I 

110TH CONGRESS 

1ST SESSION H. R. 2585 

To amend title XVIII of the Social Security Act to modify Medicare physician 

reimbursement policies to ensure a future physician workforce, and for 

other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 6, 2007 

Mr. BURGESS 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 modify 

Medicare physician reimbursement policies to ensure a 

future physician workforce, and for other purposes. 

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; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Ensuring the Future Physician Workforce Act of 2007’’. 

6 (b) TABLE OF CONTENTS.—The table of contents of 

7 this Act is as follows: 

Sec. 1. Short title; table of contents. 

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TITLE I—PAYMENT AND QUALITY INCENTIVES 

Sec. 101. Resetting to 2007 the base year for application of sustainable growth 

rate formula; elimination of sustainable growth rate formula in 

2010. 

Sec. 102. Quality incentives. 

TITLE II—HEALTH INFORMATION TECHNOLOGY INCENTIVES 

Sec. 201. Health information technology (HIT) payment incentive. 

Sec. 202. Safe harbors to antikickback, civil penalties, and criminal penalties 

for provision of health information technology and training 

services. 

Sec. 203. Exception to limitation on certain physician referrals (under Stark) 

for provision of Health Information Technology and training 

services to health care professionals. 

Sec. 204. Rules of construction regarding use of consortia. 

TITLE III—INFORMATION AND REPORTS 

Sec. 301. Information for physicians on Medicare billings. 

Sec. 302. Information for beneficiaries on Medicare expenditures. 

Sec. 303. Collection of data on Medicare savings from physicians’ services diversion. 

Sec. 304. Trustees’ ongoing examination of Medicare funding. 

Sec. 305. Independent study on Medicare Relative Value Unit Scale Update 

Committee (RUC) process. 

Sec. 306. Study of reporting requirements on health care disparities. 

TITLE IV—MISCELLANEOUS PROVISIONS 

Sec. 401. Acceleration of nationwide implementation of audit contractor program. 

1 TITLE I—PAYMENT AND 

2 QUALITY INCENTIVES 

3 SEC. 101. RESETTING TO 2007 THE BASE YEAR FOR APPLI4 CATION OF SUSTAINABLE GROWTH RATE 

5 FORMULA; ELIMINATION OF SUSTAINABLE 

6 GROWTH RATE FORMULA IN 2010. 

7 (a) IN GENERAL.—Section 1848(d)(4) of the Social 

8 Security Act (42 U.S.C. 1395w–4(d)(4)) is amended— 

9 (1) in paragraph (4)— 

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1 (A) in subparagraph (B), by striking ‘‘sub2 paragraph (D)’’ and inserting ‘‘subparagraphs 

3 (D) and (G)’’; and 

4 (B) by adding at the end the following new 

5 subparagraph: 

6 ‘‘(G) REBASING TO 2007 FOR UPDATE AD7 JUSTMENTS BEGINNING WITH 2008.—In deter8 mining the update adjustment factor under sub9 paragraph (B) for 2008 and 2009— 

10 ‘‘(i) the allowed expenditures for 2007 

11 shall be equal to the amount of the actual 

12 expenditures for physicians’ services during 

13 2007; 

14 ‘‘(ii) subparagraph (B)(ii) shall not 

15 apply to 2008; and 

16 ‘‘(iii) the reference in subparagraph 

17 (B)(ii)(I) to ‘April 1, 1996’ shall be treat18 ed, beginning with 2009, as a reference to 

19 ‘January 1, 2007’.’’; and 

20 (2) by adding at the end the following new 

21 paragraph: 

22 ‘‘(8) UPDATING BEGINNING WITH 2010.—The 

23 update to the single conversion factor for each year 

24 beginning with 2010 shall be the percentage increase 

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1 in the MEI (as defined in section 1842(i)(3)) for 

2 that year.’’. 

3 (b) CONFORMING SUNSET.—Section 1848(f)(1)(B) 

4 of such Act is amended by inserting ‘‘(ending with 2008)’’ 

5 after ‘‘each succeeding year’’. 

