I 
108TH CONGRESS 
1ST SESSION H. R. 1963
To amend title XVIII of the Social Security Act to provide for the fair 
treatment of certain physician pathology services under the Medicare 
Program. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 6, 2003
Mr. FOLEY (for himself, Mr. TANNER, Mr. HERGER, Mr. CAMP, Mr. GORDON, 
Ms. PRYCE of Ohio, Mr. FLETCHER, Mr. CRAMER, Mr. JOHN, Mr. 
BERRY, Mr. POMEROY, and Mrs. CAPPS) introduced the following bill; 
which was referred to the Committee on Ways and Means, and in addi-
tion to the Committee on Energy and Commerce, for a period to be sub-
sequently 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 provide 
for the fair treatment of certain physician pathology 
services under the Medicare Program.
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 ‘‘Physician Pathology 
Services Continuity Act of 2003’’.
SEC. 2. TREATMENT OF CERTAIN PHYSICIAN PATHOLOGY 
SERVICES. 
(a) IN GENERAL.—Section 1848(i) of the Social Se-
curity Act (42 U.S.C. 1395w–4(i)) is amended by adding 
at the end the following new paragraph: 
‘‘(4) TREATMENT OF CERTAIN PHYSICIAN PA-
THOLOGY SERVICES.—
‘‘(A) IN GENERAL.—With respect to serv-
ices furnished on or after January 1, 2001, if 
an independent laboratory furnishes the tech-
nical component of a physician pathology serv-
ice to a fee-for-service medicare beneficiary who 
is an inpatient or outpatient of a covered hos-
pital, the Secretary shall treat such component 
as a service for which payment shall be made 
to the laboratory under this section and not as 
an inpatient hospital service for which payment 
is made to the hospital under section 1886(d) 
or as a hospital outpatient service for which 
payment is made to the hospital under section 
1833(t). 
‘‘(B) DEFINITIONS.—In this paragraph: 
‘‘(i) COVERED HOSPITAL.—
‘‘(I) IN
GENERAL.—The term 
‘covered hospital’ means, with respect 
to an inpatient or outpatient, a hos-
pital that had an arrangement with 
an independent laboratory that was in 
effect as of July 22, 1999, under 
which a laboratory furnished the tech-
nical component of physician pathol-
ogy services to fee-for-service medi-
care beneficiaries who were hospital 
inpatients or outpatients, respectively, 
and submitted claims for payment for 
such component to a carrier with a 
contract under section 1842 and not 
to the hospital. 
‘‘(II) CHANGE
IN
OWNERSHIP 
DOES
NOT
AFFECT
DETERMINA-
TION.—A change in ownership with 
respect to a hospital on or after the 
date referred to in subclause (I) shall 
not affect the determination of wheth-
er such hospital is a covered hospital 
for purposes of such subclause. 
‘‘(ii) 
FEE-FOR-SERVICE
MEDICARE 
BENEFICIARY.—The term ‘fee-for-service 
medicare beneficiary’ means an individual 
who is entitled to benefits under part A, or
enrolled under this part, or both, but is not 
enrolled in any of the following: 
‘‘(I) A Medicare+Choice plan 
under part C. 
‘‘(II) A plan offered by an eligi-
ble organization under section 1876. 
‘‘(III) A program of all-inclusive 
care for the elderly (PACE) under 
section 1894. 
‘‘(IV) A social health mainte-
nance organization (SHMO) dem-
onstration project established under 
section 4018(b) of the Omnibus 
Budget Reconciliation Act of 1987 
(Public Law 100–203).’’. 
(b) CONFORMING AMENDMENT.—Section 542 of the 
Medicare, Medicaid, and SCHIP Benefits Improvement 
and Protection Act of 2000 (114 Stat. 2763A–550), as 
enacted into law by section 1(a)(6) of Public Law 106–
554, is repealed. 
(c) EFFECTIVE DATES.—The amendments made by 
this section shall take effect as if included in the enact-
ment of the Medicare, Medicaid, and SCHIP Benefits Im-
provement and Protection Act of 2000 (Appendix F, 114
Stat. 2763A–463), as enacted into law by section 1(a)(6) 
of Public Law 106–554.
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