I 

110TH CONGRESS 

2D SESSION H. R. 5545 

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 

MARCH 6, 2008 

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 2008’’. 

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. 

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) of the Social Se8 curity Act (42 U.S.C. 1395w–4(d)), as amended by section 

9 101 of the Medicare, Medicaid, and SCHIP Extension Act 

10 of 2007 (Public Law 110–173), is amended— 

11 (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 JULY 1, 2008.—In 

8 determining the update adjustment factor 

9 under subparagraph (B) for 2008, for the pe10 riod beginning on July 1, 2008, and ending on 

11 December 31, 2008, and 2009— 

12 ‘‘(i) the allowed expenditures for 2007 

13 shall be equal to the amount of the actual 

14 expenditures for physicians’ services during 

15 2007; 

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

17 apply to 2008, for the period beginning on 

18 July 1, 2008, and ending on December 31, 

19 2008; and 

20 ‘‘(iii) the reference in subparagraph 

21 (B)(ii)(I) to ‘April 1, 1996’ shall be treat22 ed, beginning with 2009, as a reference to 

23 ‘January 1, 2007’.’’; and 

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

25 paragraph: 

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1 ‘‘(9) UPDATING BEGINNING WITH 2010.—The 

2 update to the single conversion factor for each year 

3 beginning with 2010 shall be the percentage increase 

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

5 that year.’’. 

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

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

8 after ‘‘each succeeding year’’. 

9 SEC. 102. QUALITY INCENTIVES. 

10 (a) EXTENSION OF CURRENT TRANSITIONAL BONUS

11 INCENTIVE PAYMENTS FOR 2009.—Section 101(c) of divi12 sion B of the Tax Relief and Health Care Act of 2006 

13 (42 U.S.C. 1395w–4 note), as amended by section 101 

14 of the Medicare, Medicaid, and SCHIP Extension Act of 

15 2007 (Public Law 110–173), is amended— 

16 (1) in the heading, by striking ‘‘AND 2008’’ and 

17 inserting ‘‘, 2008, AND 2009’’; 

18 (2) in paragraph (1), by inserting ‘‘(or 3 per19 cent in the case of the reporting periods beginning 

20 after December 31, 2008)’’ after ‘‘1.5 percent’’; and 

21 (3) in paragraph (6)(C)— 

22 (A) in clause (i), by striking ‘‘and’’ at the 

23 end; 

24 (B) in clause (ii), by striking the period at 

25 the end and inserting ‘‘; and’’; and 

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1 (C) by adding at the end the following new 

2 clause: 

3 ‘‘(III) for 2009, all of 2009.’’. 

4 (b) ESTABLISHMENT OF NEW QUALITY INCENTIVE

5 SYSTEM EFFECTIVE IN 2010.— 

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

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

8 striking subsection (k) and inserting the following: 

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

10 ‘‘(1) IN GENERAL.—The Secretary shall estab11 lish a reporting system (in this subsection referred 

12 to as the ‘Physician Quality Incentive System’ or 

13 ‘System’) for quality measures relating to physi14 cians’ services that focuses on disease-specific high 

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

16 Secretary shall— 

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

18 have the highest proportion of spending under 

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

20 and for which reporting measures are feasible; 

21 and 

22 ‘‘(B) adopt reporting measures on these 

23 conditions, based on measures developed by the 

24 Physician Consortium of the American Medical 

25 Association. 

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1 ‘‘(2) ADD-ON PAYMENT.— 

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

3 provide, in a form and manner specified by the 

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

5 for physicians that submit information required 

6 on the conditions identified under paragraph 

7 (1). 

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

9 payment shall be equal to 1.0 percent of the 

10 payment amount otherwise computed under this 

11 section. 

12 ‘‘(C) TIMELY PAYMENTS.—Such a pay13 ment shall be made, with respect to information 

14 submitted for a month, by not later than 30 

15 days after the date the information is submitted 

16 for such month. 

17 ‘‘(D) DEDUCTIBLE AND COINSURANCE NOT

18 APPLICABLE.—Such payment shall not be sub19 ject to the deductible or coinsurance otherwise 

20 applicable to physicians’ services under this 

21 part. 