6 SEC. 102. QUALITY INCENTIVES. 

7 (a) EXTENSION OF CURRENT QUALITY REPORTING

8 SYSTEM AND TRANSITIONAL BONUS INCENTIVE PAY9 MENTS FOR 2008 AND 2009.— 

10 (1) EXTENSION OF QUALITY REPORTING SYS11 TEM THROUGH 2009.—Section 1848(k) of the Social 

12 Security Act (42 U.S.C. 1395w(k)) is amended— 

13 (A) in the heading of paragraph (2)(B), by 

14 inserting ‘‘AND 2009’’ after ‘‘2008’’; and 

15 (B) in paragraphs (2)(B) and (4), by in16 serting ‘‘and 2009’’ after ‘‘2008’’ each place it 

17 appears. 

18 (2) EXTENSION OF AND INCREASE IN BONUS

19 PAYMENTS FOR 2008 AND 2009.—Section 101(c) of 

20 the Medicare Improvement and Extension Act of 

21 2006 (division B of Public Law 109–432) is amend22 ed— 

23 (A) in the heading, by inserting ‘‘, 2008, 

24 AND 2009’’ after ‘‘2007’’; 

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1 (B) in paragraph (1), by inserting ‘‘(or 3 

2 percent in the case of reporting periods begin3 ning after December 31, 2007)’’ after ‘‘1.5 per4 cent’’; 

5 (C) in paragraph (4), by striking ‘‘single 

6 consolidated payment.’’ and inserting ‘‘single 

7 consolidated payment for each reporting period. 

8 Such payment shall be made for a reporting pe9 riod within 30 days after the date that required 

10 information has been submitted with respect to 

11 claims for such period.’’; and 

12 (D) in paragraph (6)(C), by striking ‘‘the 

13 period beginning on July 1, 2007, and ending 

14 on December 31, 2007’’ and inserting ‘‘each of 

15 the five consecutive 6-month periods beginning 

16 on July 1, 2007, and ending on December 31, 

17 2009’’. 

18 (b) ESTABLISHMENT OF NEW QUALITY INCENTIVE

19 SYSTEM EFFECTIVE IN 2010.— 

20 (1) IN GENERAL.—Section 1848 of the Social 

21 Security Act (42 U.S.C. 1395w) is amended by 

22 striking subsection (k) and inserting the following: 

23 ‘‘(k) PHYSICIAN QUALITY INCENTIVE SYSTEM.— 

24 ‘‘(1) IN GENERAL.—The Secretary shall estab25 lish a reporting system (in this subsection referred 

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1 to as the ‘Physician Quality Incentive System’ or 

2 ‘System’) for quality measures relating to physi3 cians’ services that focuses on disease-specific high 

4 cost conditions. Not later than January 1, 2010, the 

5 Secretary shall— 

6 ‘‘(A) identify the 10 health conditions that 

7 have the highest proportion of spending under 

8 this part, due in part to a gap in patient care, 

9 and for which reporting measures are feasible; 

10 and 

11 ‘‘(B) adopt reporting measures on these 

12 conditions, based on measures developed by the 

13 Physician Consortium of the American Medical 

14 Association. 

15 ‘‘(2) ADD-ON PAYMENT.— 

16 ‘‘(A) IN GENERAL.—The Secretary shall 

17 provide, in a form and manner specified by the 

18 Secretary, for a bonus or other add-on payment 

19 for physicians that submit information required 

20 on the conditions identified under paragraph 

21 (1). 

22 ‘‘(B) AMOUNT.—Such a bonus or add-on 

23 payment shall be equal to 1.0 percent of the 

24 payment amount otherwise computed under this 

25 section. 

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1 ‘‘(C) TIMELY PAYMENTS.—Such a pay2 ment shall be made, with respect to information 

3 submitted for a month, by not later than 30 

4 days after the date the information is submitted 

5 for such month. 

6 ‘‘(D) DEDUCTIBLE AND COINSURANCE NOT

7 APPLICABLE.—Such payment shall not be sub8 ject to the deductible or coinsurance otherwise 

9 applicable to physicians’ services under this 

10 part. 

11 ‘‘(E) USE OF REGISTRY.—In carrying out 

12 subparagraph (A), the Secretary shall allow the 

13 submission of the required information through 

14 an appropriate medical registry identified by 

15 the Secretary. 

16 ‘‘(3) MONITORING.—The Secretary shall mon17 itor and report to Congress on an annual basis phy18 sician participation in the Physician Quality Incen19 tive System, administrative burden encountered by 

20 participants, barriers to participation, as well as sav21 ings accrued to the Medicare program due to quality 

22 care improvements based on measures established 

23 under the Physician Quality Incentive System.’’. 

