I 
116TH CONGRESS 
1ST SESSION H. R. 3302 
To amend title XVIII of the Social Security Act to improve the accuracy 
of geographic adjustment factors under the Medicare program and to 
permanently extend certain adjustments to such factors for certain local-
ities, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 18, 2019 
Ms. FINKENAUER (for herself, Mr. KIND, Mr. SMITH of Nebraska, Mr. 
LAHOOD, and Ms. SEWELL of Alabama) 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 subse-
quently 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 improve 
the accuracy of geographic adjustment factors under the 
Medicare program and to permanently extend certain 
adjustments to such factors for certain localities, and 
for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Keep Physicians Serv-
ing Patients Act of 2019’’. 
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SEC. 2. IMPROVING THE ACCURACY OF GEOGRAPHIC AD-
JUSTMENT FACTORS. 
Section 1848(e)(1)(D) of the Social Security Act (42 
U.S.C. 1395w–4(e)(1)(D)) is amended to read as follows: 
‘‘(D) USE OF ACCURATE DATA.— 
‘‘(i) IN GENERAL.—In establishing in-
dices and index values under this para-
graph, the Secretary shall use the most re-
cent data available relating to practice ex-
penses, malpractice expenses, and physi-
cian work effort in each fee schedule area. 
‘‘(ii) PRACTICE EXPENSE AND WORK 
INDICES.—In 
establishing 
indices 
and 
index values under clause (i) or (iii) of 
subparagraph (A), the Secretary shall— 
‘‘(I) use the most recent market 
data available on physician wages, or 
if available, actual cost data for physi-
cian labor; and 
‘‘(II) not use nonphysician pro-
fessional wage data as a proxy for 
physician wage data. 
‘‘(iii) PRACTICE
EXPENSE
CALCULA-
TION.—In calculating index values under 
clause (i) of subparagraph (A), the Sec-
retary shall use the most recent office rent 
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data available or data from Federally 
qualified health centers (as defined in sec-
tion 1861(aa)(4)) expense reports.’’. 
SEC. 3. FLOOR FOR WORK AND PRACTICE EXPENSE GEO-
GRAPHIC INDICES. 
(a) 
WORK
GEOGRAPHIC
INDEX.—Section 
1848(e)(1)(E) of the Social Security Act (42 U.S.C. 
1395w–4(e)(1)(E)) is amended— 
(1) by striking ‘‘and before January 1, 2020,’’; 
and 
(2) by adding at the end the following: ‘‘Any 
such increase made for purposes of payment for 
services furnished on or after January 1, 2020, shall 
not be applied in a budget neutral manner.’’. 
(b) PRACTICE EXPENSE GEOGRAPHIC INDICES.— 
Section 1848(e)(1)(I) of the Social Security Act (42 
U.S.C. 1395w–4(e)(1)(I)) is amended— 
(1) in the header, by striking ‘‘FOR SERVICES 
FURNISHED IN FRONTIER STATES’’; 
(2) in clause (i), by inserting ‘‘and for purposes 
of payment for services furnished in any State on or 
after January 1, 2020,’’ after ‘‘2011,’’; and 
(3) in clause (ii), by inserting ‘‘before January 
1, 2020,’’ after ‘‘furnished’’. 
Æ 
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