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

23 subparagraph (A), the Secretary shall allow the 

24 submission of the required information through 

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1 an appropriate medical registry identified by 

2 the Secretary. 

3 ‘‘(3) MONITORING.—The Secretary shall mon4 itor and report to Congress on an annual basis phy5 sician participation in the Physician Quality Incen6 tive System, administrative burden encountered by 

7 participants, barriers to participation, as well as sav8 ings accrued to the Medicare program due to quality 

9 care improvements based on measures established 

10 under the Physician Quality Incentive System.’’. 

11 (2) EFFECTIVE DATE.—The amendment made 

12 by paragraph (1) shall apply to payment for physi13 cians’ services for services furnished in years begin14 ning with 2010. 

15 TITLE II—HEALTH INFORMA16 TION TECHNOLOGY INCEN17 TIVES 

18 SEC. 201. HEALTH INFORMATION TECHNOLOGY (HIT) PAY19 MENT INCENTIVE. 

20 Section 1848 of the Social Security Act is amended 

21 by adding at the end the following new subsection: 

22 ‘‘(m) HEALTH INFORMATION TECHNOLOGY PAY23 MENT INCENTIVES.— 

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

25 2009, the Secretary shall create standards for the 

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1 certification of health information technology used in 

2 the furnishing of physicians’ services. 

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

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

5 physicians that implement a health information tech6 nology system that is certified under paragraph (1). 

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

8 payment amount otherwise computed under this sec9 tion, except that— 

10 ‘‘(A) in no case may the total of such 

11 bonus and the bonus provided under subsection 

12 (k)(2) exceed 6 percent of such payment 

13 amount; and 

14 ‘‘(B) such payments with respect to a phy15 sician shall only apply to physicians’ services 

16 furnished during a period of 36 consecutive 

17 months beginning with the first day of the first 

18 month after the date of such certification. 

19 The bonus payment under this paragraph shall not 

20 be subject to the deductible or coinsurance otherwise 

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

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1 SEC. 202. SAFE HARBORS TO ANTIKICKBACK, CIVIL PEN2 ALTIES, AND CRIMINAL PENALTIES FOR PRO3 VISION OF HEALTH INFORMATION TECH4 NOLOGY AND TRAINING SERVICES. 

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

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

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

8 following new paragraph: 

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

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

11 not include the practical or other advantages resulting 

12 from health information technology or related installation, 

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

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

15 following new paragraph: 

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

17 means hardware, software, license, right, intellectual 

18 property, equipment, or other information tech19 nology (including new versions, upgrades, and 

20 connectivity) designed or provided primarily for the 

21 electronic creation, maintenance, or exchange of 

22 health information to better coordinate care or im23 prove health care quality, efficiency, or research.’’. 

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

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

26 (1) in subsection (b)(3)— 

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

2 ‘‘and’’ at the end; 

3 (B) in the subparagraph (H) added by sec4 tion 237(d) of the Medicare Prescription Drug, 

5 Improvement, and Modernization Act of 2003 

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

7 (i) by moving such subparagraph 2 

8 ems to the left; and 

9 (ii) by striking the period at the end 

10 and inserting a semicolon; 

11 (C) in the subparagraph (H) added by sec12 tion 431(a) of such Act (117 Stat. 2287)— 

13 (i) by redesignating such subpara14 graph as subparagraph (I); 

15 (ii) by moving such subparagraph 2 

16 ems to the left; and 

17 (iii) by striking the period at the end 

18 and inserting ‘‘; and’’; and 

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

20 subparagraph: 

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

22 form of health information technology, as defined in 

23 section 1128A(i)(8), or related installation, mainte24 nance, support, or training services) made to a permstockstill on PROD1PC66 with BILLS

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1 son by a specified entity (as defined in subsection 

2 (g)) if— 

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

4 without an agreement between the parties or 

5 legal condition that— 

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

7 health information technology to services 

8 provided by the physician to individuals re9 ceiving services at the specified entity; 

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

11 health information technology in conjunc12 tion with other health information tech13 nology; or 

14 ‘‘(III) conditions the provision of such 

15 remuneration on the referral of patients or 

16 business to the specified entity; 

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

18 a written agreement that is signed by the par19 ties involved (or their representatives) and that 

