Providing Relief and Stability for Medicare Patients Act of 2023
This bill temporarily increases the payment rate under Medicare for certain office-based services that involve high-priced equipment.
Specifically, the bill increases the payment rate under the Medicare physician fee schedule for services provided in a nonfacility (i.e., office) setting for which most of the cost is attributable to equipment and supplies. The increase applies to services furnished in 2024 and 2025.
Additionally, the Government Accountability Office must report on the correlation, if any, of payment rates for these services under the Medicare physician fee schedule and patient access to these services.
[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3674 Introduced in House (IH)]
<DOC>
118th CONGRESS
1st Session
H. R. 3674
To amend title XVIII of the Social Security Act to increase the
nonfacility practice expense relative value units for specified
services furnished under the Medicare program.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 25, 2023
Mr. Bilirakis (for himself, Mr. Cardenas, Mr. Murphy, and Mr. Davis of
Illinois) 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 increase the
nonfacility practice expense relative value units for specified
services furnished under the Medicare program.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Providing Relief and Stability for
Medicare Patients Act of 2023''.
SEC. 2. INCREASING THE NONFACILITY PRACTICE EXPENSE RELATIVE VALUE
UNITS FOR SPECIFIED SERVICES FURNISHED UNDER THE MEDICARE
PROGRAM.
(a) In General.--Section 1848(c)(2) of the Social Security Act (42
U.S.C. 1395w-4(c)(2)) is amended by adding at the end the following
subparagraph:
``(P) Increase of nonfacility practice expense
relative value units for specified services.--
``(i) In general.--The Secretary shall
increase the nonfacility practice expense
relative value units applied to a specified
service (as defined in clause (ii)) furnished
in--
``(I) 2024, by 10 percent of the
number of nonfacility practice expense
relative value units that would
otherwise apply to such service
furnished in such year without
application of this clause; and
``(II) 2025, by 15 percent of the
number of nonfacility practice expense
relative value units that would
otherwise apply to such service
furnished in such year without
application of this clause.
``(ii) Specified service defined.--For
purposes of this subparagraph, the term
`specified service' means, with respect to a
service furnished in a year, a service with a
nonfacility practice expense relative value
unit that was calculated for such year (without
application of this subparagraph) based on 65
percent or more of the service's direct
practice expense cost being attributed to
equipment and supply costs.
``(iii) Funding.--There shall be
transferred from the General Fund of the
Treasury to the Federal Supplementary Medical
Insurance Trust Fund under section 1841 such
sums as the Secretary determines are necessary
for purposes of increasing payment amounts
pursuant to this subparagraph, to remain
available until expended.''.
(b) Nonapplication of Budget Neutrality.--Section 1848(c)(2)(B)(iv)
of the Social Security Act (42 U.S.C. 1395w-4(c)(2)(B)(iv)) is
amended--
(1) in subclause (IV), by striking ``; and'' and inserting
a semicolon;
(2) in subclause (V), by striking the period at the end and
inserting ``; and''; and
(3) by adding at the end the following new subclause:
``(VI) subparagraph (P) shall not
be taken into account in applying
clause (ii)(II).''.
(c) Report.--Not later than 1 year after the date of the enactment
of this Act, the Comptroller General of the United States shall submit
to Congress a report on the Medicare physician fee schedule and patient
access, including--
(1) an analysis of the number of health care providers
furnishing specified services (as defined in section
1848(c)(2)(P) of the Social Security Act, as added by
subsection (a)) in a nonfacility setting under the Medicare
program over the 20 year period ending on such date of
enactment, including a description of any changes in volume of
such services furnished under such program and the availability
of such services under such program and a description of wait-
times, decreased hours, other factors that could impede a
patient's access to such services (such as increased cost
sharing);
(2) an analysis of any change in the proportion of services
payable under such schedule furnished in nonfacility settings
compared to the proportion of such services furnished at other
sites of service over such period, including an analysis of the
impact of any such change on health system consolidation,
underserved and rural populations, quality of care of Medicare
beneficiaries, and increased cost to the Medicare program;
(3) an analysis of whether significant annual changes in
provider reimbursement are a cause of any change described in
paragraph (2), disruptions in patient access to services, and
increased cost sharing; and
(4) taking into account the analyses described in
paragraphs (1) through (3), recommendations for improving
Medicare patient access to specified services (as defined in
section 1848(c)(2)(P) of the Social Security Act, as added by
subsection (a)) and minimizing health system consolidation.
<all>
Introduced in House
Introduced in House
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.
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.
Referred to the Subcommittee on Health.
Referred to the Subcommittee on Health.
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