I 

109TH CONGRESS 

2D SESSION H. R. 5118 

To amend title XVIII of the Social Security Act and the Medicare Prescription 

Drug, Improvement, and Modernization Act of 2003 to extend certain 

Medicare payment methodologies provided for rural health care providers. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 6, 2006 

Mr. WALDEN of Oregon (for himself, Mr. POMEROY, Mr. ALEXANDER, Mr. 

ALLEN, Mr. BERRY, Mr. BISHOP of Georgia, Mr. BOUCHER, Mr. BOYD, 

Mrs. CAPITO, Mr. CASE, Mr. COSTELLO, Mrs. JO ANN DAVIS of Virginia, 

Mr. DAVIS of Tennessee, Mr. DEFAZIO, Mrs. EMERSON, Mr. EVANS, Mr. 

GRAVES, Mr. HASTINGS of Washington, Ms. HERSETH, Mr. HINCHEY, 

Mr. HINOJOSA, Ms. HOOLEY, Mr. KIND, Ms. JACKSON-LEE of Texas, 

Mr. MARSHALL, Mr. MATHESON, Mr. MCHUGH, Mr. MCINTYRE, Miss 

MCMORRIS, Mr. MORAN of Kansas, Mr. OBERSTAR, Mr. ORTIZ, Mr. 

PAUL, Mr. PETERSON of Minnesota, Mr. PETERSON of Pennsylvania, Mr. 

RENZI, Mr. ROSS, Mr. SANDERS, Mr. SHUSTER, Mr. SIMPSON, Mr. 

SKELTON, Mr. STUPAK, Mr. SWEENEY, Mr. TANNER, Mr. TAYLOR of 

Mississippi, Mr. UDALL of New Mexico, Mr. WHITFIELD, Mr. WICKER, 

and Mr. YOUNG of Alaska) 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 and the 

Medicare Prescription Drug, Improvement, and Modernization Act of 2003 to extend certain Medicare payment methodologies provided for rural health care providers. 


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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 ‘‘Medicare Rural Health Provider Payment Extension Act 

6 of 2006’’. 

7 (b) TABLE OF CONTENTS.— 

Sec. 1. Short title and table of contents. 

Sec. 2. Extension of medicare rural hospital hold harmless provision under the 

prospective payment system for hospital outpatient department 

(HOPD) services. 

Sec. 3. Extension of medicare incentive payment program for physician scarcity 

areas. 

Sec. 4. Extension of medicare increase payments for ground ambulance services 

in rural areas. 

Sec. 5. Extension of floor on medicare work geographic adjustment. 

Sec. 6. Extension of medicare reasonable costs payments for certain clinical diagnostic laboratory tests furnished to hospital patients in certain rural areas. 

Sec. 7. Extension of temporary medicare payment increase for home health 

services furnished in a rural area. 

8 SEC. 2. EXTENSION OF MEDICARE RURAL HOSPITAL HOLD 

9 HARMLESS PROVISION UNDER THE PRO10 SPECTIVE PAYMENT SYSTEM FOR HOSPITAL 

11 OUTPATIENT DEPARTMENT (HOPD) SERV12 ICES. 

13 (a) IN GENERAL.—Section 1833(t)(7)(D)(i) of the 

14 Social Security Act (42 U.S.C. 1395l(t)(7)(D)(i)), as 

15 amended by section 5105 of the Deficit Reduction Act of 

16 2005, is amended— 

17 (1) in subclause (I)— 

18 (A) by striking ‘‘(I)’’; and 


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1 (B) by striking ‘‘2006’’ and inserting 

2 ‘‘2010’’; and 

3 (2) by striking subclause (II). 

4 (b) EFFECTIVE DATE.—The amendments made by 

5 subsection (a) shall apply to covered OPD services fur6 nished on or after January 1, 2006. 

7 SEC. 3. EXTENSION OF MEDICARE INCENTIVE PAYMENT 

8 PROGRAM FOR PHYSICIAN SCARCITY AREAS. 

9 Section 1833(u)(1) of the Social Security Act (42 

10 U.S.C. 1395l(u)(1)) is amended by striking ‘‘2008’’ and 

11 inserting ‘‘ 2011’’. 