20 specifies the remuneration solicited or received 

21 (or offered or paid) and states that the provi22 sion of such remuneration is made for the pri23 mary purpose of better coordination of care or 

24 improvement of health quality, efficiency, or re25 search; and 

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1 ‘‘(iii) the specified entity providing the re2 muneration (or a representative of such entity) 

3 has not taken any action to disable any basic 

4 feature of any hardware or software component 

5 of such remuneration that would permit inter6 operability.’’; and 

7 (2) by adding at the end the following new sub8 section: 

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

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

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

12 plan sponsor, a Medicare Advantage organization, or any 

13 other such entity specified by the Secretary, considering 

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

15 to better coordinate the delivery of health care and to pro16 mote the adoption and use of health information tech17 nology.’’. 

18 (c) EFFECTIVE DATE AND EFFECT ON STATE

19 LAWS.— 

20 (1) EFFECTIVE DATE.—The amendments made 

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

22 date that is 120 days after the date of the enact23 ment of this Act. 

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

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

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

2 such Act) shall have in effect a State law that im3 poses a criminal or civil penalty for a transaction de4 scribed in section 1128A(b)(4) or section 

5 1128B(b)(3)(J) of such Act, as added by subsections 

6 (a)(1) and (b), respectively, if the conditions de7 scribed in the respective provision, with respect to 

8 such transaction, are met. 

9 (d) STUDY AND REPORT TO ASSESS EFFECT OF

10 SAFE HARBORS ON HEALTH SYSTEM.— 

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

12 Human Services shall conduct a study to determine 

13 the impact of each of the safe harbors described in 

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

15 the following: 

16 (A) The effectiveness of each safe harbor 

17 in increasing the adoption of health information 

18 technology. 

19 (B) The types of health information tech20 nology provided under each safe harbor. 

21 (C) The extent to which the financial or 

22 other business relationships between providers 

23 under each safe harbor have changed as a re24 sult of the safe harbor in a way that adversely 

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1 affects or benefits the health care system or 

2 choices available to consumers. 

3 (D) The impact of the adoption of health 

4 information technology on health care quality, 

5 cost, and access under each safe harbor. 

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

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

8 Secretary of Health and Human Services shall sub9 mit to Congress a report on the study under para10 graph (1). 

11 (3) SAFE HARBORS DESCRIBED.—For purposes 

12 of paragraphs (1) and (2), the safe harbors de13 scribed in this paragraph are— 

14 (A) the safe harbor under section 

15 1128A(b)(4) of such Act (42 U.S.C. 1320a– 

16 7a(b)(4)), as added by subsection (a)(1); and 

17 (B) the safe harbor under section 

18 1128B(b)(3)(J) of such Act (42 U.S.C. 1320a– 

19 7b(b)(3)(J)), as added by subsection (b). 

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1 SEC. 203. EXCEPTION TO LIMITATION ON CERTAIN PHYSI2 CIAN REFERRALS (UNDER STARK) FOR PRO3 VISION OF HEALTH INFORMATION TECH4 NOLOGY AND TRAINING SERVICES TO 

5 HEALTH CARE PROFESSIONALS. 

6 (a) IN GENERAL.—Section 1877(b) of the Social Se7 curity Act (42 U.S.C. 1395nn(b)) is amended by adding 

8 at the end the following new paragraph: 

9 ‘‘(6) INFORMATION TECHNOLOGY AND TRAIN10 ING SERVICES.— 

11 ‘‘(A) IN GENERAL.—Any nonmonetary re12 muneration (in the form of health information 

13 technology or related installation, maintenance, 

14 support or training services) made by a speci15 fied entity to a physician if— 

16 ‘‘(i) the provision of such remunera17 tion is without an agreement between the 

18 parties or legal condition that— 

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

20 the health information technology to 

21 services provided by the physician to 

22 individuals receiving services at the 

23 specified entity; 

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

25 the health information technology in 

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1 conjunction with other health informa2 tion technology; or 

3 ‘‘(III) conditions the provision of 

4 such remuneration on the referral of 

5 patients or business to the specified 

6 entity; 

7 ‘‘(ii) such remuneration is arranged 

8 for in a written agreement that is signed 

9 by the parties involved (or their represent10 atives) and that specifies the remuneration 

11 made and states that the provision of such 

12 remuneration is made for the primary pur13 pose of better coordination of care or im14 provement of health quality, efficiency, or 

15 research; and 

16 ‘‘(iii) the specified entity (or a rep17 resentative of such entity) has not taken 

18 any action to disable any basic feature of 

19 any hardware or software component of 

20 such remuneration that would permit 

21 interoperability. 

