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sustainable growth rate for years beginning with
2002.
(c) ELIMINATION OF TRANSITIONAL ADJUSTMENT.—
Section 1848(d)(4)(F) (42 U.S.C. 1395w–4(d)(4)(F)) is
amended by striking ‘‘subparagraph (A)’’ and all that fol-
lows and inserting ‘‘subparagraph (A), for each of 2001
and 2002, of ¥0.2 percent.’’
SEC. 502. STUDIES ON ACCESS TO PHYSICIANS’ SERVICES.
(a) GAO STUDY ON BENEFICIARY ACCESS TO PHYSI-
CIANS’ SERVICES.—
(1) STUDY.—The Comptroller General of the
United States shall conduct a study on access of
medicare beneficiaries to physicians’ services under
the medicare program. The study shall include—
(A) an assessment of the use by bene-
ficiaries of such services through an analysis of
claims submitted by physicians for such services
under part B of the medicare program;
(B) an examination of changes in the use
by beneficiaries of physicians’ services over
time;
(C) an examination of the extent to which
physicians are not accepting new medicare
beneficiaries as patients.
158
(2) REPORT.—Not later than 18 months after
the date of the enactment of this Act, the Comp-
troller General shall submit to Congress a report on
the study conducted under paragraph (1). The re-
port shall include a determination whether—
(A) data from claims submitted by physi-
cians under part B of the medicare program in-
dicate potential access problems for medicare
beneficiaries in certain geographic areas; and
(B) access by medicare beneficiaries to
physicians’ services may have improved, re-
mained constant, or deteriorated over time.
(b) STUDY
AND REPORT
ON SUPPLY
OF PHYSI-
CIANS.—
(1) STUDY.—The Secretary shall request the
Institute of Medicine of the National Academy of
Sciences to conduct a study on the adequacy of the
supply of physicians (including specialists) in the
United States and the factors that affect such sup-
ply.
(2) REPORT TO CONGRESS.—Not later than 2
years after the date of enactment of this section, the
Secretary shall submit to Congress a report on the
results of the study described in paragraph (1), in-
cluding any recommendations for legislation.
159
SEC. 503. MEDPAC REPORT ON PAYMENT FOR PHYSICIANS’
SERVICES.
Not later than 1 year after the date of the enactment
of this Act, the Medicare Payment Advisory Commission
shall submit to Congress a report on the effect of refine-
ments to the practice expense component of payments for
physicians’ services in the case of services for which there
are no physician work relative value units, after the transi-
tion to a full resource-based payment system in 2002,
under section 1848 of the Social Security Act (42 U.S.C.
1395w–4). Such report shall examine the following mat-
ters by physician specialty:
(1) The effect of such refinements on payment
for physicians’ services.
(2) The interaction of the practice expense com-
ponent with other components of and adjustments to
payment for physicians’ services under such section.
(3) The appropriateness of the amount of com-
pensation by reason of such refinements.
(4) The effect of such refinements on access to
care by medicare beneficiaries to physicians’ serv-
ices.
(5) The effect of such refinements on physician
participation under the medicare program.
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SEC. 504. 1-YEAR EXTENSION OF TREATMENT OF CERTAIN
PHYSICIAN PATHOLOGY SERVICES UNDER
MEDICARE.
Section 542(c) of BIPA is amended by striking ‘‘2-
year period’’ and inserting ‘‘3-year period’’.
SEC. 505. PHYSICIAN FEE SCHEDULE WAGE INDEX REVI-
SION.
(a) IN GENERAL.—Notwithstanding any other provi-
sion of law, for purposes of payment under the physician
fee schedule under section 1848 of the Social Security Act
(42 U.S.C. 1395w–4) for physicians’ services furnished
during 2004, in no case may the work geographic index
otherwise calculated under section 1848(e)(1)(A)(iii) of
such Act (42 U.S.C. 1395w–4(e)(1)(A)(iii)) be less than
0.985.
(b) EXEMPTION FROM LIMITATION ON ANNUAL AD-
JUSTMENTS.—The increase in expenditures attributable to
subsection (a) during 2004 shall not be taken into account
in applying section 1848(c)(2)(B)(ii)(II) of such Act (42
U.S.C. 1395w–4(c)(2)(B)(ii)(II)) for that year.
(c) GAO REPORT.—
(1) STUDY.—The Comptroller General of the
United States shall conduct a study to evaluate the
following:
(A) The economic basis of the current
methodology for geographic adjustment of the
161
work component of the physician payment rate
under the physician fee schedule under section
1848 of the Social Security Act (42 U.S.C.
1395w–4).
(B) Whether the adjustment under sub-
section (a) should be continued, and whether
there is an economic basis for the continuation
of such adjustment, in those areas in which the
adjustment applies.
(C) The effect of the methodology on phy-
sician location and retention in areas affected
by such adjustment.
(D) The differences in recruitment costs
and retention rates for physicians, including
specialists, between large urban areas and other
areas.
(E) The mobility of physicians, including
specialists, over the last decade.
(F) The effect of raising the floor of the
geographic index to a value of 1.0 for adjust-
ment of the work component.
(2) REPORT.—The Comptroller General shall
submit to Congress a report on the study conducted
under paragraph (1) by not later than 1 year after
the date of the enactment of this Act.
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Subtitle B—Other Services
SEC. 511. COMPETITIVE ACQUISITION OF CERTAIN ITEMS
AND SERVICES.
(a) IN GENERAL.—Section 1847 (42 U.S.C. 1395w–
3) is amended to read as follows:
‘‘COMPETITIVE ACQUISITION OF CERTAIN ITEMS AND
SERVICES
‘‘SEC. 1847. (a) ESTABLISHMENT OF COMPETITIVE
ACQUISITION PROGRAMS.—
‘‘(1) IMPLEMENTATION OF PROGRAMS.—
‘‘(A) IN
GENERAL.—The Secretary shall
establish and implement programs under which,
beginning in 2008, competitive acquisition areas
are established throughout the United States
for contract award purposes for the furnishing
under this part of competitively priced items
and services (described in paragraph (2)) for
which payment is made under this part. Such
areas may differ for different items and serv-
ices.
‘‘(B) PHASED-IN IMPLEMENTATION.—The
programs shall be phased-in among competitive
acquisition areas over a period of not longer
than 3 years in a manner so that the competi-
tion under the programs occurs in—