II 

113TH CONGRESS 

2D SESSION S. 2186 

To amend title XVIII of the Social Security Act to provide for a minimum 

Medicare payment rate for primary care services furnished by primary 

care physicians. 

IN THE SENATE OF THE UNITED STATES 

MARCH 31, 2014 

Mr. BEGICH 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 

for a minimum Medicare payment rate for primary care 

services furnished by primary care physicians. 

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 Access Im5 provement Act of 2014’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds that the 2010 Report to Congress of 

8 the Interagency Access to Health Care In Alaska Task 

9 Force found that— 


tjames on DSK6SPTVN1PROD with BILLS
2 

•S 2186 IS

1 (1) there is a shortage of primary care Medi2 care providers in Alaska, a problem most severe in 

3 Anchorage but evident in Fairbanks as well as in 

4 rural Alaska; 

5 (2) the main reason physicians give for not 

6 wanting to add new Medicare patients is their per7 ception of Medicare’s inadequate reimbursement; 

8 (3) the Medicare program has the lowest reim9 bursement level of the six primary payers of health 

10 care in Alaska; 

11 (4) the typical physician can have a viable prac12 tice in Alaska without servicing any Medicare pa13 tients; and 

14 (5) many in the provider community believe 

15 that a fair, adequate, and uniform Federal rate 

16 would alleviate existing provider shortages in Alaska. 

17 SEC. 3. MINIMUM MEDICARE PAYMENT RATE FOR PRIMARY 

18 CARE SERVICES FURNISHED BY PRIMARY 

19 CARE PHYSICIANS. 

20 Section 1848(b) of the Social Security Act (42 U.S.C. 

21 1395w–4(b)) is amended by adding at the end the fol22 lowing new paragraph: 

23 ‘‘(8) MINIMUM PAYMENT RATE FOR PRIMARY

24 CARE SERVICES FURNISHED BY PRIMARY CARE PHY25 SICIANS.— 


tjames on DSK6SPTVN1PROD with BILLS
3 

•S 2186 IS

1 ‘‘(A) IN GENERAL.—Notwithstanding any 

2 other provision of this section, subject to para3 graphs (3), (7), and (8) of subsection (a) and 

4 subsection (p), the payment rate under the fee 

5 schedule under this section for primary care 

6 services (as defined in subparagraph (B)) fur7 nished in 2015 and 2016 by a physician with 

8 a primary specialty designation of family medi9 cine, general internal medicine, or geriatric 

10 medicine may not be less than 100 percent of 

11 the payment rate that applied in 2013 to such 

12 services and such a physician under the Med13 icaid plan under title XIX for the State in 

14 which the service is furnished. 

15 ‘‘(B) PRIMARY CARE SERVICES DE16 FINED.—In subparagraph (A), the term ‘pri17 mary care services’ means evaluation and man18 agement services that are procedure codes for 

19 services in the category designated Evaluation 

20 and Management in the Healthcare Common 

21 Procedure Coding System (established by the 

22 Secretary under subsection (c)(5) as of Decem23 ber 31, 2014, and as subsequently modified).’’. 

Æ 


tjames on DSK6SPTVN1PROD with BILLS