24 (2) EFFECTIVE DATE.—The amendment made 

25 by paragraph (1) shall apply to payment for physimstockstill on PROD1PC66 with BILLS

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1 cians’ services for services furnished in years begin2 ning with 2010. 

3 TITLE II—HEALTH INFORMA4 TION TECHNOLOGY INCEN5 TIVES 

6 SEC. 201. HEALTH INFORMATION TECHNOLOGY (HIT) PAY7 MENT INCENTIVE. 

8 Section 1848 of the Social Security Act is amended 

9 by adding at the end the following new subsection: 

10 ‘‘(m) HEALTH INFORMATION TECHNOLOGY PAY11 MENT INCENTIVES.— 

12 ‘‘(1) STANDARDS.—Not later than January 1, 

13 2008, the Secretary shall create standards for the 

14 certification of health information technology used in 

15 the furnishing of physicians’ services. 

16 ‘‘(2) ADD-ON PAYMENT.—The Secretary shall 

17 provide for a bonus or other add-on payment for 

18 physicians that implement a health information tech19 nology system that is certified under paragraph (1). 

20 Such a bonus shall be equal to 3.0 percent of the 

21 payment amount otherwise computed under this sec22 tion, except that— 

23 ‘‘(A) in no case may total of such bonus 

24 and the bonus provided under subsection (k)(2) 

25 exceed 6 percent of such payment amount; and 

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1 ‘‘(B) such payments with respect to a phy2 sician shall only apply to physicians’ services 

3 furnished during a period of 36 consecutive 

4 months beginning with the first day of the first 

5 month after the date of such certification. 

6 The bonus payment under this paragraph shall not 

7 be subject to the deductible or coinsurance otherwise 

8 applicable to physicians’ services under this part.’’. 

9 SEC. 202. SAFE HARBORS TO ANTIKICKBACK, CIVIL PEN10 ALTIES, AND CRIMINAL PENALTIES FOR PRO11 VISION OF HEALTH INFORMATION TECH12 NOLOGY AND TRAINING SERVICES. 

13 (a) FOR CIVIL PENALTIES.—Section 1128A of the 

14 Social Security Act (42 U.S.C. 1320a–7a) is amended— 

15 (1) in subsection (b), by adding at the end the 

16 following new paragraph: 

17 ‘‘(4) For purposes of this subsection, inducements to 

18 reduce or limit services described in paragraph (1) shall 

19 not include the practical or other advantages resulting 

20 from health information technology or related installation, 

21 maintenance, support, or training services.’’; and 

22 (2) in subsection (i), by adding at the end the 

23 following new paragraph: 

24 ‘‘(8) The term ‘health information technology’ 

25 means hardware, software, license, right, intellectual 

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1 property, equipment, or other information tech2 nology (including new versions, upgrades, and 

3 connectivity) designed or provided primarily for the 

4 electronic creation, maintenance, or exchange of 

5 health information to better coordinate care or im6 prove health care quality, efficiency, or research.’’. 

7 (b) FOR CRIMINAL PENALTIES.—Section 1128B of 

8 such Act (42 U.S.C. 1320a–7b) is amended— 

9 (1) in subsection (b)(3)— 

10 (A) in subparagraph (G), by striking 

11 ‘‘and’’ at the end; 

12 (B) in the subparagraph (H) added by sec13 tion 237(d) of the Medicare Prescription Drug, 

14 Improvement, and Modernization Act of 2003 

15 (Public Law 108–173; 117 Stat. 2213)— 

16 (i) by moving such subparagraph 2 

17 ems to the left; and 

18 (ii) by striking the period at the end 

19 and inserting a semicolon; 

20 (C) in the subparagraph (H) added by sec21 tion 431(a) of such Act (117 Stat. 2287)— 

22 (i) by redesignating such subpara23 graph as subparagraph (I); 

24 (ii) by moving such subparagraph 2 

25 ems to the left; and 

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1 (iii) by striking the period at the end 

2 and inserting ‘‘; and’’; and 

3 (D) by adding at the end the following new 

4 subparagraph: 

5 ‘‘(J) any nonmonetary remuneration (in the 

6 form of health information technology, as defined in 

7 section 1128A(i)(8), or related installation, mainte8 nance, support or training services) made to a per9 son by a specified entity (as defined in subsection 

