II 113th CONGRESS 2d Session S. 2492 IN THE SENATE OF THE UNITED STATES June 18, 2014 Mr. Scott introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend the Internal Revenue Code of 1986 to increase access for the uninsured to high quality physician care.

1. Short title This Act may be cited as the Charity Care Expansion Act of 2014 . 2. Physician charity care deduction (a) In general Part VI of subchapter B of chapter 1 of the Internal Revenue Code of 1986 is amended by adding at the end the following new section: 199A. Physician charity care (a) In general In the case of a physician, there shall be allowed as a deduction for the taxable year an amount equal to the amount such physician would have otherwise charged for qualified charity care provided by such physician during the taxable year. (b) Qualified charity care For purposes of this section— (1) Qualified charity care The term qualified charity care means physicians’ services (as defined in section 1861(q) of the Social Security Act) provided on a volunteer or pro bono basis through a qualifying arrangement. (2) Physician The term physician has the meaning given to such term in section 1861 of the Social Security Act ( 42 U.S.C. 1395x(r) ). (3) Qualifying arrangement The term qualifying arrangement means an agreement or contract to provide physicians' services on a volunteer or pro bono basis which is entered into— (A) between the physician and a health care clinic or other organization providing health care which is targeted to serve underserved or low-income individuals, and (B) before the date the services are provided. (c) Limitations (1) Service charge limitation The amount determined under subsection (a) with respect to any services shall not exceed the medicare economic index (referred to in the fourth sentence of section 1842(b)(3) of the Social Security Act ( 42 U.S.C. 1395u(b)(3) )) applicable to the services provided. In the case of physicians’ services to which the medicare economic index is not applicable, the Secretary, in consultation with the Secretary of Health and Human Services, shall use data on uncompensated care for purposes of the limitation under subparagraph (B), and may adjust such data so as to be an appropriate proxy, including a downward adjustment to eliminate bad debt data from uncompensated care data. (2) Overall limitation The amount allowed as a deduction under subsection (a) for any taxable year shall not exceed an amount equal to— (A) 10 percent of the gross income of the taxpayer for the taxable year derived from the taxpayer’s provision of physicians’ services (as defined in section 1861(q) of the Social Security Act), or (B) in the case of a physician who does not have income for the taxable year derived from the provision of physicians' services, $10,000. (3) Exclusion for services with respect to which any reimbursement is received Physicians' services shall not be treated as qualified charity care under subsection (b) if a physician receives any reimbursement, including payment at a partial or discounted rate, for such services. . (b) Clerical amendment The table of sections for part VI of subchapter B of chapter 1 of such Code is amended by adding at the end the following new item: Sec. 199A. Physician charity care. . (c) Effective date The amendments made by this section shall apply to taxable years beginning after the date of the enactment of this Act. 3. Preventive health and health services block grant Part A of title XIX of the Public Health Service Act ( 42 U.S.C. 300w et seq. ) is repealed.