H.R. 33House108th Congress (2003-2005)In Committee

Rural Equity Payment Index Reform Act of 2003

Introduced January 7, 2003

Legislative Activity

Stay on top of the latest movement without scrolling through every action

3 earlier actions
HouseCommittee Latest Action

Referred to the Subcommittee on Health.

February 3, 2003

View full timeline
HouseIntro Referral

Introduced in House

January 7, 2003

HouseIntro Referral

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.

January 7, 2003

HouseCommittee

Referred to the Subcommittee on Health.

January 13, 2003

HouseCommittee

Referred to the Subcommittee on Health.

February 3, 2003

Floor Debate

22 members

What members said about H.R. 33 on the floor

7 Republicans15 Democrats
Jon Kyl
Sen. Jon KylR-AZ · Apr 10, 2003

Mr. President, I rise today to introduce the Intermediate Sanctions Compensatory Revenue Adjustment Act of 2003, ISCRAA. This legislation will restore to the States billions of dollars in revenue due…

John Cornyn
Sen. John CornynR-TX · Apr 10, 2003

Mr. President, I am pleased to join my colleague, Senator Kyl, to introduce today this landmark legislation to clean up our civil justice system. This legislation would enact a badly needed reform to…

Olympia J. Snowe
Sen. Olympia J. SnoweR-ME · May 15, 2003

Mr. President, I rise to speak to the critical issue of State fiscal relief, which I believe adds tremendous value to this economic growth package. As I have discussed on numerous occasions, I…

Joseph R. Biden Jr.
Sen. Joseph R. Biden Jr.D-DE · May 15, 2003

Mr. President, I rise to speak in opposition to the amendment of the Senator from Arizona. This amendment would retroactively breach the contracts entered into by States and their attorneys, and the…

John F. Kerry
Sen. John F. KerryD-MA · Apr 10, 2003

Mr. President, I am pleased to join my colleague Senator Snowe in introducing the Medicare Mental Health Copayment Equity Act. This legislation will establish mental health care parity in the…

Show 8 more
John D. Rockefeller IV
Sen. John D. Rockefeller IVD-WV · Apr 10, 2003

Mr. President, today I am introducing two key education initiatives designed to promote quality education across our country and respond to the compelling needs in our schools. When I meet with…

Ron Wyden
Sen. Ron WydenD-OR · Apr 10, 2003

Mr. President, Senators Collins, Clinton, Byrd, Lieberman and I want the rebuilding of Iraq to be done in the best way possible-- for the Iraqi people and for the American taxpayers who will foot the…

Paul S. Sarbanes
Sen. Paul S. SarbanesD-MD · May 15, 2003

Mr. President, I too am concerned that the language of Section 333 could have unintended consequences. It was my understanding that Section 333 was intended to exclude certain payments. Mr.…

Gordon H. Smith
Sen. Gordon H. SmithR-OR · Apr 10, 2003

Mr. President, I rise today to introduce legislation that will restore to the members of the Confederated Tribes of the Coos, Lower Umpqua and Siuslaw Indians a small portion of their ancestral…

Olympia J. Snowe
Sen. Olympia J. SnoweR-ME · Apr 10, 2003

Mr. President, I rise today to introduce the Medicare Mental Health Copayment Equity Act with my colleague on the Finance Committee, Senator John Kerry. In brief, my bill would a correct a serious…

Edward M. Kennedy
Sen. Edward M. KennedyD-MA · May 15, 2003

Mr. President, this Republican tax bill provides lavish support for the wealthy, but it gives only the back of its hand to America's senior citizens. This amendment changes those backward priorities.…

Ernest F. Hollings
Sen. Ernest F. HollingsD-SC · Apr 10, 2003

Mr. President, I rise today with my colleague Senator Gregg to introduce the Coastal and Estuarine Land Protection Act of 2003. Senator Gregg and I introduced this bill last session, and it was…

Jim Talent
Sen. Jim TalentR-MO · Apr 10, 2003

Mr. President, today I rise on behalf of myself and my colleagues, Senators Charles Schumer and Lindsey Graham, in support of the Sickle Cell Treatment Act of 2003, which will help hundreds of…

Show 11 more
Jeff Bingaman
Sen. Jeff BingamanD-NM · May 15, 2003

Mr. President, I am pleased to cosponsor and support amendment No. 594 being offered by the chairman of the Finance Committee with respect to the Medicare Program. The amendment provides…

Thomas A. Daschle
Sen. Thomas A. DaschleD-SD · Apr 10, 2003

Mr. President, today I join with a bipartisan group of colleagues from the Senate Guard Caucus to introduce the National Guard and Reserve Comprehensive Health Benefits Act of 2003. This bill will…

Conrad R. Burns
Sen. Conrad R. BurnsR-MT · Apr 10, 2003

Mr. President, I would like to introduce a bill which names one of our post offices in Billings, Montana, after one of this Nation's greatest leaders and true patriot: former President Ronald Reagan.…

Tim Johnson
Sen. Tim JohnsonD-SD · May 15, 2003

Mr. President, I rise today to share my thoughts on the tax measure before us. Few issues touch more Americans than the economy. Now that hostilities with Iraq are winding down, we need to focus on…

Patrick J. Leahy
Sen. Patrick J. LeahyD-VT · May 15, 2003

Mr. President, I see the distinguished majority leader, Senator Frist, and wonder if I could ask him to address a concern I and other Senators have about a provision entitled ``Limitation'' which is…

Richard J. Durbin
Sen. Richard J. DurbinD-IL · Apr 10, 2003

Mr. President, I am honored to be a cosponsor of the Microbicides Development Act of 2003. The legislation calls for a redoubling of the effort at the National Institutes of Health and the Centers…