10 (g)) if— 

11 ‘‘(i) the provision of such remuneration is 

12 without an agreement between the parties or 

13 legal condition that— 

14 ‘‘(I) limits or restricts the use of the 

15 health information technology to services 

16 provided by the physician to individuals re17 ceiving services at the specified entity; 

18 ‘‘(II) limits or restricts the use of the 

19 health information technology in conjunc20 tion with other health information tech21 nology; or 

22 ‘‘(III) conditions the provision of such 

23 remuneration on the referral of patients or 

24 business to the specified entity; 

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1 ‘‘(ii) such remuneration is arranged for in 

2 a written agreement that is signed by the par3 ties involved (or their representatives) and that 

4 specifies the remuneration solicited or received 

5 (or offered or paid) and states that the provi6 sion of such remuneration is made for the pri7 mary purpose of better coordination of care or 

8 improvement of health quality, efficiency, or re9 search; and 

10 ‘‘(iii) the specified entity providing the re11 muneration (or a representative of such entity) 

12 has not taken any action to disable any basic 

13 feature of any hardware or software component 

14 of such remuneration that would permit inter15 operability.’’; and 

16 (2) by adding at the end the following new sub17 section: 

18 ‘‘(g) SPECIFIED ENTITY DEFINED.—For purposes of 

19 subsection (b)(3)(J), the term ‘specified entity’ means an 

20 entity that is a hospital, group practice, prescription drug 

21 plan sponsor, a Medicare Advantage organization, or any 

22 other such entity specified by the Secretary, considering 

23 the goals and objectives of this section, as well as the goals 

24 to better coordinate the delivery of health care and to promstockstill on PROD1PC66 with BILLS

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1 mote the adoption and use of health information tech2 nology.’’. 

3 (c) EFFECTIVE DATE AND EFFECT ON STATE

4 LAWS.— 

5 (1) EFFECTIVE DATE.—The amendments made 

6 by subsections (a) and (b) shall take effect on the 

7 date that is 120 days after the date of the enact8 ment of this Act. 

9 (2) PREEMPTION OF STATE LAWS.—No State 

10 (as defined in section 1101(a) of the Social Security 

11 Act (42 U.S.C. 1301(a)) for purposes of title XI of 

12 such Act) shall have in effect a State law that im13 poses a criminal or civil penalty for a transaction de14 scribed in section 1128A(b)(4) or section 

15 1128B(b)(3)(J) of such Act, as added by subsections 

16 (a)(1) and (b), respectively, if the conditions de17 scribed in the respective provision, with respect to 

18 such transaction, are met. 

19 (d) STUDY AND REPORT TO ASSESS EFFECT OF

20 SAFE HARBORS ON HEALTH SYSTEM.— 

21 (1) IN GENERAL.—The Secretary of Health and 

22 Human Services shall conduct a study to determine 

23 the impact of each of the safe harbors described in 

24 paragraph (3). In particular, the study shall examine 

25 the following: 

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1 (A) The effectiveness of each safe harbor 

2 in increasing the adoption of health information 

3 technology. 

4 (B) The types of health information tech5 nology provided under each safe harbor. 

6 (C) The extent to which the financial or 

7 other business relationships between providers 

8 under each safe harbor have changed as a re9 sult of the safe harbor in a way that adversely 

10 affects or benefits the health care system or 

11 choices available to consumers. 

12 (D) The impact of the adoption of health 

13 information technology on health care quality, 

14 cost, and access under each safe harbor. 

15 (2) REPORT.—Not later than three years after 

16 the effective date described in subsection (c)(1), the 

17 Secretary of Health and Human Services shall sub18 mit to Congress a report on the study under para19 graph (1). 

20 (3) SAFE HARBORS DESCRIBED.—For purposes 

21 of paragraphs (1) and (2), the safe harbors de22 scribed in this paragraph are— 

23 (A) the safe harbor under section 

24 1128A(b)(4) of such Act (42 U.S.C. 1320a– 

25 7a(b)(4)), as added by subsection (a)(1); and 

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1 (B) the safe harbor under section 

2 1128B(b)(3)(J) of such Act (42 U.S.C. 1320a– 

3 7b(b)(3)(J)), as added by subsection (b). 

