Page:United States Statutes at Large Volume 117.djvu/2320

 PUBLIC LAW 108–173—DEC. 8, 2003

117 STAT. 2301

(2) CONFORMING AMENDMENT.—Paragraph (4)(B) of such section is amended, in the matter before clause (i), by inserting ‘‘and paragraph (5)’’ after ‘‘subparagraph (D)’’. (3) NOT TREATED AS CHANGE IN LAW AND REGULATION IN SUSTAINABLE GROWTH RATE DETERMINATION.—The amendments made by this subsection shall not be treated as a change in law for purposes of applying section 1848(f)(2)(D) of the Social Security Act (42 U.S.C. 1395w–4(f)(2)(D)). (b) USE OF 10-YEAR ROLLING AVERAGE IN COMPUTING GROSS DOMESTIC PRODUCT.— (1) IN GENERAL.—Section 1848(f)(2)(C) (42 U.S.C. 1395w– 4(f)(2)(C)) is amended— (A) by striking ‘‘projected’’ and inserting ‘‘annual average’’; and (B) by striking ‘‘from the previous applicable period to the applicable period involved’’ and inserting ‘‘during the 10-year period ending with the applicable period involved’’. (2) EFFECTIVE DATE.—The amendments made by paragraph (1) shall apply to computations of the sustainable growth rate for years beginning with 2003.

42 USC 1395w–4 note.

42 USC 1395w–4 note.

SEC. 602. TREATMENT OF PHYSICIANS’ SERVICES FURNISHED IN ALASKA.

Section 1848(e)(1) (42 U.S.C. 1395w–4(e)(1)), as amended by section 421, is amended— (1) in subparagraph (A), by striking ‘‘subparagraphs (B), (C), (E), and (F)’’ and inserting ‘‘subparagraphs (B), (C), (E), (F) and (G)’’; and (2) by adding at the end the following new subparagraph: ‘‘(G) FLOOR FOR PRACTICE EXPENSE, MALPRACTICE, AND WORK GEOGRAPHIC INDICES FOR SERVICES FURNISHED IN ALASKA.—For purposes of payment for services furnished

in Alaska on or after January 1, 2004, and before January 1, 2006, after calculating the practice expense, malpractice, and work geographic indices in clauses (i), (ii), and (iii) of subparagraph (A) and in subparagraph (B), the Secretary shall increase any such index to 1.67 if such index would otherwise be less than 1.67.’’. SEC. 603. INCLUSION OF PODIATRISTS, DENTISTS, AND OPTOMETRISTS UNDER PRIVATE CONTRACTING AUTHORITY.

Section 1802(b)(5)(B) (42 U.S.C. 1395a(b)(5)(B)) is amended by striking ‘‘section 1861(r)(1)’’ and inserting ‘‘paragraphs (1), (2), (3), and (4) of section 1861(r)’’. SEC. 604. GAO STUDY ON ACCESS TO PHYSICIANS’ SERVICES.

(a) STUDY.—The Comptroller General of the United States shall conduct a study on access of medicare beneficiaries to physicians’ services under the medicare program. The study shall include— (1) an assessment of the use by beneficiaries of such services through an analysis of claims submitted by physicians for such services under part B of the medicare program; (2) an examination of changes in the use by beneficiaries of physicians’ services over time; and (3) an examination of the extent to which physicians are not accepting new medicare beneficiaries as patients.

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42 USC 1395ll note.

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