,i  #aahth ,,congress  #ast ,session    
,h4 ,r4 #fcac  ,,in ,,the ,,house ,,of  
,,representatives  ,november #h1        
#bjbc,mr4 ,smith of ,nebraska 7for      
himself1 ,mr4 ,la,hood1 ,ms4 ,sewell1   
and ,ms4 ,stansbury7 introduced the     
following bill2 which was referred to   
the ,committee on ,energy and ,commerce1
 and in addition to the ,committee on   
,ways and ,means1 for a period to be    
subsequently determined by the ,speaker1
 in each case for consideration of such 
provisions as fall within the           
jurisdiction of the committee concerned 
,a ,,bill  ,to amend title ,,xviii of   
the ,social ,security ,act to improve   
the accuracy of geographic adjustment   
factors under the ,medicare program and 
to permanently extend certain           
adjustments to such factors for certain 
localities1 and for other purposes4  #a4
 ,short title ,this ,act may be cited as
 the ,keep ,physicians ,serving         
,patients ,act of #bjbc4  #b4 ,improving
 the accuracy of geographic adjustment  

factors ,section #ahdh7;e77#a77;,d7 of  
the ,social ,security ,act 7#db         
,u4,s4,c4 #aciew-#d7;e77#a77;,d77 is    
amended to read as follows3  7,d7 ,use  
of accurate data  7i7 ,in general ,in   
establishing indices and index values   
under this paragraph1 the ,secretary    
shall use the most recent data available
 relating to practice expenses1         
malpractice expenses1 and physician work
 effort in each fee schedule area4  7ii7
 ,practice expense and work indices ,in 
establishing indices and index values   
under clause 7i7 or 7iii7 of            
subparagraph 7,a71 the ,secretary       
shall-- 7,i7 use the most recent market 
data available on physician wages1 or if
 available1 actual cost data for        
physician labor2 and  7,,ii7 not use    
nonphysician professional wage data as a
 proxy for physician wage data4  7iii7  
,practice expense calculation ,in       
calculating index values under clause   
7i7 of subparagraph 7,a71 the ,secretary
 shall use the most recent office rent  

data available or data from ,federally  
qualified health centers 7as defined in 
section #ahfa7;aa77#d77 expense reports4
  4  #c4 ,floor for work and practice   
expense geographic indices  7a7 ,work   
geographic index ,section               
#ahdh7;e77#a77;,e7 of the ,social       
,security ,act 7#db ,u4,s4,c4           
#aciew-#d7;e77#a77;,e77 is amended--    
7#a7 by striking and before ,january #a1
 #bjbd12 and  7#b7 by adding at the end 
the following3 ,any such increase made  
for purposes of payment for services    
furnished on or after ,january #a1      
#bjbd1 shall not be applied in a budget 
neutral manner44  7b7 ,practice expense 
geographic indices ,section             
#ahdh7;e77#a77;,i7 of the ,social       
,security ,act 7#db ,u4,s4,c4           
#aciew-#d7;e77#a77;,i77 is amended--    
7#a7 in the header1 by striking for     
services furnished in frontier states2  
7#b7 in clause 7i71 by inserting and for
 purposes of payment for services       
furnished in any ,state on or after     

,january #a1 #bjbd1 after #bjaa12 and   
7#c7 in clause 7ii71 by inserting before
 ,january #a1 #bjbd1 after furnished4