text: SECTION 1. SHORT TITLE.
  
      This Act may be cited as the ``Medicare Incentive Access Act of 
  2002''.
  
  SEC. 2. INCENTIVE PAYMENT IN MEDICARE HEALTH PROFESSIONAL SHORTAGE 
                AREAS DEMONSTRATION PROJECT.
  
      Title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) is 
  amended by adding at the end the following new section:
  
    ``incentive payments in medicare health professional shortage areas 
                           demonstration project
  
      ``Sec. 1897. (a) Establishment.--
              ``(1) In general.--The Secretary shall establish a 
          demonstration project under which--
                      ``(A) pursuant to paragraph (3), the Secretary 
                  designates areas in a State selected under paragraph 
                  (5) as medicare health professional shortage areas; and
                      ``(B) an incentive payment is provided under part B 
                  to primary care physicians for each physician's service 
                  (as defined in section 1861(q)) that is furnished in a 
                  medicare health professional shortage area to an 
                  individual enrolled under such part.
              ``(2) Primary care physician defined.--For purposes of this 
          section, the term `primary care physician' has the meaning 
          given such term for purposes of designating health professional 
          shortage areas under section 332(a) of the Public Health 
          Service Act (42 U.S.C. 254e(a)).
              ``(3) Designation of areas.--The Secretary shall designate 
          an area in a State selected under paragraph (5) as a medicare 
          health professional shortage area if the Secretary determines, 
          using the methodology established under subsection (b)(1)(B), 
          that individuals enrolled under part B and residing in the area 
          have inadequate access to primary care physicians.
              ``(4) Terms and conditions.--
                      ``(A) Incentive payment in addition to payment 
                  otherwise made.--
                              ``(i) In general.--Subject to clause (ii), 
                          the incentive payment made under the 
                          demonstration project for a physician's service 
                          shall be in addition to the amount otherwise 
                          made for the service under part B.
                              ``(ii) No payments under the incentive 
                          payment program in a demonstration state during 
                          operation of the demonstration program.--
                          Subject to subparagraph (D), notwithstanding 
                          section 1833(m), during the operation of the 
                          demonstration project in a State selected under 
                          paragraph (5), the Secretary may not make any 
                          incentive payment to any physician under such 
                          section for any service furnished in any part 
                          of such State, regardless of--
                                      ``(I) whether the physician is 
                                  eligible for bonus payments under the 
                                  demonstration program; and
                                      ``(II) where the service was 
                                  furnished in the State.
                      ``(B) Amount of incentive payment.--The amount of 
                  the incentive payment for a physician's service 
                  furnished under the demonstration project shall be an 
                  amount equal to 40 percent of the payment amount for 
                  the service under part B.
                      ``(C) No effect on amount of coinsurance an 
                  individual is required to pay.--The amount of any 
                  coinsurance that an individual enrolled under part B is 
                  responsible for paying with respect to a physicians' 
                  service furnished to the individual shall be determined 
                  as if this section had not been enacted.
                      ``(D) No effect on payments to critical access 
                  hospitals.--The amount of payment for outpatient 
                  critical access services of a critical access hospital 
                  under section 1834(g) shall be determined as if this 
                  section had not been enacted.
              ``(5) Demonstration sites.--The Secretary shall conduct the 
          demonstration project in 5 States selected by the Secretary as 
          demonstration sites.
              ``(6) Automation of incentive payments.--
                      ``(A) In general.--Under the demonstration project, 
                  incentive payments under paragraph (1)(B) to a primary 
                  care physician shall be made automatically to the 
                  physician rather than the physician being responsible 
                  for determining when a payment is required to be made 
                  under that paragraph.
                      ``(B) Incentive payment based on zip codes.--In 
                  order to comply with subparagraph (A), the Secretary 
                  shall establish procedures in which the amount of 
                  payment otherwise made for a physician's service is 
                  automatically increased by the amount of the incentive 
                  payment under the demonstration project if the service 
                  was furnished in any zip code that is entirely 
  or partially in a designated medicare health professional shortage area 
  in a State selected under paragraph (5).
              ``(7) Duration.--The demonstration project shall be 
          conducted for a 3-year period. The period for establishing the 
          methodology under subsection (b) shall not be counted for 
