To amend title XVIII of the Social Security Act to increase the bonus payment provided for physicians' services furnished under part B of the medicare program in a health professional shortage area to 20 percent in the case or primary care services, to establish updates for 1995 in the conversion factors used to determine the amount of payment made for physicians' services under the medicare program, and for other purposes.

Referred to the Subcommittee on Health and the Environment.

Congressional Research Service

Official summary

Version 00 · Introduced in House · Jun 30, 1994

Amends title XVIII (Medicare) of the Social Security Act to increase from ten percent to 20 percent the bonus payment provided for physicians' primary care services furnished under part B of the Medicare program in a health professional shortage area. Extends such bonus payments to certain nonphysician providers and other Medicare-dependent providers in such areas. Establishes the following updates for 1995 in the conversion factors used to determine the amount of Medicare payments: (1) 10.7 percent for surgical services; (2) 10.1 percent for primary care services; and (3) 7.4 percent for all other services.

Read the summary on Congress.gov

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People & committees

Who introduced it

Rep. Lambert, Blanche M. [D-AR-1] · D–AR

Committees

Energy and Commerce Committee
Ways and Means Committee

0 cosponsorship records, including any withdrawals

Legislative record

Actions

A procedural vote is different from passage. Passage in one chamber does not establish enactment. Explore the glossary.

Jul 22, 1994
Referred to the Subcommittee on Health and the Environment.
Jul 7, 1994
Referred to the Subcommittee on Health.
Jun 30, 1994
Referred to the House Committee on Ways and Means.
Jun 30, 1994
Referred to the House Committee on Energy and Commerce.
Jun 30, 1994
Sponsor introductory remarks on measure. (CR H5457, E1395-1396)
Jun 30, 1994
Introduced in House
Jun 30, 1994
Introduced in House

Primary sources

Bill text & related measures

Text links open the official source. We currently store references to these documents.

Introduced in House · Jun 30, 1994 Formatted Text PDF

Related bills identified by Congress.gov

No related bills are listed in this snapshot. This does not establish whether the proposal has appeared in earlier Congresses.

Source last updated: Jun 3, 2026. Consult Congress.gov for the current record.

AI Conversation Starters

Explore the bill from different angles

Choose a perspective, copy a prompt, and paste it into your preferred AI. Each prompt includes the bill version and available official source links, and asks for counterarguments as well as supporting evidence.

Neutral evidence review

Objective

Analyze H.R.4689 as objectively as possible. Explain its main provisions, who would be affected, possible benefits and harms, implementation, exceptions, and uncertainties. Present the strongest arguments for and against it, and identify evidence needed to assess its public impact.

View full prompt & sources

Discuss H.R.4689, 103rd Congress: To amend title XVIII of the Social Security Act to increase the bonus payment provided for physicians' services furnished under part B of the medicare program in a health professional shortage area to 20 percent in the case or primary care services, to establish updates for 1995 in the conversion factors used to determine the amount of payment made for physicians' services under the medicare program, and for other purposes.

Official record: https://www.congress.gov/bill/103rd-congress/house-bill/4689

Text version to examine: Introduced in House · 1994-06-30.

Official full text: https://www.congress.gov/103/bills/hr4689/BILLS-103hr4689ih.htm

Imported record last updated by the source: 2026-06-03T16:29:19Z. Verify current status and distinguish any later version from the version above.

Read the official text before answering. If you cannot access it, say so and ask me to provide it; do not assume a link means you have read the document. Distinguish proposals from enacted law, cite sources, and separate facts, interpretation, and uncertain predictions. Include counterarguments even when using a particular perspective.

Analyze H.R.4689 as objectively as possible. Explain its main provisions, who would be affected, possible benefits and harms, implementation, exceptions, and uncertainties. Present the strongest arguments for and against it, and identify evidence needed to assess its public impact.

Fairness and public impact

Progressive lens

Examine H.R.4689 through a progressive lens, focusing on fairness, access, economic inequality, and effects on vulnerable communities. Explain potential benefits, costs, and unintended consequences. Consider the strongest counterarguments and distinguish stated goals from demonstrated outcomes.

