Title: To amend title XVIII of the Social Security Act to improve the accuracy of geographic adjustment factors under the Medicare program and to permanently extend certain adjustments to such factors for certain localities, and for other purposes.
Policy area: Health

Summary:
This bill alters provisions relating to the determination of geographic adjustment factors for the payment of physician services under Medicare, and makes permanent certain adjustments for services furnished in Wisconsin and Iowa.

[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3817 Introduced in House (IH)]

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115th CONGRESS
  1st Session
                                H. R. 3817

To amend title XVIII of the Social Security Act to improve the accuracy 
  of geographic adjustment factors under the Medicare program and to 
  permanently extend certain adjustments to such factors for certain 
                  localities, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 21, 2017

  Mr. Young of Iowa (for himself, Mr. Kind, Mr. Blum, Mr. Duffy, Mr. 
Loebsack, Mr. Pocan, and Mr. Gallagher) introduced the following bill; 
  which was referred to the Committee on Energy and Commerce, and in 
    addition to the Committee on Ways and Means, 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 amend title XVIII of the Social Security Act to improve the accuracy 
  of geographic adjustment factors under the Medicare program and to 
  permanently extend certain adjustments to such factors for certain 
                  localities, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. IMPROVING THE ACCURACY OF GEOGRAPHIC ADJUSTMENT FACTORS.

    Section 1848(e)(1)(D) of the Social Security Act (42 U.S.C. 1395w-
4(e)(1)(D)) is amended to read as follows:
                    ``(D) Use of accurate data.--
                            ``(i) In general.--In establishing indices 
                        and index values under this paragraph, the 
                        Secretary shall use the most recent data 
                        available relating to practice expenses, 
                        malpractice expenses, and physician work effort 
                        in each fee schedule area.
                            ``(ii) Practice expense and work indices.--
                        In establishing indices and index values under 
                        clause (i) or (iii) of subparagraph (A), the 
                        Secretary shall--
                                    ``(I) use the most recent market 
                                data available on physician wages, or 
                                if available, actual cost data for 
                                physician labor; and
                                    ``(II) not use nonphysician 
                                professional wage data as a proxy for 
                                physician wage data.
                            ``(iii) Practice expense calculation.--In 
                        calculating index values under clause (i) of 
                        subparagraph (A), the Secretary shall use the 
                        most recent office rent data available or data 
                        from Federally qualified health centers (as 
                        defined in section 1861(aa)(4)) expense 
                        reports.''.

SEC. 2. FLOOR FOR WORK AND PRACTICE EXPENSE GEOGRAPHIC INDICES FOR 
              SERVICES FURNISHED IN WISCONSIN AND IOWA.

    (a) Work Geographic Index.--Section 1848(e)(1)(E) of the Social 
Security Act (42 U.S.C. 1395w-4(e)(1)(D)) is amended to read as 
follows:
                    ``(E) Floor at 1.0 on work geographic index.--
                            ``(i) For 2004 through 2017.--After 
                        calculating the work geographic index in 
                        subparagraph (A)(iii), for purposes of payment 
                        for services furnished on or after January 1, 
                        2004, and before January 1, 2018, the Secretary 
                        shall increase the work geographic index to 
                        1.00 for any locality for which such work 
                        geographic index is less than 1.00.
                            ``(ii) For 2018 and subsequent years.--
                        After calculating the work geographic index in 
                        subparagraph (A)(iii), for purposes of payment 
                        for services furnished in Wisconsin or Iowa on 
                        or after January 1, 2018, the Secretary shall 
                        increase any such index to 1.00 if such index 
                        would otherwise be less than 1.00.''.
    (b) Practice Expense Geographic Indices.--Section 1848(e)(1) of the 
Social Security Act (42 U.S.C. 1395w-4(e)(1)) is amended--
            (1) in subparagraph (A), by striking ``(B), (C), (E), (G), 
        (H), and (I)'' and inserting ``(B), (C), (E), (G), (H), (I), 
        and (J)''; and
            (2) by adding at the end the following new subparagraph:
                    ``(J) Floor for practice expense geographic indices 
                for services furnished in wisconsin or iowa.--For 
                purposes of payment for services furnished in Wisconsin 
                or Iowa on or after January 1, 2018, after calculating 
                the practice expense index in subparagraph (A)(i), the 
                Secretary shall increase any such index to 1.00 if such 
                index would otherwise be less than 1.00.''.
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