Chuck Grassley
Sen. Chuck GrassleyR-IA · May 15, 2003

Mr. President, is it in order to continue now on the growth package? Mr. President, I have a series of amendments that both sides have cleared. I send the amendments to the desk, ask that they be…

Patrick J. Leahy
Sen. Patrick J. LeahyD-VT · Apr 10, 2003

Mr. President, today I am joined by Senator DeWine, by our minority leader, Senator Daschle, and by Senator Smith in introducing legislation that will boost the readiness of our Nation's military…

Jon S. Corzine
Sen. Jon S. CorzineD-NJ · Apr 10, 2003

Mr. President, I rise today to introduce legislation, the Microbicides Development Act of 2003. I am very pleased to be introducing this bipartisan bill along with my colleagues, Senators Snowe,…

Carl Levin
Sen. Carl LevinD-MI · May 15, 2003

Mr. President, I cannot support this fiscally irresponsible and unfair tax cut package. Our economy is struggling right now. Eight-and-a-half million Americans are out of work, and we now have about…

Herb Kohl
Sen. Herb KohlD-WI · Apr 10, 2003

Mr. President, I rise today to introduce the Child Safety Lock Act of 2003, on behalf of myself, Senator Durbin, Senator Schumer, Senator Corzine, and Senator Feinstein. Our measure will save…

Bill Text

Latest available legislative text

Reading Mode
Latest
Introduced in HouseIssued January 7, 2003
        [Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 33 Introduced in House (IH)]

108th CONGRESS
1st Session
H. R. 33

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.

_______________________________________________________________________

IN THE HOUSE OF REPRESENTATIVES

January 7, 2003

Mr. Bereuter (for himself, Mr. Berry, Mr. Foley, Mr. Murtha, Mr.
Kildee, Mr. Costello, Mr. Green of Wisconsin, Mr. Nethercutt, Mr.
McIntyre, Mr. Towns, Mr. Lucas of Oklahoma, Mrs. Wilson of New Mexico,
Mr. Boucher, Mr. Terry, Mr. Baird, Mrs. Cubin, Mr. Bass, Mr. Frost, and
Mr. Osborne) 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 establish a minimum
geographic cost-of-practice index value for physicians' services
furnished under the Medicare Program.

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 ``Rural Equity
Payment Index Reform Act of 2003''.
(b) Findings.--Congress makes the following findings:
(1) Variations in the physician work adjustment factors
under section 1848(e) of the Social Security Act (42 U.S.C.
1395w-4w(e)) result in a physician work payment inequity
between urban and rural localities under the medicare physician
fee schedule.
(2) The amount the medicare program spends on its
beneficiaries varies substantially across the country, far more
than can be accounted for by differences in the cost of living
or differences in health status.
(3) Since beneficiaries and others pay into the program on
the basis of income and wages and beneficiaries pay the same
premium for Part B services, these payments result in
substantial crosssubsidies from people living in low payment
States with conservative practice styles or beneficiary
preferences to people living in higher payment States with
aggressive practice styles or beneficiary preferences.
(4) Congress has been mindful of these variations when it
comes to capitation payments made to managed care plans under
the Medicare+Choice program and has put in place floors that
increase monthly payments by more than one-third in some of the
lowest payment counties over what would otherwise occur. But
this change addresses only a very small fraction of medicare
beneficiaries who are presently enrolled in Medicare+Choice
plans operating in low payment counties.
(5) Unfortunately, Congress has only begun to address the
underlying problem of substantial geographic variations in fee-
for-service spending under traditional medicare.
(6) Improvements in rural hospital payment systems under
the medicare program help to reduce aggregate per capita
payment variation as rural hospitals are in large part located
in low payment counties.
(7) Many rural communities have great difficulty attracting
and retaining physicians and other skilled health
professionals.
(8) Targeted efforts to provide relief to rural doctors in
low payment localities would further reduce variation by
improving access to primary and tertiary services along with
more equitable payment.
(9) Geographic adjustment factors in the medicare program's
resource-based relative value scale unfairly suppress fee-for-
service payments to rural providers.
(10) Actual costs are not presently being measured
accurately and payments do not reflect the costs of providing
care.
(11) Unless something is done about medicare payment in
rural areas, as the baby boom cohort ages into medicare, the
financial demands on rural communities to subsidize care for
their aged and disabled medicare beneficiaries will progress
from difficult to impossible in another 10 years.
(12) The impact on rural health care infrastructure will be
first felt in economically depressed rural areas where the
ability to shift costs is already limited.

SEC. 2. PHYSICIAN FEE SCHEDULE WAGE INDEX REVISION.

Section 1848(e)(1) of the Social Security Act (42 U.S.C. 1395w-
4(e)(1)) is amended--
(1) in subparagraph (A), by striking ``subparagraphs (B)
and (C)'' and inserting ``subparagraphs (B), (C), and (E)'';
and
(2) by adding at the end the following new subparagraph:
``(E) Floor for work geographic indices.--
``(i) In general.--Notwithstanding the work
geographic index otherwise calculated under
subparagraph (A)(iii), in no case may the work
geographic index applied for payment under this
section be less than--
``(I) 0.976 for services furnished
during 2004;
``(II) 0.987 for services furnished
during 2005;
``(III) 0.995 for services
furnished during 2006; and
``(IV) 1.000 for services furnished
during 2007 and subsequent years.
``(ii) Exemption from limitation on annual
adjustments.--The increase in expenditures
attributable to clause (i) shall not be taken
into account in applying subsection
(c)(2)(B)(ii)(II).''.
<all>