22 ‘‘(B) HEALTH INFORMATION TECHNOLOGY

23 DEFINED.—For purposes of this paragraph, the 

24 term ‘health information technology’ means 

25 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 

4 the electronic creation, maintenance, or ex5 change of health information to better coordi6 nate care or improve health care quality, effi7 ciency, or research. 

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

9 purposes of this paragraph, the term ‘specified 

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

11 practice, prescription drug plan sponsor, a 

12 Medicare Advantage organization, or any other 

13 such entity specified by the Secretary, consid14 ering the goals and objectives of this section, as 

15 well as the goals to better coordinate the deliv16 ery of health care and to promote the adoption 

17 and use of health information technology.’’. 

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

19 (1) EFFECTIVE DATE.—The amendment made 

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

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

22 Act. 

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

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

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

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1 such Act) shall have in effect a State law that im2 poses a criminal or civil penalty for a transaction de3 scribed in section 1877(b)(6) of such Act, as added 

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

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

6 (c) STUDY AND REPORT TO ASSESS EFFECT OF EX7 CEPTION ON HEALTH SYSTEM.— 

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

9 Human Services shall conduct a study to determine 

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

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

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

13 the following: 

14 (A) The effectiveness of the exception in 

15 increasing the adoption of health information 

16 technology. 

17 (B) The types of health information tech18 nology provided under the exception. 

19 (C) The extent to which the financial or 

20 other business relationships between providers 

21 under the exception have changed as a result of 

22 the exception in a way that adversely affects or 

23 benefits the health care system or choices avail24 able to consumers. 

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1 (D) The impact of the adoption of health 

2 information technology on health care quality, 

3 cost, and access under the exception. 

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

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

6 Secretary of Health and Human Services shall sub7 mit to Congress a report on the study conducted 

8 under paragraph (1). 

9 SEC. 204. RULES OF CONSTRUCTION REGARDING USE OF 

10 CONSORTIA. 

11 (a) APPLICATION TO SAFE HARBOR FROM CRIMINAL

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

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

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

15 202(b)(1), the following: ‘‘For purposes of subparagraph 

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

17 preventing a specified entity, consistent with the specific 

18 requirements of such subparagraph, from forming a con19 sortium composed of health care providers, payers, em20 ployers, and other interested entities to collectively pur21 chase and donate health information technology, or from 

22 offering health care providers a choice of health informa23 tion technology products in order to take into account the 

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

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1 (b) APPLICATION TO STARK EXCEPTION.—Para2 graph (6) of section 1877(b) of the Social Security Act 

3 (42 U.S.C. 1395nn(b)), as added by section 203(a), is 

4 amended by adding at the end the following new subpara5 graph: 

6 ‘‘(D) RULE OF CONSTRUCTION.—For pur7 poses of subparagraph (A), nothing in such 

8 subparagraph shall be construed as preventing 

9 a specified entity, consistent with the specific 

10 requirements of such subparagraph, from— 

11 ‘‘(i) forming a consortium composed 

12 of health care providers, payers, employers, 

13 and other interested entities to collectively 

14 purchase and donate health information 

15 technology; or 

16 ‘‘(ii) offering health care providers a 

17 choice of health information technology 

18 products in order to take into account the 

19 varying needs of such providers receiving 

20 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 amended by adding 

7 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 anyone other than the physician to 

22 whom the information relates. 

23 ‘‘(3) REPORT NOT TO BE USED IN DETER24 MINING REIMBURSEMENT RATES FOR A SPECIFIC

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1 tion contained in a report under this subsection with 

2 respect to a physician in determining reimbursement 

3 rates under this part for items and services fur4 nished by that physician.’’. 

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

6 Human Services shall first provide for reporting of infor7 mation under the amendment made by subsection (a) for 

8 billings during 2007. 

