SEC. 2. INCREASING THE NONFACILITY PRACTICE EX-
PENSE RELATIVE VALUE UNITS FOR SPECI-
FIED 
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)) is amended by 
adding at the end the following subparagraph: 
‘‘(P) INCREASE OF NONFACILITY PRACTICE 
EXPENSE RELATIVE VALUE UNITS FOR SPECI-
FIED SERVICES.— 
‘‘(i) IN
GENERAL.—The Secretary 
shall increase the nonfacility practice ex-
pense 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 other-
wise 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 other-
wise apply to such service furnished in 
VerDate Sep 11 2014 
02:41 Jun 17, 2023
Jkt 039200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H3674.IH
H3674
kjohnson on DSK79L0C42PROD with BILLS
such year without application of this 
clause. 
‘‘(ii) SPECIFIED SERVICE DEFINED.— 
For purposes of this subparagraph, the 
term ‘specified service’ means, with respect 
to a service furnished in a year, a service 
with a nonfacility practice expense relative 
value unit that was calculated for such 
year (without application of this subpara-
graph) based on 65 percent or more of the 
service’s direct practice expense cost being 
attributed to equipment and supply costs. 
‘‘(iii) 
FUNDING.—There 
shall 
be 
transferred from the General Fund of the 
Treasury to the Federal Supplementary 
Medical Insurance Trust Fund under sec-
tion 1841 such sums as the Secretary de-
termines are necessary for purposes of in-
creasing 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)) is amended— 
VerDate Sep 11 2014 
02:41 Jun 17, 2023
Jkt 039200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H3674.IH
H3674
kjohnson on DSK79L0C42PROD with BILLS
(1) in subclause (IV), by striking ‘‘; and’’ and 
inserting a semicolon; 
(2) in subclause (V), by striking the period at 
the end and inserting ‘‘; and’’; and 
(3) by adding at the end the following new sub-
clause: 
‘‘(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 de-
scription 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 
VerDate Sep 11 2014 
02:41 Jun 17, 2023
Jkt 039200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H3674.IH
H3674
kjohnson on DSK79L0C42PROD with BILLS
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, un-
derserved 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 serv-
ices (as defined in section 1848(c)(2)(P) of the So-
cial Security Act, as added by subsection (a)) and 
minimizing health system consolidation. 
Æ 
VerDate Sep 11 2014 
02:41 Jun 17, 2023
Jkt 039200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6301
E:\BILLS\H3674.IH
H3674
kjohnson on DSK79L0C42PROD with BILLS