4 SEC. 203. EXCEPTION TO LIMITATION ON CERTAIN PHYSI5 CIAN REFERRALS (UNDER STARK) FOR PRO6 VISION OF HEALTH INFORMATION TECH7 NOLOGY AND TRAINING SERVICES TO 

8 HEALTH CARE PROFESSIONALS. 

9 (a) IN GENERAL.—Section 1877(b) of the Social Se10 curity Act (42 U.S.C. 1395nn(b)) is amended by adding 

11 at the end the following new paragraph: 

12 ‘‘(6) INFORMATION TECHNOLOGY AND TRAIN13 ING SERVICES.— 

14 ‘‘(A) IN GENERAL.—Any nonmonetary re15 muneration (in the form of health information 

16 technology or related installation, maintenance, 

17 support or training services) made by a speci18 fied entity to a physician if— 

19 ‘‘(i) the provision of such remunera20 tion is without an agreement between the 

21 parties or legal condition that— 

22 ‘‘(I) limits or restricts the use of 

23 the health information technology to 

24 services provided by the physician to 

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1 individuals receiving services at the 

2 specified entity; 

3 ‘‘(II) limits or restricts the use of 

4 the health information technology in 

5 conjunction with other health informa6 tion technology; or 

7 ‘‘(III) conditions the provision of 

8 such remuneration on the referral of 

9 patients or business to the specified 

10 entity; 

11 ‘‘(ii) such remuneration is arranged 

12 for in a written agreement that is signed 

13 by the parties involved (or their represent14 atives) and that specifies the remuneration 

15 made and states that the provision of such 

16 remuneration is made for the primary pur17 pose of better coordination of care or im18 provement of health quality, efficiency, or 

19 research; and 

20 ‘‘(iii) the specified entity (or a rep21 resentative of such entity) has not taken 

22 any action to disable any basic feature of 

23 any hardware or software component of 

24 such remuneration that would permit 

25 interoperability. 

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1 ‘‘(B) HEALTH INFORMATION TECHNOLOGY

2 DEFINED.—For purposes of this paragraph, the 

3 term ‘health information technology’ means 

4 hardware, software, license, right, intellectual 

5 property, equipment, or other information tech6 nology (including new versions, upgrades, and 

7 connectivity) designed or provided primarily for 

8 the electronic creation, maintenance, or ex9 change of health information to better coordi10 nate care or improve health care quality, effi11 ciency, or research. 

12 ‘‘(C) SPECIFIED ENTITY DEFINED.—For 

13 purposes of this paragraph, the term ‘specified 

14 entity’ means an entity that is a hospital, group 

15 practice, prescription drug plan sponsor, a 

16 Medicare Advantage organization, or any other 

17 such entity specified by the Secretary, consid18 ering the goals and objectives of this section, as 

19 well as the goals to better coordinate the deliv20 ery of health care and to promote the adoption 

21 and use of health information technology.’’. 

22 (b) EFFECTIVE DATE; EFFECT ON STATE LAWS.— 

23 (1) EFFECTIVE DATE.—The amendment made 

24 by subsection (a) shall take effect on the date that 

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1 is 120 days after the date of the enactment of this 

2 Act. 

3 (2) PREEMPTION OF STATE LAWS.—No State 

4 (as defined in section 1101(a) of the Social Security 

5 Act (42 U.S.C. 1301(a)) for purposes of title XI of 

6 such Act) shall have in effect a State law that im7 poses a criminal or civil penalty for a transaction de8 scribed in section 1877(b)(6) of such Act, as added 

9 by subsection (a), if the conditions described in such 

10 section, with respect to such transaction, are met. 

11 (c) STUDY AND REPORT TO ASSESS EFFECT OF EX12 CEPTION ON HEALTH SYSTEM.— 

13 (1) IN GENERAL.—The Secretary of Health and 

14 Human Services shall conduct a study to determine 

15 the impact of the exception under section 1877(b)(6) 

16 of such Act (42 U.S.C. 1395nn(b)(6)), as added by 

17 subsection (a). In particular, the study shall examine 

18 the following: 

19 (A) The effectiveness of the exception in 

20 increasing the adoption of health information 

21 technology. 

22 (B) The types of health information tech23 nology provided under the exception. 

