II

107TH CONGRESS

1ST SESSION S. 1367

To amend title XVIII of the Social Security Act to provide appropriate

reimbursement under the medicare program for ambulance trips originating in rural areas.

IN THE SENATE OF THE UNITED STATES

AUGUST 3, 2001

Ms. COLLINS (for herself and Mr. FEINGOLD) introduced the following bill;

which was read twice and referred to the Committee on Finance

A BILL

To amend title XVIII of the Social Security Act to provide

appropriate reimbursement under the medicare program

for ambulance trips originating in rural areas.

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 Rural Ambu5 lance Relief Act of 2001’’.

6 SEC. 2. HOLD HARMLESS PROVISION FOR RURAL AMBU7 LANCE SERVICES.

8 (a) IN GENERAL.—Section 1834(l) of the Social Se9 curity Act (42 U.S.C. 1395m(l)) is amended—
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1 (1) in paragraph (2)(A), by inserting ‘‘(other

2 than increases required by paragraph (10))’’ after

3 ‘‘part’’;

4 (2) in paragraph (3)(A), by inserting ‘‘and if

5 the services for which payment is made under para6 graph (10) were paid under such fee schedule’’ after

7 ‘‘in effect’’;

8 (3) by redesignating paragraph (8), as added by

9 section 221(a) of the Medicare, Medicaid, and

10 SCHIP Benefits Improvement and Protection Act of

11 2000 (114 Stat. 2763A–486), as enacted into law by

12 section 1(a)(6) of Public Law 106–554, as para13 graph (9); and

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

15 paragraph:

16 ‘‘(10) HOLD HARMLESS PROVISION FOR RURAL

17 AMBULANCE SERVICES.—

18 ‘‘(A) IN GENERAL.—Notwithstanding the

19 fee schedule established under paragraph (1), in

20 the case of ambulance services furnished on or

21 after the date on which the phase-in required

22 under paragraph (2)(E) is initially implemented

23 and before the date on which the fee schedule

24 established under this subsection is modified to

25 incorporate the adjustments authorized under
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1 section 221(c) of the Medicare, Medicaid, and

2 SCHIP Benefits Improvement and Protection

3 Act of 2000 (or the date on which the Secretary

4 determines that such a modification is unneces5 sary), for which the transportation originates in

6 a rural area (as defined in section

7 1886(d)(2)(D)) or in a rural census tract of a

8 metropolitan statistical area (as determined

9 under the most recent modification of the Gold10 smith Modification, originally published in the

11 Federal Register on February 27, 1992 (57

12 Fed. Reg. 6725)), the amount of payment

13 under this subsection for such services shall be

14 the greater of—

15 ‘‘(i) the amount determined under the

16 fee schedule established under paragraph

17 (1) (without regard to any phase-in estab18 lished under paragraph (2)(E)); or

19 ‘‘(ii) the amount that would have been

20 paid for such service if the amendments

21 made by section 4531(b) of the Balanced

22 Budget Act of 1997 had not been enacted.

23 ‘‘(B) PROHIBITING CERTAIN REDUC24 TIONS.—Notwithstanding paragraph (3), the

25 Secretary shall not reduce the payment
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1 amounts under the fee schedule established

2 under paragraph (1) to offset the increase in

3 payments resulting from the application of sub4 paragraph (A).’’.

5 (b) CONFORMING AMENDMENT.—Section

6 1833(a)(1)(R)(i) of the Social Security Act (42 U.S.C.

7 1395l(a)(1)(R)(i)) is amended by inserting ‘‘(or, in the

8 case of ambulance services to which paragraph (10) of

9 such section applies, 80 percent of the lesser of the actual

10 charge for such service or the amount determined under

11 such paragraph)’’ after ‘‘1834(l)’’.

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