,i  #aahth ,,congress  #b;d ,session    
,h4 ,r4 #hefc  ,,in ,,the ,,house ,,of  
,,representatives  ,may #bc1 #bjbd,ms4  
,tokuda 7for herself and ,mr4 ,case7    
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 establish a floor on  
the work geographic index for           
physicians' services furnished in       
,hawaii4  #a4 ,short title ,this ,act   
may be cited as the ,preserving ,access 
,to ,care in ,hawaii ,act or the ,,patch
 ,act4  #b4 ,floor on work geographic   
index for physicians' services furnished
 in ,hawaii ,section #ahdh7;e7 of the   
,social ,security ,act 7#db ,u4,s4,c4   
#aciew-#d7;e77 is amended-- 7#a7 in     

paragraph 7#a77;,a71 in the matter      
preceding clause 7i71 by striking and   
7,i7 and inserting 7,i71 and 7,j72 and  
7#b7 by adding at the end the following 
new subparagraph3  7,j7 ,floor on work  
geographic index for services furnished 
in ,hawaii ,for purposes of payment for 
services furnished in ,hawaii on or     
after ,january #a1 #bjbe1 after         
calculating the work geographic index in
 subparagraph 7,a77iii71 the ,secretary 
shall increase the work geographic index
 to #a4e if such index would otherwise  
be less than #a4e4 ,the preceding       
sentence shall not be applied in a      
budget neutral manner4  4