24 (C) The extent to which the financial or 

25 other business relationships between providers 

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1 under the exception have changed as a result of 

2 the exception in a way that adversely affects or 

3 benefits the health care system or choices avail4 able to consumers. 

5 (D) The impact of the adoption of health 

6 information technology on health care quality, 

7 cost, and access under the exception. 

8 (2) REPORT.—Not later than three years after 

9 the effective date described in subsection (b)(1), the 

10 Secretary of Health and Human Services shall sub11 mit to Congress a report on the study under para12 graph (1). 

13 SEC. 204. RULES OF CONSTRUCTION REGARDING USE OF 

14 CONSORTIA. 

15 (a) APPLICATION TO SAFE HARBOR FROM CRIMINAL

16 PENALTIES.—Section 1128B(b)(3) of the Social Security 

17 Act (42 U.S.C. 1320a–7b(b)(3)) is amended by adding 

18 after and below subparagraph (J), as added by section 

19 203(b)(1), the following: ‘‘For purposes of subparagraph 

20 (J), nothing in such subparagraph shall be construed as 

21 preventing a specified entity, consistent with the specific 

22 requirements of such subparagraph, from forming a con23 sortium composed of health care providers, payers, em24 ployers, and other interested entities to collectively pur25 chase and donate health information technology, or from 

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1 offering health care providers a choice of health informa2 tion technology products in order to take into account the 

3 varying needs of such providers receiving such products.’’. 

4 (b) APPLICATION TO STARK EXCEPTION.—Para5 graph (6) of section 1877(b) of the Social Security Act 

6 (42 U.S.C. 1395nn(b)), as added by section 203(a), is 

7 amended by adding at the end the following new subpara8 graph: 

9 ‘‘(D) RULE OF CONSTRUCTION.—For pur10 poses of subparagraph (A), nothing in such 

11 subparagraph shall be construed as preventing 

12 a specified entity, consistent with the specific 

13 requirements of such subparagraph, from— 

14 ‘‘(i) forming a consortium composed 

15 of health care providers, payers, employers, 

16 and other interested entities to collectively 

17 purchase and donate health information 

18 technology; or 

19 ‘‘(ii) offering health care providers a 

20 choice of health information technology 

21 products in order to take into account the 

22 varying needs of such providers receiving 

23 such products.’’. 

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1 TITLE III—INFORMATION AND 

2 REPORTS 

3 SEC. 301. INFORMATION FOR PHYSICIANS ON MEDICARE 

4 BILLINGS. 

5 (a) IN GENERAL.—Section 1848 of the Social Secu6 rity Act, as amended by section 201, is further amended 

7 by adding at the end the following new subsection: 

8 ‘‘(n) ANNUAL REPORTING OF INFORMATION TO PHY9 SICIANS.— 

10 ‘‘(1) IN GENERAL.—The Secretary shall annu11 ally report to each physician information on total bil12 lings by the physician (including laboratory tests 

13 and other items and services ordered by the physi14 cian) under this title. Such information shall be pro15 vided in a comparative format by code, weighting for 

16 practice size, number of Medicare patients treated, 

17 and relative number of Medicare beneficiaries in the 

18 geographical area. 

19 ‘‘(2) CONFIDENTIALITY.—Information reported 

20 under paragraph (1) is confidential and shall not be 

21 disclosed to other than the physician to whom the 

22 information relates.’’. 

23 (b) EFFECTIVE DATE.—The Secretary of Health and 

24 Human Services shall first provide for reporting of informstockstill on PROD1PC66 with BILLS

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1 mation under the amendment made by subsection (a) for 

2 billings during 2007. 

3 SEC. 302. INFORMATION FOR BENEFICIARIES ON MEDI4 CARE EXPENDITURES. 

5 (a) IN GENERAL.—Section 1804 of the Social Secu6 rity Act is amended by adding at the end the following 

7 new subsection: 

8 ‘‘(d) ANNUAL REPORT ON INDIVIDUAL RESOURCE

9 UTILIZATION.—The Secretary shall provide for the report10 ing, on an annual basis, to each individual entitled to ben11 efits under part A or enrolled under part B, on the amount 

12 of payments made to or on behalf of the individual under 

13 this title during the year involved. Such information shall 

14 be provided in a format that compares such amount with 

15 the average per capita expenditures in the region or area 

16 involved.’’. 

