,i  #aaf? ,,congress  #a/ ,session  ,h4 
,r4 #ccjb  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,june #ah1 #bjai,ms4  
,f9k5au] 7= h]self1 ,mr4 ,k9d1 ,mr4     
,smi? ( ,nebraska1 ,mr4 ,la,hood1 & ,ms4
 ,sewell ( ,alabama7 introduc$ ! foll[+ 
bill2 :i* 0 ref]r$ to ! ,committee on   
,en]gy & ,comm]ce1 & 9 addition to !    
,committee on ,ways & ,means1 = a p]iod 
to be subsequ5tly det]m9$ by ! ,speak]1 
9 ea* case = consid]ation ( su*         
provisions z fall )9 ! jurisdiction ( ! 
committee conc]n$  ,a ,,bill  ,to am5d  
title ,,xviii ( ! ,social ,security ,act
 to improve ! accuracy ( geographic     
adju/m5t factors "u ! ,m$ic>e program & 
to p]man5tly ext5d c]ta9 adju/m5ts to   
su* factors = c]ta9 localities1 & = o!r 
purposes4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,keep ,physicians ,s]v+    
,pati5ts ,act ( #bjai4  #b4 ,improv+ !  
accuracy ( geographic adju/m5t factors  
,section #ahdh7;e77#a77;,d7 ( ! ,social 
,security ,act 7#db ,u4,s4,c4           
#aciew-#d7;e77#a77;,d77 is am5d$ to read

 z foll[s3  7,d7 ,use ( accurate data   
7i7 ,9 g5]al ,9 e/abli%+ indices & index
 values "u ?is p>agraph1 ! ,secret>y    
%all use ! mo/ rec5t data available     
relat+ to practice exp5ses1 malpractice 
exp5ses1 & physician "w ef=t 9 ea* fee  
s*$ule area4  7ii7 ,practice exp5se & "w
 indices ,9 e/abli%+ indices & index    
values "u clause 7i7 or 7iii7 (         
subp>agraph 7,a71 ! ,secret>y %all--    
7,i7 use ! mo/ rec5t m>ket data         
available on physician wages1 or if     
available1 actual co/ data = physician  
labor2 &  7,,ii7 n use nonphysician     
pr(essional wage data z a proxy =       
physician wage data4  7iii7 ,practice   
exp5se calculation ,9 calculat+ index   
values "u clause 7i7 ( subp>agraph 7,a71
 ! ,secret>y %all use ! mo/ rec5t (fice 
r5t data available or data f ,f$]ally   
qualifi$ heal? c5t]s 7z def9$ 9 section 
#ahfa7;aa77#d77 exp5se reports4  4  #c4 
,floor = "w & practice exp5se geographic
 indices  7a7 ,"w geographic index      
,section #ahdh7;e77#a77;,e7 ( ! ,social 

,security ,act 7#db ,u4,s4,c4           
#aciew-#d7;e77#a77;,e77 is am5d$-- 7#a7 
by /rik+ & be=e ,janu>y #a1 #bjbj12 &   
7#b7 by add+ at ! end ! foll[+3 ,any su*
 increase made = purposes ( paym5t =    
s]vices furni%$ on or aft] ,janu>y #a1  
#bjbj1 %all n be appli$ 9 a budget      
neutral mann]44  7b7 ,practice exp5se   
geographic indices ,section             
#ahdh7;e77#a77;,i7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4                    
#aciew-#d7;e77#a77;,i77 is am5d$-- 7#a7 
9 ! head]1 by /rik+ = s]vices furni%$ 9 
fronti] /ates2  7#b7 9 clause 7i71 by   
ins]t+ & = purposes ( paym5t = s]vices  
furni%$ 9 any ,/ate on or aft] ,janu>y  
#a1 #bjbj1 aft] #bjaa12 &  7#c7 9 clause
 7ii71 by ins]t+ be=e ,janu>y #a1 #bjbj1
 aft] furni%$4