I 
108TH CONGRESS 
1ST SESSION H. R. 3396
To direct the Secretary of Health and Human Services to establish a process 
under which a provider of services or other health care provider under 
the Medicare Program may petition the Secretary for an adjustment 
of the rate of payment made to that provider under the Medicare Pro-
gram based on a significant inequity between the rate of payment appli-
cable to that provider, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
OCTOBER 29, 2003
Mr. KING of Iowa introduced the following bill; which was referred to the 
Committee on Ways and Means, and in addition to the Committee on En-
ergy and Commerce, 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 direct the Secretary of Health and Human Services to 
establish a process under which a provider of services 
or other health care provider under the Medicare Pro-
gram may petition the Secretary for an adjustment of 
the rate of payment made to that provider under the 
Medicare Program based on a significant inequity be-
tween the rate of payment applicable to that provider, 
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 ‘‘Medicare Inequity Ad-
justment Act’’. 
SEC. 2. CORRECTION OF SIGNIFICANT MEDICARE PAY-
MENT INEQUITIES. 
(a) FINDINGS.—Congress finds that inequities exist 
in medicare’s legacy reimbursement formulas and in the 
evaluations of reports that promote and perpetuate dis-
parate compensation rates for similar services. 
(b) ADJUSTMENT AUTHORITY.—
(1) IN GENERAL.—The Secretary of Health and 
Human Services shall establish a process under 
which a provider of services or other health care pro-
vider under the medicare program may petition the 
Secretary for an adjustment of the rate of payment 
made to that provider under the medicare program 
based on a significant inequity between the rate of 
payment applicable to that provider and the rate of 
payment applicable to similar providers located in 
adjoining areas. Under such process the provider 
shall have the right to compile records and present 
to the Secretary empirical evidence of such inequi-
ties. The Secretary shall make a determination on 
such a petition and notify the provider of such deter-
mination.
(2) ADJUSTMENT.—Based upon a petition 
under paragraph (1), the Secretary, notwithstanding 
any other provision of law, shall provide for such ad-
justment of payment rate as is necessary to correct 
significant inequities. 
(3) TAKING QUALITY INTO ACCOUNT.—In pro-
viding an adjustment under paragraph (2), the Sec-
retary shall take into account and provide for a 
higher payment adjustment, insofar as reliable data 
are available, a provider that is a high quality, cost-
effective provider. 
(4) JUDICIAL
REVIEW.—Notwithstanding any 
other provision of law, if a provider is dissatisfied 
with a determination under paragraph (1), or the 
amount of any adjustment effected under paragraph 
(2), the provider shall have the right to a review of 
such determination in an action before an appro-
priate district court of the United States and the 
court shall hear such action de novo and shall not 
give deference to any findings of fact or conclusions 
of law of the Secretary. 
(5) NO BUDGET NEUTRALITY OR OTHER AD-
JUSTMENT
FOR
OTHER
PROVIDERS.—Nothing in 
this section shall be construed as authorizing the 
Secretary to reduce medicare payment rates to any
providers as a result of a payment adjustment made 
to other providers under this section.
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