I 

108TH CONGRESS 

1ST SESSION H. R. 2451

To amend title XVIII of the Social Security Act to improve geographic 

equity in the provision of items and services provided to Medicare beneficiaries. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 12, 2003

Mr. KING of Iowa 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 improve 

geographic equity in the provision of items and services 

provided to Medicare beneficiaries.

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 ‘‘Medicare Geographic 

5 Equity in Reimbursement Act of 2003’’. 
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1 SEC. 2. IMPROVING EQUITY OF PAYMENTS TO PROVIDERS 

2 UNDER THE MEDICARE FEE-FOR-SERVICE 

3 PROGRAM. 

4 Title XVIII of the Social Security Act (42 U.S.C. 

5 1395 et seq.) is amended by adding at the end the fol6 lowing new section: 

7 ‘‘IMPROVING EQUITY OF PAYMENTS UNDER THE

8 ORIGINAL MEDICARE FEE-FOR-SERVICE PROGRAM. 

9 ‘‘SEC. 1897. (a) ESTABLISHMENT OF SYSTEM.—Not10 withstanding any other provision of law, the Secretary 

11 shall establish a system for making adjustments to the 

12 amount of payment made to entities and individuals for 

13 items and services provided under the original medicare 

14 fee-for-service program under parts A and B. 

15 ‘‘(b) SYSTEM REQUIREMENTS.—

16 ‘‘(1) ADJUSTMENTS.—If the State average 

17 yearly per beneficiary amount for the most recent 

18 recorded year is 8 percent or more below the average 

19 of contiguous states per beneficiary amount for the 

20 same year (not to include the state of comparison), 

21 then the Secretary shall provide a 5 percent add-on 

22 to the amount of applicable payments. 

23 ‘‘(2) DETERMINATION OF AVERAGES.—

24 ‘‘(A) STATE AVERAGE PER BENEFICIARY

25 AMOUNT.—The Secretary shall determine a 

26 State average per beneficiary amount for each 
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1 State which shall be equal to the Secretary’s es2 timate of the average amount of expenditures 

3 under the original medicare fee-for-service pro4 gram under parts A and B for the year for a 

5 beneficiary enrolled under such parts that re6 sides in the State and services provided within 

7 the State. 

8 ‘‘(B) CONTIGUOUS STATE AVERAGE PER

9 BENEFICIARY AMOUNT.—The Secretary shall 

10 determine the average of contiguous states for 

11 each state per beneficiary amount 

12 ‘‘(c) DEFINITIONS.—In this section: 

13 ‘‘(1) APPLICABLE PAYMENTS.—The term ‘ap14 plicable payments’ means payments made to entities 

15 and individuals for items and services provided 

16 under the original medicare fee-for-service program 

17 under parts A and B to beneficiaries enrolled under 

18 such parts that reside in the State and services pro19 vided within the state. 

20 ‘‘(2) STATE.—The term ‘State’ has the mean21 ing given such term in section 210(h).

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