          purposes determining such 3-year period.
      ``(b) Establishment of Methodology for Assisting Secretary in 
  Designating Medicare Health Professional Shortage Areas.--
              ``(1) In general.--The Secretary shall select 1 or more 
          Federal rural health research centers within the Health 
          Resources Services Administration to establish a methodology to 
          assist the Secretary in designating areas within the States 
          selected under subsection (a)(5) as medicare health 
          professional shortage areas pursuant to subsection (a)(3).
              ``(2) Rules for establishing methodology.--
                      ``(A) In general.--The methodology established 
                  under paragraph (1) shall address--
                              ``(i) how to measure the percentage of the 
                          total population in an area that consists of 
                          individuals enrolled under part B; and
                              ``(ii) the appropriate ratio of such 
                          individuals to primary care physicians in an 
                          area in order to ensure that such individuals 
                          have adequate access to services furnished by 
                          such physicians.
                      ``(B) Methodology may be similar to methodologies 
                  used under the public health service act.--The 
                  methodology established under paragraph (1) may be 
                  similar to methodologies utilized by the Secretary for 
                  designating areas, and population groups within areas, 
                  as health professional shortage areas under section 
                  332(a) of the Public Health Service Act (42 U.S.C. 
                  254e(a)).
                      ``(C) Consultation.--The Federal rural health 
                  research centers selected under paragraph (1) shall 
                  consult with the State and local medical societies of 
                  the States selected under subsection (a)(5) in 
                  establishing the methodology under paragraph (1).
      ``(c) No Effect on Designation as a Health Professional Shortage 
  Area.--Except as provided in subsection (a)(4)(A)(ii), the designation 
  of an area as a medicare health professional shortage area under 
  subsection (a)(3) shall have no effect on the designation of such area 
  as a health professional shortage area under section 332(a) of the 
  Public Health Service Act (42 U.S.C. 254e(a)).
      ``(d) Waiver Authority.--The Secretary may waive such requirements 
  of title XI and this title as may be necessary for the purpose of 
  carrying out the demonstration project.
      ``(e) Report.--
              ``(1) In general.--Not later than 6 months after the 
          completion of the demonstration project, the Secretary shall 
          submit to Congress a report on such project.
              ``(2) Contents.--The report submitted under paragraph (1) 
          shall contain--
                      ``(A) an evaluation of whether the demonstration 
                  project has had the effect of stabilizing, maintaining, 
                  or increasing access of individuals enrolled under part 
                  B to physicians' services furnished by primary care 
                  physicians, including whether the amount of the 
                  incentive payment is adequate to stabilize, maintain, 
                  or increase such access and if not, then what amount 
                  will;
                      ``(B) a comparison of the effectiveness of the 
                  demonstration project in stabilizing, maintaining, or 
                  increasing such access with the effectiveness of other 
                  Federal, State, and local programs, such as the 
                  incentive program under section 1833(m), that are 
                  designed to stabilize, maintain, or increase such 
                  access;
                      ``(C) recommendations for such legislation and 
                  administrative actions as the Secretary considers 
                  appropriate; and
                      ``(D) any other items that the Secretary considers 
                  appropriate.
      ``(f) Funding.--
              ``(1) Incentive payments.--The Secretary shall use funds in 
          the Federal Supplementary Medical Insurance Trust Fund under 
          section 1841 to make the incentive payments under this section.
              ``(2) Establishment of methodology.--
                      ``(A) In general.--There is authorized to be 
                  appropriated $6,000,000 to establish the methodology 
                  under subsection (b)(1).
                      ``(B) Availability.--Any amounts appropriated 
                  pursuant to subparagraph (A) shall remain available 
                  until expended.''.
target: Medicare Incentive Access Act of 2002 - Amends title XVIII (Medicare) of the Social Security Act (SSA) part B (Supplementary Medical Insurance) to establish a three-year demonstration project under which the Secretary of Health and Human Services shall: (1) select one or more Federal rural health research centers within the Health Resources Services Administration to develop a methodology for designating Medicare health professional shortage areas; (2) select five States as demonstration sites and designate Medicare health professional shortage areas in them; and (3) provide incentive payments to primary care physicians to service those shortage areas.
feat_title: A bill to amend title XVIII of the Social Security Act to establish a medicare demonstration project under which incentive payments are provided in certain areas in order to stabilize, maintain, or increase access to primary care services for individuals enrolled under part B of such title.