12 SEC. 4. EXTENSION OF MEDICARE INCREASE PAYMENTS 

13 FOR GROUND AMBULANCE SERVICES IN 

14 RURAL AREAS. 

15 Section 1834(l)(13) of the Social Security Act (42 

16 U.S.C. 1395m(l)(13)) is amended— 

17 (1) in subparagraph (A)— 

18 (A) in the matter before clause (i), by 

19 striking ‘‘furnished on or after July 1, 2004, 

20 and before January 1, 2007,’’; 

21 (B) in clause (i), by inserting ‘‘for services 

22 furnished on or after July 1, 2004, and before 

23 January 1, 2011,’’ after ‘‘in such paragraph,’’; 

24 and 


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1 (C) in clause (ii), by inserting ‘‘for services 

2 furnished on or after July 1, 2004, and before 

3 January 1, 2007,’’ after ‘‘in clause (i),’’; and 

4 (2) in subparagraph (B)— 

5 (A) in the heading, by striking ‘‘AFTER

6 2006’’ and inserting ‘‘FOR SUBSEQUENT PERI7 ODS’’; 

8 (B) by inserting ‘‘clauses (i) and (ii) of’’ 

9 before ‘‘subparagraph (A)’’; and 

10 (C) by striking ‘‘in such subparagraph’’ 

11 and inserting ‘‘in the respective clause’’. 

12 SEC. 5. EXTENSION OF FLOOR ON MEDICARE WORK GEO13 GRAPHIC ADJUSTMENT. 

14 Section 1848(e)(1)(E) of the Social Security Act (42 

15 U.S.C. 1395w–4(e)(1)(E)) is amended by striking ‘‘2007’’ 

16 and inserting ‘‘2011’’. 

17 SEC. 6. EXTENSION OF MEDICARE REASONABLE COSTS 

18 PAYMENTS FOR CERTAIN CLINICAL DIAG19 NOSTIC LABORATORY TESTS FURNISHED TO 

20 HOSPITAL PATIENTS IN CERTAIN RURAL 

21 AREAS. 

22 Section 416(b) of the Medicare Prescription Drug, 

23 Improvement, and Modernization Act of 2003 (Public Law 

24 108–173; 117 Stat. 2282; 42 U.S.C. 1395l–4(b)) is 

25 amended by striking ‘‘2-year’’ and inserting ‘‘7-year’’. 


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1 SEC. 7. EXTENSION OF TEMPORARY MEDICARE PAYMENT 

2 INCREASE FOR HOME HEALTH SERVICES 

3 FURNISHED IN A RURAL AREA. 

4 (a) IN GENERAL.—Section 421 of the Medicare Pre5 scription Drug, Improvement, and Modernization Act of 

6 2003 (Public Law 108–173; 117 Stat. 2283; 42 U.S.C. 

7 1395fff note), as amended by section 5201(b) of the Def8 icit Reduction Act of 2005, is amended— 

9 (1) in the heading, by striking ‘‘ONE-YEAR’’ 

10 and inserting ‘‘TEMPORARY’’; and 

11 (2) in subsection (a) by striking ‘‘before April 

12 1, 2005, and episodes and visits beginning on or 

13 after January 1, 2006, and before January 1, 2007’’ 

14 and inserting ‘‘before December 31, 2011’’. 

15 (b) APPLICATION TO CERTAIN HOME HEALTH SERV16 ICES FURNISHED PRIOR TO DATE OF ENACTMENT.—For 

17 episodes and visits for home health services furnished on 

18 or after April 1, 2005, and before the date of the enact19 ment of this Act, the Secretary of Health and Human 

20 Services shall provide for a lump sum payment, not later 

21 than 60 days after such enactment, of amounts due under 

22 the amendment made by subsection (a)(2). 

23 (c) EFFECTIVE DATE.—The amendments made by 

24 subsection (a) shall apply to episodes and visits on or after 

25 April 1, 2005. 

Æ 


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