Rural Health Care Fairness and Medicare Equity Act of 2003

Rural Health Care Fairness and Medicare Equity Act of 2003 - Amends title XVIII (Medicare) of the Social Security Act (SSA) to direct the Secretary of Health and Human Services, for discharges occurring in a fiscal year beginning with FY 2004, to compute a standardized amount for hospitals in rural and small urban areas that is equal to the standardized amount computed for the previous fiscal year for hospitals located in a large urban area increased by the applicable percentage increase for the fiscal year involved.

Sets the wage index at 62 percent for discharges occurring in FY 2004, except that hospitals receiving lower payments as a result of such new wage index would be held harmless.

Creates a wage index floor for use in determining payments for discharges occurring in FY 2004 for hospitals with a wage index under 0.85.

Directs the Secretary to publish and use alternative guidelines for geographic reclassification of certain hospitals located in sparsely populated States.

Establishes a floor of 1.00 for the work geographic cost-of-practice index under the physician payment system.