To amend title XVIII of the Security Act to preserve access to physicians' services under the Medicare Program.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Save Medicare Act of 2008''.

SEC. 2. INCREASE IN MEDICARE PHYSICIAN PAYMENT UPDATE.

    Section 1848(d) of the Social Security Act (42 U.S.C. 1395w-4(d)), 
as amended by section 101 of the Medicare, Medicaid, and SCHIP 
Extension Act of 2007 (Public Law 110-173), is amended--
            (1) in paragraph (8)--
                    (A) in the heading, by striking ``a portion of'';
                    (B) in subparagraph (A)--
                            (i) by striking ``(A) In general.--Subject 
                        to'' and inserting ``Notwithstanding''; and
                            (ii) by striking ``for the period beginning 
                        on January 1, 2008, and ending on June 30, 
                        2008,'';
                    (C) by striking subparagraph (B); and
            (2) by adding at the end the following new paragraph:
            ``(9) Update for 2009.--In lieu of the update to the single 
        conversion factor established in paragraph (1)(C) that would 
        otherwise apply for 2009, the update to the single conversion 
        factor shall be 1.8 percent.''.

SEC. 3. EXTENSION OF THE PHYSICIAN QUALITY REPORTING SYSTEM.

    (a) System.--Section 1848(k)(2)(B) of the Social Security Act (42 
U.S.C. 1395w-4(k)(2)(B)), as amended by section 101 of the Medicare, 
Medicaid, and SCHIP Extension Act of 2007 (Public Law 110-173), is 
amended--
            (1) in the heading, by striking ``and 2009'' and inserting 
        ``, 2009, and 2010'';
            (2) in clause (i), by striking ``and 2009'' and inserting 
        ``, 2009, and 2010''; and
            (3) in each of clauses (ii) and (iii)--
                    (A) by striking ``and 2008'' and inserting ``, 
                2008, and 2009''; and
                    (B) by striking ``or 2009'' and inserting ``, 2009, 
                or 2010''.
    (b) Reporting.--Section 101(c) of division B of the Tax Relief and 
Health Care Act of 2006 (42 U.S.C. 1395w-4 note), as amended by section 
101 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (Public 
Law 110-173), is amended--
            (1) in the heading, by striking ``and 2008'' and inserting 
        ``, 2008, and 2009''; and
            (2) in paragraph (6)(C)--
                    (A) in clause (i), by striking ``and'' at the end;
                    (B) in clause (ii), by striking the period at the 
                end and inserting ``; and''; and
                    (C) by adding at the end the following new clause:
                            ``(iii) for 2009, all of 2009.''.

SEC. 4. EXTENSION OF MEDICARE INCENTIVE PAYMENT PROGRAM FOR PHYSICIAN 
              SCARCITY AREAS.

    Section 1833(u) of the Social Security Act (42 U.S.C. 1395l(u)), as 
amended by section 102 of the Medicare, Medicaid, and SCHIP Extension 
Act of 2007 (Public Law 110-173), is amended--
            (1) in paragraph (1), by striking ``July 1, 2008'' and 
        inserting ``January 1, 2010''; and
            (2) in subparagraph (4)(D), by striking ``July 1, 2008'' 
        and inserting ``January 1, 2010''.

SEC. 5. EXTENSION OF FLOOR ON MEDICARE WORK GEOGRAPHIC ADJUSTMENT UNDER 
              THE MEDICARE PHYSICIAN FEE SCHEDULE.

    Section 1848(e)(1) of the Social Security Act (42 U.S.C. 1395w-
4(e)(1)), as amended by section 103 of the Medicare, Medicaid, and 
SCHIP Extension Act of 2007 (Public Law 110-173), is amended--
            (1) in subparagraph (A), in the matter preceding clause 
        (i), by striking ``subparagraphs (B)'' through ``the 
        Secretary'' and inserting ``the succeeding provisions of this 
        paragraph, the Secretary''; and
            (2) in subparagraph (E), by striking ``July 1, 2008'' and 
        inserting ``January 1, 2010''.

SEC. 6. EXTENSION OF ACCOMMODATION OF PHYSICIANS ORDERED TO ACTIVE DUTY 
              IN THE ARMED SERVICES.

    Section 1842(b)(6)(D)(iii) of the Social Security Act (42 U.S.C. 
1395u(b)(6)(D)(iii)), as amended by section 116 of the Medicare, 
Medicaid, and SCHIP Extension Act of 2007 (Public Law 110-173), is 
amended by striking ``July 1, 2008'' and inserting ``January 1, 2010''.

SEC. 7. SENSE OF CONGRESS REGARDING FISCAL RESPONSIBILITY.

    It is the sense of Congress that--
            (1) the provisions of, and amendments made by, this Act 
        should be deficit neutral over the 5-year period beginning on 
        October 1, 2008; and
            (2) Congress should address the challenges facing the 
        Medicare program in a fiscally responsible manner.

SEC. 8. SENSE OF CONGRESS REGARDING QUALITY.

    It is the sense of Congress that--
            (1) the Medicare program should provide payments to 
        physicians and other health professionals that serve as 
        positive incentives for participation in voluntary initiatives 
        to improve health care quality;
            (2) such initiatives should include pay-for-reporting 
        programs, programs to facilitate coordination of care, the use 
        of clinical appropriateness criteria developed by organizations 
        representing physicians and other health care professionals, 
        grants for developing and pilot testing data registry systems, 
        grants for participation in such data registries, and other 
        appropriate initiatives; and
            (3) financing for such initiatives should be non-punitive 
        and exempt from the Medicare physician fee schedule budget 
        neutrality requirements.

Summary: Save Medicare Act of 2008 - Amends title XVIII (Medicare) of the Social Security Act, as amended by the Medicare, Medicaid, and SCHIP Extension Act of 2007, to: (1) increase the Medicare physician payment update for 2009; and (2) extend the physician quality reporting system, the incentive payment program for physician scarcity areas, the floor on the work geographic adjustment to the physician fee schedule, and the accommodation for physicians ordered to active duty in the armed services.

Expresses the sense of Congress that: (1) the provisions of, and amendments made by, this Act should be deficit neutral over the five year period beginning on October 1, 2008; and (2) Congress should address the challenges facing the Medicare program in a fiscally responsible manner.

Expresses the sense of Congress that: (1) the Medicare program should provide payments to physicians and other health professionals that serve as positive incentives for participation in voluntary initiatives to improve health care quality; and (2) financing for such initiatives should be non-punitive and exempt from the Medicare physician fee schedule budget neutrality requirements.