Providing Relief and Stability for Medicare Patients Act of 2023

To amend title XVIII of the Social Security Act to increase the nonfacility practice expense relative value units for specified services furnished under the Medicare program. 1. Short title This Act may be cited as the Providing Relief and Stability for Medicare Patients Act of 2023 2. Increasing the nonfacility practice expense relative value units for specified services furnished under the Medicare program (a) In general Section 1848(c)(2) of the Social Security Act ( 42 U.S.C. 1395w–4(c)(2) (P) Increase of nonfacility practice expense relative value units for specified services (i) In general The Secretary shall increase the nonfacility practice expense relative value units applied to a specified service (as defined in clause (ii)) furnished in— (I) 2024, by 10 percent of the number of nonfacility practice expense relative value units that would otherwise apply to such service furnished in such year without application of this clause; and (II) 2025, by 15 percent of the number of nonfacility practice expense relative value units that would otherwise apply to such service furnished in such year without application of this clause. (ii) Specified service defined For purposes of this subparagraph, the term specified service (iii) Funding There shall be transferred from the General Fund of the Treasury to the Federal Supplementary Medical Insurance Trust Fund under section 1841 such sums as the Secretary determines are necessary for purposes of increasing payment amounts pursuant to this subparagraph, to remain available until expended. . (b) Nonapplication of budget neutrality Section 1848(c)(2)(B)(iv) of the Social Security Act ( 42 U.S.C. 1395w–4(c)(2)(B)(iv) (1) in subclause (IV), by striking ; and (2) in subclause (V), by striking the period at the end and inserting ; and (3) by adding at the end the following new subclause: (VI) subparagraph (P) shall not be taken into account in applying clause (ii)(II). . (c) Report Not later than 1 year after the date of the enactment of this Act, the Comptroller General of the United States shall submit to Congress a report on the Medicare physician fee schedule and patient access, including— (1) an analysis of the number of health care providers furnishing specified services (as defined in section 1848(c)(2)(P) of the Social Security Act, as added by subsection (a)) in a nonfacility setting under the Medicare program over the 20 year period ending on such date of enactment, including a description of any changes in volume of such services furnished under such program and the availability of such services under such program and a description of wait-times, decreased hours, other factors that could impede a patient’s access to such services (such as increased cost sharing); (2) an analysis of any change in the proportion of services payable under such schedule furnished in nonfacility settings compared to the proportion of such services furnished at other sites of service over such period, including an analysis of the impact of any such change on health system consolidation, underserved and rural populations, quality of care of Medicare beneficiaries, and increased cost to the Medicare program; (3) an analysis of whether significant annual changes in provider reimbursement are a cause of any change described in paragraph (2), disruptions in patient access to services, and increased cost sharing; and (4) taking into account the analyses described in paragraphs (1) through (3), recommendations for improving Medicare patient access to specified services (as defined in section 1848(c)(2)(P) of the Social Security Act, as added by subsection (a)) and minimizing health system consolidation.

Summary: Providing Relief and Stability for Medicare Patients Act of 2023This bill temporarily increases the payment rate under Medicare for certain office-based services that involve high-priced equipment. Specifically, the bill increases the payment rate under the Medicare physician fee schedule for services provided in a nonfacility (i.e., office) setting for which most of the cost is attributable to equipment and supplies. The increase applies to services furnished in 2024 and 2025.Additionally, the Government Accountability Office must report on the correlation, if any, of payment rates for these services under the Medicare physician fee schedule and patient access to these services.