View full prompt & sources

Discuss H.R.4689, 103rd Congress: To amend title XVIII of the Social Security Act to increase the bonus payment provided for physicians' services furnished under part B of the medicare program in a health professional shortage area to 20 percent in the case or primary care services, to establish updates for 1995 in the conversion factors used to determine the amount of payment made for physicians' services under the medicare program, and for other purposes.

Official record: https://www.congress.gov/bill/103rd-congress/house-bill/4689

Text version to examine: Introduced in House · 1994-06-30.

Official full text: https://www.congress.gov/103/bills/hr4689/BILLS-103hr4689ih.htm

Imported record last updated by the source: 2026-06-03T16:29:19Z. Verify current status and distinguish any later version from the version above.

Read the official text before answering. If you cannot access it, say so and ask me to provide it; do not assume a link means you have read the document. Distinguish proposals from enacted law, cite sources, and separate facts, interpretation, and uncertain predictions. Include counterarguments even when using a particular perspective.

Examine H.R.4689 through a progressive lens, focusing on fairness, access, economic inequality, and effects on vulnerable communities. Explain potential benefits, costs, and unintended consequences. Consider the strongest counterarguments and distinguish stated goals from demonstrated outcomes.

Institutions and government scope

Conservative lens

Examine H.R.4689 through a conservative lens, focusing on fiscal responsibility, institutional stability, federalism, and the scope of government. Explain potential benefits, costs, and unintended consequences. Consider the strongest counterarguments and any provisions that challenge this perspective.

View full prompt & sources

Discuss H.R.4689, 103rd Congress: To amend title XVIII of the Social Security Act to increase the bonus payment provided for physicians' services furnished under part B of the medicare program in a health professional shortage area to 20 percent in the case or primary care services, to establish updates for 1995 in the conversion factors used to determine the amount of payment made for physicians' services under the medicare program, and for other purposes.

Official record: https://www.congress.gov/bill/103rd-congress/house-bill/4689

Text version to examine: Introduced in House · 1994-06-30.

Official full text: https://www.congress.gov/103/bills/hr4689/BILLS-103hr4689ih.htm

Imported record last updated by the source: 2026-06-03T16:29:19Z. Verify current status and distinguish any later version from the version above.

Read the official text before answering. If you cannot access it, say so and ask me to provide it; do not assume a link means you have read the document. Distinguish proposals from enacted law, cite sources, and separate facts, interpretation, and uncertain predictions. Include counterarguments even when using a particular perspective.

Examine H.R.4689 through a conservative lens, focusing on fiscal responsibility, institutional stability, federalism, and the scope of government. Explain potential benefits, costs, and unintended consequences. Consider the strongest counterarguments and any provisions that challenge this perspective.

Individual rights and government power

Liberty lens

Examine H.R.4689 through a civil-liberties and limited-government lens. Consider individual rights, privacy, voluntary choice, accountability, and government power. Explain tradeoffs, possible safeguards, and the strongest counterarguments without assuming the proposal is beneficial or harmful.

View full prompt & sources

Discuss H.R.4689, 103rd Congress: To amend title XVIII of the Social Security Act to increase the bonus payment provided for physicians' services furnished under part B of the medicare program in a health professional shortage area to 20 percent in the case or primary care services, to establish updates for 1995 in the conversion factors used to determine the amount of payment made for physicians' services under the medicare program, and for other purposes.

Official record: https://www.congress.gov/bill/103rd-congress/house-bill/4689

Text version to examine: Introduced in House · 1994-06-30.

Official full text: https://www.congress.gov/103/bills/hr4689/BILLS-103hr4689ih.htm

Imported record last updated by the source: 2026-06-03T16:29:19Z. Verify current status and distinguish any later version from the version above.

Read the official text before answering. If you cannot access it, say so and ask me to provide it; do not assume a link means you have read the document. Distinguish proposals from enacted law, cite sources, and separate facts, interpretation, and uncertain predictions. Include counterarguments even when using a particular perspective.

Examine H.R.4689 through a civil-liberties and limited-government lens. Consider individual rights, privacy, voluntary choice, accountability, and government power. Explain tradeoffs, possible safeguards, and the strongest counterarguments without assuming the proposal is beneficial or harmful.