17 (b) EFFECTIVE DATE.—The Secretary of Health and 

18 Human Services shall first provide for reporting of infor19 mation under the amendment made by subsection (a) for 

20 payments made during 2007. 

21 SEC. 303. COLLECTION OF DATA ON MEDICARE SAVINGS 

22 FROM PHYSICIANS’ SERVICES DIVERSION. 

23 (a) IN GENERAL.—The Secretary of Health and 

24 Human Services shall collect data on annual savings in 

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1 expenditures in the Medicare program due to physicians’ 

2 services that resulted in hospital or in-patient diversion. 

3 (b) REPORT.—The Secretary shall transmit to Con4 gress annually a summary of the data collected under sub5 section (a). 

6 SEC. 304. TRUSTEES’ ONGOING EXAMINATION OF MEDI7 CARE FUNDING. 

8 (a) EXAMINATION BY BOARD OF TRUSTEES.—The 

9 Board of Trustees of the Federal Hospital Insurance 

10 Trust Fund and of the Federal Supplementary Medical 

11 Insurance Trust Fund shall monitor and examine the ex12 tent to which the different funding mechanisms under 

13 parts A, B, and D of title XVIII of the Social Security 

14 Act provide an appropriate alignment with the program 

15 goals of the respective parts. Such examination shall in16 clude an examination of each of the following: 

17 (1) The extent to which, as volume of services 

18 increases in physician settings under such part B, 

19 there is a corresponding reduction in similar services 

20 provided in a hospital setting under such part A. 

21 (2) The extent to which, as a result of increased 

22 coordination between physicians and the delivery of 

23 prescription drugs under such part D, particularly 

24 with respect to individuals with chronic conditions, 

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1 there will there be a decrease in hospitalizations 

2 under such part A. 

3 (3) The extent to which other changes in physi4 cian or other health care practice results in a shift5 ing of expenditures among the various parts. 

6 (b) INCLUSION IN ANNUAL REPORTS.—In each an7 nual report submitted to the Congress after the date of 

8 the enactment of this Act under section 1817(b)(2) or sec9 tion 1841(b)(2) of the Social Security Act (42 U.S.C. 

10 1395i(b)(2), 1395t(b)(2)), such Board of Trustees shall 

11 include information on the matters described in subsection 

12 (a). 

13 SEC. 305. INDEPENDENT STUDY ON MEDICARE RELATIVE 

14 VALUE UNIT SCALE UPDATE COMMITTEE 

15 (RUC) PROCESS. 

16 (a) IN GENERAL.—The Secretary of Health and 

17 Human Services shall enter into an arrangement with an 

18 appropriate independent entity to conduct a study of price 

19 inputs and relative values for physicians’ services rec20 ommended by the AMA/Specialty Society Relative Value 

21 Unit Scale Update Committee (RUC) process. The study 

22 shall examine (and make recommendations on) how to im23 prove accuracy in pricing the mix of physicians’ services 

24 and such process could improve value weighting as new 

25 services become available. 

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25 

•HR 2585 IH

1 (b) REPORT.—The Secretary shall provide for com2 pletion of the study under subsection (a) by January 1, 

3 2010, and shall provide for a report to Congress on the 

4 results of the study. 

5 SEC. 306. STUDY OF REPORTING REQUIREMENTS ON 

6 HEALTH CARE DISPARITIES. 

7 (a) IN GENERAL.—The Secretary of Health and 

8 Human Services shall provide for a study of health care 

9 disparities in high-risk health condition areas and minor10 ity communities about the impact reporting requirements 

11 may have on physician penetration in such communities. 

12 (b) REPORT.—The Secretary shall provide for the 

13 completion of the study by not later than January 1, 2011, 

14 and shall submit to Congress a report on the study upon 

15 its completion. 

16 TITLE IV—MISCELLANEOUS 

17 PROVISIONS 

18 SEC. 401. ACCELERATION OF NATIONWIDE IMPLEMENTA19 TION OF AUDIT CONTRACTOR PROGRAM. 

20 Section 1893(h)(3) of the Social Security Act (42 

21 U.S.C. 1395ddd(h)(3)), as added by section 302(a) of the 

22 Medicare Improvements and Extension Act of 2006 (divi23 sion B of Public Law 109–432), is amended by striking 

24 ‘‘January 1, 2010’’ and inserting ‘‘January 1, 2008’’. 

Æ 

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