Providing Relief and Stability for Medicare Patients Act of 2023

I 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. CA´RDENAS, Mr. MURPHY, and Mr. DAVIS of Illinois) introduced the following bill; which was referred to the Com- mittee 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 Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Providing Relief and 4 Stability for Medicare Patients Act of 2023’’. 5 VerDate Sep 11 2014 02:41 Jun 17, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H3674.IH H3674 kjohnson on DSK79L0C42PROD with BILLS 2 •HR 3674 IH SEC. 2. INCREASING THE NONFACILITY PRACTICE EX- 1 PENSE RELATIVE VALUE UNITS FOR SPECI- 2 FIED SERVICES FURNISHED UNDER THE 3 MEDICARE PROGRAM. 4 (a) IN GENERAL.—Section 1848(c)(2) of the Social 5 Security Act (42 U.S.C. 1395w–4(c)(2)) is amended by 6 adding at the end the following subparagraph: 7 ‘‘(P) INCREASE OF NONFACILITY PRACTICE 8 EXPENSE RELATIVE VALUE UNITS FOR SPECI- 9 FIED SERVICES.— 10 ‘‘(i) IN GENERAL.—The Secretary 11 shall increase the nonfacility practice ex- 12 pense relative value units applied to a 13 specified service (as defined in clause (ii)) 14 furnished in— 15 ‘‘(I) 2024, by 10 percent of the 16 number of nonfacility practice expense 17 relative value units that would other- 18 wise apply to such service furnished in 19 such year without application of this 20 clause; and 21 ‘‘(II) 2025, by 15 percent of the 22 number of nonfacility practice expense 23 relative value units that would other- 24 wise apply to such service furnished in 25 VerDate Sep 11 2014 02:41 Jun 17, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H3674.IH H3674 kjohnson on DSK79L0C42PROD with BILLS 3 •HR 3674 IH such year without application of this 1 clause. 2 ‘‘(ii) SPECIFIED SERVICE DEFINED.— 3 For purposes of this subparagraph, the 4 term ‘specified service’ means, with respect 5 to a service furnished in a year, a service 6 with a nonfacility practice expense relative 7 value unit that was calculated for such 8 year (without application of this subpara- 9 graph) based on 65 percent or more of the 10 service’s direct practice expense cost being 11 attributed to equipment and supply costs. 12 ‘‘(iii) FUNDING.—There shall be 13 transferred from the General Fund of the 14 Treasury to the Federal Supplementary 15 Medical Insurance Trust Fund under sec- 16 tion 1841 such sums as the Secretary de- 17 termines are necessary for purposes of in- 18 creasing payment amounts pursuant to 19 this subparagraph, to remain available 20 until expended.’’. 21 (b) NONAPPLICATION OF BUDGET NEUTRALITY.— 22 Section 1848(c)(2)(B)(iv) of the Social Security Act (42 23 U.S.C. 1395w–4(c)(2)(B)(iv)) is amended— 24 VerDate Sep 11 2014 02:41 Jun 17, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H3674.IH H3674 kjohnson on DSK79L0C42PROD with BILLS 4 •HR 3674 IH (1) in subclause (IV), by striking ‘‘; and’’ and 1 inserting a semicolon; 2 (2) in subclause (V), by striking the period at 3 the end and inserting ‘‘; and’’; and 4 (3) by adding at the end the following new sub- 5 clause: 6 ‘‘(VI) subparagraph (P) shall not 7 be taken into account in applying 8 clause (ii)(II).’’. 9 (c) REPORT.—Not later than 1 year after the date 10 of the enactment of this Act, the Comptroller General of 11 the United States shall submit to Congress a report on 12 the Medicare physician fee schedule and patient access, 13 including— 14 (1) an analysis of the number of health care 15 providers furnishing specified services (as defined in 16 section 1848(c)(2)(P) of the Social Security Act, as 17 added by subsection (a)) in a nonfacility setting 18 under the Medicare program over the 20 year period 19 ending on such date of enactment, including a de- 20 scription of any changes in volume of such services 21 furnished under such program and the availability of 22 such services under such program and a description 23 of wait-times, decreased hours, other factors that 24 VerDate Sep 11 2014 02:41 Jun 17, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H3674.IH H3674 kjohnson on DSK79L0C42PROD with BILLS 5 •HR 3674 IH could impede a patient’s access to such services 1 (such as increased cost sharing); 2 (2) an analysis of any change in the proportion 3 of services payable under such schedule furnished in 4 nonfacility settings compared to the proportion of 5 such services furnished at other sites of service over 6 such period, including an analysis of the impact of 7 any such change on health system consolidation, un- 8 derserved and rural populations, quality of care of 9 Medicare beneficiaries, and increased cost to the 10 Medicare program; 11 (3) an analysis of whether significant annual 12 changes in provider reimbursement are a cause of 13 any change described in paragraph (2), disruptions 14 in patient access to services, and increased cost 15 sharing; and 16 (4) taking into account the analyses described 17 in paragraphs (1) through (3), recommendations for 18 improving Medicare patient access to specified serv- 19 ices (as defined in section 1848(c)(2)(P) of the So- 20 cial Security Act, as added by subsection (a)) and 21 minimizing health system consolidation. 22 Æ VerDate Sep 11 2014 02:41 Jun 17, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6301 E:\BILLS\H3674.IH H3674 kjohnson on DSK79L0C42PROD with BILLS