any other
provision of law--
(1) 2010.--
(A) Premium.--Nothing in this section shall be construed as
modifying the premium previously computed under section 1839
of the Social Security Act for months in 2010.
(B) Government contribution.--In computing the amount of
the Government contribution under section 1844(a) of the
Social Security Act for months in 2010, the Secretary of
Health and Human Services shall compute and apply a new
actuarially adequate rate per enrollee age 65 and over under
section 1839(a)(1) of such Act taking into account the
provisions of this section.
(2) 2011.--
(A) Premium.--The monthly premium under section 1839 of the
Social Security Act for months in 2011 shall be computed as
if this section had not been enacted.
(B) Government contribution.--The Government contribution
under section 1844(a) of the Social Security Act for months
in 2011 shall be computed taking into account the provisions
of this section, including subparagraph (A).
(c) Funding.--Notwithstanding any other provision of this
division or division A, amounts made available by this
division or division A for Mandatory provisions, excluding
provisions relating to Veterans, are reduced by the pro rata
percentage required to carry out the provisions of, and
amendments made by, subsections (a) and (b).
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