II

106TH CONGRESS

2D SESSION S. 3167

To establish a physician recruitment and retention demonstration project

under the medicare program under title XVIII of the Social Security Act.

IN THE SENATE OF THE UNITED STATES

OCTOBER 5 (legislative day, SEPTEMBER 22), 2000

Mr. DOMENICI (for himself and Mr. BINGAMAN) introduced the following bill;

which was read twice and referred to the Committee on Finance

A BILL

To establish a physician recruitment and retention demonstration project under the medicare program under

title XVIII of the Social Security Act.

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 Recruitment

5 and Retention Act of 2000’’.

6 SEC. 2. MEDICARE PHYSICIAN RECRUITMENT AND RETEN7 TION DEMONSTRATION PROJECT.

8 (a) ESTABLISHMENT.—The Secretary of Health and

9 Human Services (in this section referred to as the ‘‘Sec-
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1 retary’’) shall establish a demonstration project for the

2 purpose of improving—

3 (1) access to health care for beneficiaries under

4 part B of the medicare program under title XVIII

5 of the Social Security Act (42 U.S.C. 1395j et seq.);

6 and

7 (2) the ability of States to recruit and retain

8 physicians.

9 (b) CONDUCT OF DEMONSTRATION PROJECT.—

10 (1) DEMONSTRATION SITES.—The demonstra11 tion project under this section shall be conducted in

12 2 sites, which shall be statewide.

13 (2) RECRUITMENT AND RETENTION OF PHYSI14 CIANS.—Under the demonstration project, the Sec15 retary shall increase by 5 percent payments for phy16 sicians’ services (as defined in section 1861(q) of the

17 Social Security Act (42 U.S.C. 1395x(q)) under sec18 tion 1848 of such Act (42 U.S.C. 1395w–4) to phy19 sicians furnishing such services in any State that

20 submits an application under paragraph (3) that is

21 approved by the Secretary under paragraph (4).

22 (3) APPLICATION.—Any State wishing to par23 ticipate in the demonstration program shall submit

24 an application to the Secretary at such time, in such
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1 manner, and in such form as the Secretary may rea2 sonably require.

3 (4) APPROVAL.—The Secretary shall approve

4 the applications of 2 States that, based upon 1998

5 data, have—

6 (A) an uninsured population above 20 per7 cent (as determined by the Bureau of the Cen8 sus);

9 (B) a population eligible for medical assist10 ance under the medicaid program under title

11 XIX of the Social Security Act (42 U.S.C. 1396

12 et seq.) above 17 percent (as determined by the

13 Health Care Financing Administration);

14 (C) an unemployment rate above 4.8 per15 cent (as determined by the Bureau of Labor

16 Statistics);

17 (D) an average per capita income below

18 $21,200 (as determined by the Bureau of Eco19 nomic Analysis); and

20 (E) a geographic practice cost indices com21 ponent of the reimbursement rate for physicians

22 under the medicare program that is below the

23 national average (as determined by the Health

24 Care Financing Administration).
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1 (5) DURATION.—The demonstration project

2 under this section shall be conducted for a period of

3 3 years.

4 (c) WAIVER AUTHORITY.—The Secretary may waive

5 such requirements of the medicare program under title

6 XVIII of the Social Security Act (42 U.S.C. 1395 et seq.)

7 to the extent and for the period that the Secretary deter8 mines is necessary for carrying out the demonstration

9 project under this section.

10 (d) GAO STUDY AND REPORT.—

11 (1) STUDY.—The Comptroller General of the

12 United States shall conduct a study on the dem13 onstration project conducted under this section to

14 determine whether the access of beneficiaries under

15 the medicare program to health care and the ability

16 of States to recruit and retain physicians is—

17 (A) adversely impacted by the factors de18 scribed in subparagraphs (A) through (E) of

19 subsection (b)(4); and

20 (B) improved by increased payments to

21 physicians under subsection (b)(2).

22 (2) REPORT.—Not later than 1 year after the

23 Secretary completes the demonstration project under

24 this section, the Comptroller General of the United

25 States shall submit a report on the results of the
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1 study conducted under paragraph (1) to the appro2 priate committees of Congress.

3 (e) APPROPRIATION.—There are hereby appropriated

4 $50,000,000 for each of fiscal years 2001, 2002, and 2003

5 to carry out the provisions of this section. Such sums shall

6 remain available until expended.

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