I 

111TH CONGRESS 

1ST SESSION H. R. 2919 

To amend part B of title XVIII of the Social Security Act to provide 

Medicare physician incentive payments for efficient areas. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 17, 2009 

Mr. BLUMENAUER 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 part B of title XVIII of the Social Security 

Act to provide Medicare physician incentive payments 

for efficient areas. 

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 Efficiency 

5 Incentive Act of 2009’’. 


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1 SEC. 2. PAYMENTS FOR EFFICIENT PHYSICIANS. 

2 Section 1833 of the Social Security Act (42 U.S.C. 

3 1395l) is amended by adding at the end the following new 

4 subsection: 

5 ‘‘(x) INCENTIVE PAYMENTS FOR EFFICIENT PHYSI6 CIANS.— 

7 ‘‘(1) IN GENERAL.—In the case of physicians’ 

8 services furnished on or after January 1, 2010, and 

9 before January 1, 2014, by a participating physician 

10 in an efficient area (as identified under paragraph 

11 (2)), in addition to the amount of payment that 

12 would otherwise be made for such services under this 

13 part, there also shall be paid an amount equal to 5 

14 percent of the payment amount for the services 

15 under this part. 

16 ‘‘(2) IDENTIFICATION OF EFFICIENT AREAS.— 

17 ‘‘(A) IN GENERAL.—Based upon available 

18 data, the Secretary shall identify those counties 

19 or equivalent areas in the United States in the 

20 lowest fifth percentile of utilization based on 

21 per capita spending for services provided in 

22 2007 under this part and part A. 

23 ‘‘(B) IDENTIFICATION OF COUNTIES

24 WHERE SERVICE IS FURNISHED.—For purposes 

25 of paying the additional amount specified in 

26 paragraph (1), if the Secretary uses the 5-digit 


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1 postal ZIP Code where the service is furnished, 

2 the dominant county of the postal ZIP Code (as 

3 determined by the United States Postal Service, 

4 or otherwise) shall be used to determine wheth5 er the postal ZIP Code is in a county described 

6 in subparagraph (A). 

7 ‘‘(C) JUDICIAL REVIEW.—There shall be 

8 no administrative or judicial review under sec9 tion 1869, 1878, or otherwise, respecting— 

10 ‘‘(i) the identification of a county or 

11 other area under subparagraph (A); or 

12 ‘‘(ii) the assignment of a postal ZIP 

13 Code to a county or other area under sub14 paragraph (B). 

15 ‘‘(D) PUBLICATION OF LIST OF COUNTIES; 

16 POSTING ON WEBSITE.—With respect to a year 

17 for which a county or area is identified under 

18 this paragraph, the Secretary shall identify 

19 such counties or areas as part of the proposed 

20 and final rule to implement the physician fee 

21 schedule under section 1848 for the applicable 

22 year. The Secretary shall post the list of coun23 ties identified under this paragraph on the 


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1 Internet website of the Centers for Medicare & 

2 Medicaid Services.’’. 

Æ 


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