Page:United States Statutes at Large Volume 117.djvu/2296

 PUBLIC LAW 108–173—DEC. 8, 2003

117 STAT. 2277

the Internet website of the Centers for Medicare & Medicaid Services.’’. (b) IMPROVEMENT TO MEDICARE INCENTIVE PAYMENT PROGRAM.— (1) IN GENERAL.—Section 1833(m) (42 U.S.C. 1395l(m)) is amended— (A) by inserting ‘‘(1)’’ after ‘‘(m)’’; (B) in paragraph (1), as designated by subparagraph (A)— (i) by inserting ‘‘in a year’’ after ‘‘In the case of physicians’ services furnished’’; and (ii) by inserting ‘‘as identified by the Secretary prior to the beginning of such year’’ after ‘‘as a health professional shortage area’’; and (C) by adding at the end the following new paragraphs: ‘‘(2) For each health professional shortage area identified in paragraph (1) that consists of an entire county, the Secretary shall provide for the additional payment under paragraph (1) without any requirement on the physician to identify the health professional shortage area involved. The Secretary may implement the previous sentence using the method specified in subsection (u)(4)(C). ‘‘(3) The Secretary shall post on the Internet website of the Centers for Medicare & Medicaid Services a list of the health professional shortage areas identified in paragraph (1) that consist of a partial county to facilitate the additional payment under paragraph (1) in such areas. ‘‘(4) There shall be no administrative or judicial review under section 1869, section 1878, or otherwise, respecting— ‘‘(A) the identification of a county or area; ‘‘(B) the assignment of a specialty of any physician under this paragraph; ‘‘(C) the assignment of a physician to a county under this subsection; or ‘‘(D) the assignment of a postal ZIP Code to a county or other area under this subsection.’’. (2) EFFECTIVE DATE.—The amendments made by paragraph (1) shall apply to physicians’ services furnished on or after January 1, 2005. (c) GAO STUDY OF GEOGRAPHIC DIFFERENCES IN PAYMENTS FOR PHYSICIANS’ SERVICES.— (1) STUDY.—The Comptroller General of the United States shall conduct a study of differences in payment amounts under the physician fee schedule under section 1848 of the Social Security Act (42 U.S.C. 1395w–4) for physicians’ services in different geographic areas. Such study shall include— (A) an assessment of the validity of the geographic adjustment factors used for each component of the fee schedule; (B) an evaluation of the measures used for such adjustment, including the frequency of revisions; (C) an evaluation of the methods used to determine professional liability insurance costs used in computing the malpractice component, including a review of increases in professional liability insurance premiums and variation in such increases by State and physician specialty and methods used to update the geographic cost of practice

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42 USC 1395l note. 42 USC 1395w–4 note.

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