I 

108TH CONGRESS 

1ST SESSION H. R. 1963

To amend title XVIII of the Social Security Act to provide for the fair 

treatment of certain physician pathology services under the Medicare 

Program. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 6, 2003

Mr. FOLEY (for himself, Mr. TANNER, Mr. HERGER, Mr. CAMP, Mr. GORDON, 

Ms. PRYCE of Ohio, Mr. FLETCHER, Mr. CRAMER, Mr. JOHN, Mr. 

BERRY, Mr. POMEROY, and Mrs. CAPPS) introduced the following bill; 

which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, 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 provide 

for the fair treatment of certain physician pathology 

services under the Medicare Program.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Physician Pathology 

5 Services Continuity Act of 2003’’. 
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1 SEC. 2. TREATMENT OF CERTAIN PHYSICIAN PATHOLOGY 

2 SERVICES. 

3 (a) IN GENERAL.—Section 1848(i) of the Social Se4 curity Act (42 U.S.C. 1395w–4(i)) is amended by adding 

5 at the end the following new paragraph: 

6 ‘‘(4) TREATMENT OF CERTAIN PHYSICIAN PA7 THOLOGY SERVICES.—

8 ‘‘(A) IN GENERAL.—With respect to serv9 ices furnished on or after January 1, 2001, if 

10 an independent laboratory furnishes the tech11 nical component of a physician pathology serv12 ice to a fee-for-service medicare beneficiary who 

13 is an inpatient or outpatient of a covered hos14 pital, the Secretary shall treat such component 

15 as a service for which payment shall be made 

16 to the laboratory under this section and not as 

17 an inpatient hospital service for which payment 

18 is made to the hospital under section 1886(d) 

19 or as a hospital outpatient service for which 

20 payment is made to the hospital under section 

21 1833(t). 

22 ‘‘(B) DEFINITIONS.—In this paragraph: 

23 ‘‘(i) COVERED HOSPITAL.—

24 ‘‘(I) IN GENERAL.—The term 

25 ‘covered hospital’ means, with respect 

26 to an inpatient or outpatient, a hos-
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1 pital that had an arrangement with 

2 an independent laboratory that was in 

3 effect as of July 22, 1999, under 

4 which a laboratory furnished the tech5 nical component of physician pathol6 ogy services to fee-for-service medi7 care beneficiaries who were hospital 

8 inpatients or outpatients, respectively, 

9 and submitted claims for payment for 

10 such component to a carrier with a 

11 contract under section 1842 and not 

12 to the hospital. 

13 ‘‘(II) CHANGE IN OWNERSHIP

14 DOES NOT AFFECT DETERMINA15 TION.—A change in ownership with 

16 respect to a hospital on or after the 

17 date referred to in subclause (I) shall 

18 not affect the determination of wheth19 er such hospital is a covered hospital 

20 for purposes of such subclause. 

21 ‘‘(ii) FEE-FOR-SERVICE MEDICARE

22 BENEFICIARY.—The term ‘fee-for-service 

23 medicare beneficiary’ means an individual 

24 who is entitled to benefits under part A, or 
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1 enrolled under this part, or both, but is not 

2 enrolled in any of the following: 

3 ‘‘(I) A Medicare+Choice plan 

4 under part C. 

5 ‘‘(II) A plan offered by an eligi6 ble organization under section 1876. 

7 ‘‘(III) A program of all-inclusive 

8 care for the elderly (PACE) under 

9 section 1894. 

10 ‘‘(IV) A social health mainte11 nance organization (SHMO) dem12 onstration project established under 

13 section 4018(b) of the Omnibus 

14 Budget Reconciliation Act of 1987 

15 (Public Law 100–203).’’. 

16 (b) CONFORMING AMENDMENT.—Section 542 of the 

17 Medicare, Medicaid, and SCHIP Benefits Improvement 

18 and Protection Act of 2000 (114 Stat. 2763A–550), as 

19 enacted into law by section 1(a)(6) of Public Law 106–

20 554, is repealed. 

21 (c) EFFECTIVE DATES.—The amendments made by 

22 this section shall take effect as if included in the enact23 ment of the Medicare, Medicaid, and SCHIP Benefits Im24 provement and Protection Act of 2000 (Appendix F, 114 
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1 Stat. 2763A–463), as enacted into law by section 1(a)(6) 

2 of Public Law 106–554.

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