,,ii  #aad? ,,congress  #a/ ,session    
,s4 #baah  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,octob] #a1 #bjae,ms4  
,klobu*> 7= h]self & ,mr4 ,he9ri*7      
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,f9ance  ,a ,,bill  ,to am5d title ,,xix
 ( ! ,social ,security ,act to ext5d !  
application ( ! ,m$ic>e paym5t rate     
floor to prim>y c>e s]vices furni%$ "u  
,m$icaid & to apply ! rate floor to     
additional provid]s ( prim>y c>e        
s]vices4  #a4 ,%ort title ,?is ,act may 
be cit$ z ! ,ensur+ ,enhanc$ ,access to 
,prim>y ,c>e ,act4  #b4 ,ext5sion (     
application ( ,m$ic>e paym5t rate floor 
to prim>y c>e s]vices furni%$ "u        
,m$icaid & application to additional    
provid]s  7a7 ,r5ewal ( paym5t floor2   
additional provid]s  ,section           
#aijb7;a77#ac7 ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #acif;a7a77#ac77 is 
am5d$ by /rik+ subp>agraph 7,c7 & ins]t+
 ! foll[+3  7,c7 paym5t = prim>y c>e    
s]vices 7z def9$ 9 subsection 7jj77 at a

 rate t is n less ?an #ajj p]c5t ( !    
paym5t rate t applies to su* s]vices &  
physician "u "p ,b ( title ,,xviii 7or1 
if great]1 ! paym5t rate t w\ld be      
applicable "u su* "p if ! conv]sion     
factor "u section #ahdh7;d7 = ! ye>     
involv$ 7 ! conv]sion factor "u su*     
section = #bjji71 & t is n less ?an !   
rate t w\ld o!rwise apply to su* s]vices
 "u ?is title if ! rate 7 det]m9$ )\t   
reg>d to ?is subp>agraph1 & t are--  7i7
 furni%$ 9 #bjac & #bjad1 by a physician
 ) a prim>y specialty designation (     
family m$ic9e1 g5]al int]nal m$ic9e1 or 
p$iatric m$ic9e2 or  7ii7 furni%$ 9 !   
#b-ye> p]iod t beg9s on ! fir/ day ( !  
fir/ mon? t beg9s aft] ! date ( enactm5t
 ( ! ,ensur+ ,enhanc$ ,access to ,prim>y
 ,c>e ,act--  7,i7 by a physician ) a   
prim>y specialty designation ( family   
m$ic9e1 g5]al int]nal m$ic9e1 or        
p$iatric m$ic9e1 b only if ! physician  
self-atte/s t ! physician is ,bo>d      
c]tifi$ 9 family m$ic9e1 g5]al int]nal  
m$ic9e1 or p$iatric m$ic9e2  7,,ii7 by a

 physician ) a prim>y specialty         
designation ( ob/etrics & gynecology1 b 
only if ! physician self-atte/s t !     
physician is ,bo>d c]tifi$ 9 ob/etrics &
 gynecology2 or  7,,iii7 by physician ) 
a prim>y specialty designation (        
psy*iatry or neurology1 b only if !     
physician self-atte/s t ! physician is  
,bo>d c]tifi$ 9 psy*iatry or neurology2 
4  7b7 ,con=m+ am5dm5t ,section         
#aije7;dd7 ( ! ,social ,security ,act   
7#db ,u4,s4,c4 #acif;d7dd77 is am5d$ by 
ins]t+ or furni%$ dur+ ! #b-ye> p]iod t 
beg9s on ! fir/ day ( ! fir/ mon? t     
beg9s aft] ! date ( enactm5t ( ! ,ensur+
 ,enhanc$ ,access to ,prim>y ,c>e ,act1 
aft] #bjae14