,,ii  #aadth ,,congress  #ast ,session  
,s4 #baah  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,october #a1   
#bjae,ms4 ,klobuchar 7for herself and   
,mr4 ,heinrich7 introduced the following
 bill2 which was read twice and referred
 to the ,committee on ,finance  ,a      
,,bill  ,to amend title ,,xix of the    
,social ,security ,act to extend the    
application of the ,medicare payment    
rate floor to primary care services     
furnished under ,medicaid and to apply  
the rate floor to additional providers  
of primary care services4  #a4 ,short   
title ,this ,act may be cited as the    
,ensuring ,enhanced ,access to ,primary 
,care ,act4  #b4 ,extension of          
application of ,medicare payment rate   
floor to primary care services furnished
 under ,medicaid and application to     
additional providers  7a7 ,renewal of   
payment floor2 additional providers     
,section #aijb7;a77#ac7 of the ,social  
,security ,act 7#db ,u4,s4,c4           
#acif;a7a77#ac77 is amended by striking 

subparagraph 7,c7 and inserting the     
following3  7,c7 payment for primary    
care services 7as defined in subsection 
7jj77 at a rate that is not less than   
#ajj percent of the payment rate that   
applies to such services and physician  
under part ,b of title ,,xviii 7or1 if  
greater1 the payment rate that would be 
applicable under such part if the       
conversion factor under section         
#ahdh7;d7 for the year involved were the
 conversion factor under such section   
for #bjji71 and that is not less than   
the rate that would otherwise apply to  
such services under this title if the   
rate were determined without regard to  
this subparagraph1 and that are--  7i7  
furnished in #bjac and #bjad1 by a      
physician with a primary specialty      
designation of family medicine1 general 
internal medicine1 or pediatric         
medicine2 or  7ii7 furnished in the     
#b-year period that begins on the first 
day of the first month that begins after
 the date of enactment of the ,ensuring 

,enhanced ,access to ,primary ,care     
,act--  7,i7 by a physician with a      
primary specialty designation of family 
medicine1 general internal medicine1 or 
pediatric medicine1 but only if the     
physician self-attests that the         
physician is ,board certified in family 
medicine1 general internal medicine1 or 
pediatric medicine2  7,,ii7 by a        
physician with a primary specialty      
designation of obstetrics and           
gynecology1 but only if the physician   
self-attests that the physician is      
,board certified in obstetrics and      
gynecology2 or  7,,iii7 by physician    
with a primary specialty designation of 
psychiatry or neurology1 but only if the
 physician self-attests that the        
physician is ,board certified in        
psychiatry or neurology2  4  7b7        
,conforming amendment ,section          
#aije7;dd7 of the ,social ,security ,act
 7#db ,u4,s4,c4 #acif;d7dd77 is amended 
by inserting or furnished during the    
#b-year period that begins on the first 

day of the first month that begins after
 the date of enactment of the ,ensuring 
,enhanced ,access to ,primary ,care     
,act1 after #bjae14