Page:United States Statutes at Large Volume 124.djvu/442

 124 STAT. 416 PUBLIC LAW 111–148—MAR. 23, 2010 SEC. 3102. EXTENSION OF THE WORK GEOGRAPHIC INDEX FLOOR AND REVISIONS TO THE PRACTICE EXPENSE GEOGRAPHIC ADJUSTMENT UNDER THE MEDICARE PHYSICIAN FEE SCHEDULE. (a) EXTENSION OF WORK GPCI FLOOR.—Section 1848(e)(1)(E) of the Social Security Act (42 U.S.C. 1395w–4(e)(1)(E)) is amended by striking ‘‘before January 1, 2010’’ and inserting ‘‘before January 1, 2011’’. (b) PRACTICE EXPENSE GEOGRAPHIC ADJUSTMENT FOR 2010 AND SUBSEQUENT YEARS.—Section 1848(e)(1) of the Social Security Act (42 U.S.C. 1395w4(e)(1)) is amended— (1) in subparagraph (A), by striking ‘‘and (G)’’ and inserting ‘‘(G), and (H)’’; and (2) by adding at the end the following new subparagraph: ‘‘(H) PRACTICE EXPENSE GEOGRAPHIC ADJUSTMENT FOR 2010 AND SUBSEQUENT YEARS.— ‘‘(i) FOR 2010.—Subject to clause (iii), for services furnished during 2010, the employee wage and rent portions of the practice expense geographic index described in subparagraph (A)(i) shall reflect 3⁄4 of the difference between the relative costs of employee wages and rents in each of the different fee schedule areas and the national average of such employee wages and rents. ‘‘(ii) FOR 2011.—Subject to clause (iii), for services furnished during 2011, the employee wage and rent portions of the practice expense geographic index described in subparagraph (A)(i) shall reflect 1⁄2 of the difference between the relative costs of employee wages and rents in each of the different fee schedule areas and the national average of such employee wages and rents. ‘‘(iii) HOLD HARMLESS.—The practice expense por- tion of the geographic adjustment factor applied in a fee schedule area for services furnished in 2010 or 2011 shall not, as a result of the application of clause (i) or (ii), be reduced below the practice expense portion of the geographic adjustment factor under subpara- graph (A)(i) (as calculated prior to the application of such clause (i) or (ii), respectively) for such area for such year. ‘‘(iv) ANALYSIS.—The Secretary shall analyze cur- rent methods of establishing practice expense geographic adjustments under subparagraph (A)(i) and evaluate data that fairly and reliably establishes distinctions in the costs of operating a medical practice in the different fee schedule areas. Such analysis shall include an evaluation of the following: ‘‘(I) The feasibility of using actual data or reli- able survey data developed by medical organiza- tions on the costs of operating a medical practice, including office rents and non-physician staff wages, in different fee schedule areas. ‘‘(II) The office expense portion of the practice expense geographic adjustment described in subparagraph (A)(i), including the extent to which 42 USC 1395w–4.