To amend part B of title XVIII of the Social Security Act to improve payments for physicians' services and other outpatient services furnished under the Medicare Program, and for other purposes.
Latest action · Jun 28, 2002 Committee on Ways and Means discharged.
Progress
Where this bill reached, and when. A stage with no date was not reached; one that failed a vote and later carried shows the date it carried.
- IntroducedJun 21, 2002
- Passed HouseNot reached
- Passed SenateNot reached
- To the PresidentNot reached
- Became lawNot reached
Summary
(Sec. 502) Directs the Comptroller General to conduct a study for a report to Congress: (1) examining the adequacy of current reimbursements for inhalation therapy under the Medicare program; and (2) concerning the access of Medicare beneficiaries to physicians' services under the Medicare program.
(Sec. 503) Mandates that the Medicare Payment Advisory Commission (MEDPAC) submit to Congress a described report on the effect of refinements to the practice expense component of payments for physicians' services, after the transition to a full resource-based payment system in 2002.
(Sec. 504) Provides that, for purposes of payment under the physician fee schedule, for physicians' services furnished during 2004, in no case may the work geographic index otherwise calculated be less than 0.985.
Requires the Comptroller General to conduct a study and report to Congress on the physician payment rate, including adjustment of the work component.
Subtitle B: Other Services (sic) - Amends SSA title XVIII to replace provisions under Medicare part B (Supplementary Medical Insurance) for a limited number of demonstration projects for competitive acquisition of items and services with provisions for a permanent program for the establishment of programs for competitive acquisition of described items and services, including provisions for a demonstration project for application of competitive acquisition to clinical diagnostic laboratory tests.
(Sec. 512) Substitutes a new phase-in methodology for the ambulance fee schedule amount portion of the phase-in and lengthens the phase-in schedule, including in such methodology adjustment in payment for certain long trips.
(Sec. 513) Extends the moratorium on application of the therapy caps for an additional two years, through FY 2004.
Directs the Secretary to: (1) submit to Congress overdue reports required under the Balanced Budget Act of 1997 relating to alternatives to a single annual dollar cap on outpatient therapy and under the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 relating to utilization patterns for outpatient therapy; and (2) request the Institute of Medicine of the National Academy of Sciences to identify conditions or diseases that should justify conducting an assessment of the need to waive therapy caps.
Requires the Comptroller General to conduct a study for a report to Congress on access to physical therapist services in States authorizing such services without a physician referral and in States that require such a physician referral.
(Sec. 514) Modifies the limitation on copayment amount for hospital outpatient department (OPD) services, requiring the Secretary to reduce the national unadjusted copayment amount for a covered OPD service (or group of such services) furnished in a year in a manner so that the effective copayment rate (determined on a national unadjusted basis) for that service in the year does not exceed the following percentage: (1) for procedures performed in 2004, 45 percent; (2) for procedures performed in 2005, 40 percent; (3) for procedures performed in 2006, 2007, 2008 and 2009, 35 percent; (4) for procedures performed in 2010, 30 percent; (5) for procedures performed in 2011, 25 percent; and (5) for procedures performed in 2012 and thereafter, 20 percent.
(Sec. 515) Provides for coverage of an initial preventive physical examination.
(Sec. 516) Directs the Comptroller General to submit to Congress a report containing: (1) an analysis of the differences in costs of providing renal dialysis services under the Medicare program in home settings and in facility settings; (2) an assessment of the percentage of overhead costs in home settings and in facility settings; and (3) an evaluation of whether the charges for home dialysis supplies and equipment are reasonable and necessary.
Amends BIPA (sic) to specify that the prohibition on exceptions to the composite rate shall not apply to pediatric facilities that, as of October 1, 2002, do not have an exception rate as of such date. Defines "pediatric facility" as a renal facility at least 50 percent of whose patients are individuals under 18 years of age.
Increases the composite rate 1.2 percent for renal dialysis services furnished in 2004.
(Sec. 517) Amends SSA title XVIII to exclude payment for screening mammography and unilateral and bilateral diagnostic mammography under the system for hospital outpatient services.
Provides that for diagnostic mammography performed on or after January 1, 2004, for which payment is made under the physician fee schedule, the Secretary, based on the most recent cost data available, shall provide for an appropriate adjustment in the payment amount for the technical component of the diagnostic mammography.
Cosponsors
Members who signed on, in the order they did.
Committees 2
Where it was sent and what each committee and subcommittee did with it, in order.
| Chamber | Committee | What it did |
|---|---|---|
| House | Energy and Commerce Committee | Referred Jun 21, 2002Reported Jun 27, 2002 |
| House | Ways and Means Committee | Referred Jun 21, 2002Discharged Jun 28, 2002 |
Actions 6
Everything that happened, newest first.
- Jun 28, 2002Placed on the Union Calendar, Calendar No. 332.
- Jun 28, 2002Committee on Ways and Means discharged.
- Jun 26, 2002Reported by the Committee on Energy and Commerce. H. Rept. 107-549, Part I.
- Jun 26, 2002House Committee on Ways and Means Granted an extension for further consideration ending not later than June 28, 2002.
- Jun 21, 2002Introduced in House
- Jun 21, 2002Referred 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.
Research
What has been written about this bill: committee reports, cost estimates, the sponsor’s authority statement, printed hearings and the Congressional Research Service’s work.
Committee report
Printed hearings 1
Hearings whose printed record names this bill, newest first: hearings on it, and wider hearings where it came up.
| Number | Hearing | Committee | Held |
|---|---|---|---|
| S. Hrg. 107-143 | LEGISLATIVE BRANCH APPROPRIATIONS FOR FISCAL YEAR 2002266 pages | Appropriations Committee | May 2, 2001–Jun 26, 2001 |
Titles 1
Every title it has carried, official and short, at each stage.
- Official Title as Introduced
- To amend part B of title XVIII of the Social Security Act to improve payments for physicians' services and other outpatient services furnished under the Medicare Program, and for other purposes.
Subjects
Assigned by the Library of Congress. Policy area: Health.
- Access to health care
- Ambulances
- Ambulatory care
- Child health
- Coinsurance
- Commerce
- Competitive bidding
- Congress
- Congressional investigations
- Congressional reporting requirements
- Consumer complaints
- Cost of living adjustments
- Customer service
- Drugs
- Economics and Public Finance
- Emergency Management
- Emergency medical services
- Families
- Federal advisory bodies
- Finance and Financial Sector
- Government contractors
- Government Operations and Politics
- Government procurement
- Government publicity
- Gross national product
- Health
- Health facilities
- Home care services
- Kidney diseases
- Legislation
- Mammography
- Medical fees
- Medical laboratories
- Medical supplies
- Medical tests
- Medicare
- Overhead costs
- Patient satisfaction
- Physical examinations
- Physical therapy
- Physicians
- Preventive medicine
- Prosthesis
- Quality of care
- Respiratory diseases
- Social Welfare
- Standards
- Transportation and Public Works
- Women
Text 2
Each version as it was printed, newest first.
- Jun 28, 2002Reported in House
- Jun 21, 2002Introduced in House
Everything here is as published by Congress: the summary is the Congressional Research Service's, the action wording is the clerks', and the subjects are the Library of Congress's. How far it got is read from the actions themselves, taking the most recent one of each kind, so a bill that failed a vote and later passed is shown as having passed. Records come from this bill on Congress.gov and govinfo.gov; cost estimates are the Congressional Budget Office's, and the hearings are the printed hearings GovInfo publishes, which can appear months after the hearing.
