To amend the title XVIII of the Social Security Act to provide additional payments to Medicare ambulance suppliers for transports originating in certain rural areas with low population densities. 

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, 

SEC. 1. SHORT TITLE. 
This Act may be cited as the ‘‘Medicare Rural Ambulance Payment Reform Act of 2003’’. 

SEC. 2. RURAL AMBULANCE PAYMENT RATES. 
Section 1834(l) (42 U.S.C. 1395m(l)) is amended by adding at the end the following new paragraph: 

‘‘(9)  PAYMENT RATES TO LOW DENSITY RURAL PROVIDERS.—In the case of ground ambulance services furnished on or after January 1, 2004, for which the transportation originates within a zip code that has a low population density and is not in an urbanized area (as defined by the Bureau of the Census) the fee schedule established under this subsection shall be increased by: 

(a) 20% in zip codes with a population density less than 150 persons per square mile but more than 75 persons per square mile, 

(b) 150% in zip codes with a population density equal to or less than 75 persons per square mile but more than 25 persons per square mile, 

(c) 250% in zip codes with a population density equal to or less than 25 persons per square mile.” 

CONFORMING AMENDMENT. —Section 221(c) of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (114 Stat. 2763A–487), as enacted into law by section 1(a)(6) of Public Law 106–554, is repealed.