9 SEC. 302. INFORMATION FOR BENEFICIARIES ON MEDI10 CARE EXPENDITURES. 

11 (a) IN GENERAL.—Section 1804 of the Social Secu12 rity Act (42 U.S.C. 1395b–2) is amended by adding at 

13 the end the following new subsection: 

14 ‘‘(d) ANNUAL REPORT ON INDIVIDUAL RESOURCE

15 UTILIZATION.—The Secretary shall provide for the report16 ing, on an annual basis, to each individual entitled to ben17 efits under part A or enrolled under part B, on the amount 

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

19 this title during the year involved. Such information shall 

20 be provided in a format that compares such amount with 

21 the average per capita expenditures in the region or area 

22 involved.’’. 

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 payments made during 2007. 

3 SEC. 303. COLLECTION OF DATA ON MEDICARE SAVINGS 

4 FROM PHYSICIANS’ SERVICES DIVERSION. 

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

6 Human Services shall collect data on annual savings in 

7 expenditures in the Medicare program due to physicians’ 

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

9 (b) REPORT.—The Secretary shall transmit to Con10 gress annually a summary of the data collected under sub11 section (a). 

12 SEC. 304. TRUSTEES’ ONGOING EXAMINATION OF MEDI13 CARE FUNDING. 

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

15 Board of Trustees of the Federal Hospital Insurance 

16 Trust Fund under section 1817 of the Social Security Act 

17 (42 U.S.C. 1395i) and of the Federal Supplementary Med18 ical Insurance Trust Fund under section 1841 of such Act 

19 (42 U.S.C. 1395t) shall monitor and examine the extent 

20 to which the different funding mechanisms under parts A, 

21 B, and D of title XVIII of such Act provide an appropriate 

22 alignment with the program goals of the respective parts. 

23 Such examination shall include an analysis of each of the 

24 following: 

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1 (1) The extent to which, as the volume of serv2 ices increases in physician settings under such part 

3 B, there is a corresponding reduction in similar serv4 ices provided in a hospital setting under such part 

5 A. 

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

7 coordination between physicians and the delivery of 

8 prescription drugs under such part D, particularly 

9 with respect to individuals with chronic conditions, 

10 there will be a decrease in hospitalizations under 

11 such part A. 

12 (3) The extent to which other changes in physi13 cian or other health care practice results in a shift14 ing of expenditures among the various parts of such 

15 title XVIII. 

16 (b) INCLUSION IN ANNUAL REPORTS.—In each an17 nual report submitted to the Congress after the date of 

18 the enactment of this Act under section 1817(b)(2) or sec19 tion 1841(b)(2) of the Social Security Act (42 U.S.C. 

20 1395i(b)(2), 1395t(b)(2)), such Board of Trustees shall 

21 include information on the matters described in subsection 

22 (a). 

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1 SEC. 305. INDEPENDENT STUDY ON MEDICARE RELATIVE 

2 VALUE UNIT SCALE UPDATE COMMITTEE 

3 (RUC) PROCESS. 

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

5 Human Services shall enter into an arrangement with an 

6 appropriate independent entity to conduct a study of price 

7 inputs and relative values for physicians’ services rec8 ommended by the AMA/Specialty Society Relative Value 

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

10 shall examine (and make recommendations on) how to im11 prove accuracy in pricing the mix of physicians’ services 

12 and how such process could improve value weighting as 

13 new services become available. 

14 (b) REPORT.—The Secretary shall provide for com15 pletion of the study under subsection (a) by January 1, 

16 2010, and shall provide for a report to Congress on the 

17 results of the study. 

18 SEC. 306. STUDY OF REPORTING REQUIREMENTS ON 

19 HEALTH CARE DISPARITIES. 

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

21 Human Services shall provide for a study of health care 

22 disparities in high-risk health condition areas and minor23 ity communities about the impact reporting requirements 

24 may have on physician penetration in such communities. 

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

26 completion of the study conducted under subsection (a) 

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26 

•HR 5545 IH

1 by not later than January 1, 2011, and shall submit to 

2 Congress a report on the study upon its completion. 

Æ 

mstockstill on PROD1PC66 with BILLS