I 

118TH CONGRESS 

1ST SESSION H. R. 6313 

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

of geographic adjustment factors under the Medicare program and to 

permanently extend certain adjustments to such factors for certain localities, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

NOVEMBER 8, 2023 

Mr. SMITH of Nebraska (for himself, Mr. LAHOOD, Ms. SEWELL, and Ms. 

STANSBURY) 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 improve 

the accuracy of geographic adjustment factors under the 

Medicare program and to permanently extend certain 

adjustments to such factors for certain localities, 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. 

4 This Act may be cited as the ‘‘Keep Physicians Serv5 ing Patients Act of 2023’’. 


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1 SEC. 2. IMPROVING THE ACCURACY OF GEOGRAPHIC AD2 JUSTMENT FACTORS. 

3 Section 1848(e)(1)(D) of the Social Security Act (42 

4 U.S.C. 1395w–4(e)(1)(D)) is amended to read as follows: 

5 ‘‘(D) USE OF ACCURATE DATA.— 

6 ‘‘(i) IN GENERAL.—In establishing in7 dices and index values under this para8 graph, the Secretary shall use the most re9 cent data available relating to practice ex10 penses, malpractice expenses, and physi11 cian work effort in each fee schedule area. 

12 ‘‘(ii) PRACTICE EXPENSE AND WORK

13 INDICES.—In establishing indices and 

14 index values under clause (i) or (iii) of 

15 subparagraph (A), the Secretary shall— 

16 ‘‘(I) use the most recent market 

17 data available on physician wages, or 

18 if available, actual cost data for physi19 cian labor; and 

20 ‘‘(II) not use nonphysician pro21 fessional wage data as a proxy for 

22 physician wage data. 

23 ‘‘(iii) PRACTICE EXPENSE CALCULA24 TION.—In calculating index values under 

25 clause (i) of subparagraph (A), the Sec26 retary shall use the most recent office rent 


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•HR 6313 IH

1 data available or data from Federally 

2 qualified health centers (as defined in sec3 tion 1861(aa)(4)) expense reports.’’. 

4 SEC. 3. FLOOR FOR WORK AND PRACTICE EXPENSE GEO5 GRAPHIC INDICES. 

6 (a) WORK GEOGRAPHIC INDEX.—Section 

7 1848(e)(1)(E) of the Social Security Act (42 U.S.C. 

8 1395w–4(e)(1)(E)) is amended— 

9 (1) by striking ‘‘and before January 1, 2024,’’; 

10 and 

11 (2) by adding at the end the following: ‘‘Any 

12 such increase made for purposes of payment for 

13 services furnished on or after January 1, 2024, shall 

14 not be applied in a budget neutral manner.’’. 

15 (b) PRACTICE EXPENSE GEOGRAPHIC INDICES.— 

16 Section 1848(e)(1)(I) of the Social Security Act (42 

17 U.S.C. 1395w–4(e)(1)(I)) is amended— 

18 (1) in the header, by striking ‘‘FOR SERVICES

19 FURNISHED IN FRONTIER STATES’’; 

20 (2) in clause (i), by inserting ‘‘and for purposes 

21 of payment for services furnished in any State on or 

22 after January 1, 2024,’’ after ‘‘2011,’’; and 

23 (3) in clause (ii), by inserting ‘‘before January 

24 1, 2024,’’ after ‘‘furnished’’. 

Æ 


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