Page:United States Statutes at Large Volume 100 Part 3.djvu/198

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PUBLIC LAW 99-000—MMMM. DD, 1986

100 STAT. 2006 42 USC 1395x note.

42 USC 1395x note.

PUBLIC LAW 99-509—OCT. 21, 1986

(b) CONSIDERATIONS IN ESTABLISHING LIMITS.—In establishing limitations under section 1861(v)(l)(L) of the Social Security Act on payment for home health services for cost reporting periods beginning on or after July 1, 1986, the Secretary of Health and Human Services shall— (1) base such limitations on the most recent data available, which data may be for cost reporting periods beginning no t - " earlier than October 1, 1983; and (2) take into account the changes in costs of home health agencies for billing and verification procedures that result from the Secretary's changing the requirements for such procedures, to the extent the changes in costs are not reflected in such data. Paragraph (2) shall apply to changes in requirements effected before, on, or after July 1, 1986. (c) GAO REPORT.—The Comptroller General shall study and report to Congress, not later than February 1, 1988, on— (1) the appropriateness and impact on medicare beneficiaries of applying the per visit cost limits for home health services under section 1861(v)(l)(L) of the Social Security Act on a discipline-specific basis, rather than on an aggregate basis, for all home health services furnished by an agency, and (2) the appropriateness of the percentage limits established under such section. SEC. 9316. ESTABLISHMENT OF PATIENT OUTCOME ASSESSMENT RESEARCH PROGRAM.

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Health care professionals, contracts. 42 USC 1320c.

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(a) IN GENERAL,—Section 1875 of the Social Security Act (42 U.S.C. 139511) is amended by adding at the end the following new subsection: "(c)(1) The Secretary shall establish a patient outcome assessment research program (in this subsection referred to as the 'research program') to promote research with respect to patient outcomes of selected medical treatments and surgical procedures for the purpose of assessing their appropriateness, necessity, and effectiveness. The research program shall include— "(A) reorganization of data relating to claims under parts A

  • ' * and B of this title in a manner that facilitates research with

respect to patient outcomes, "(B) assessments of the appropriateness of admissions and ,,^; discharges, "(C) assessments of the extent of professional uncertainty tlJ regarding efficacy, "(D) development of improved methods for measuring patient outcomes, «W' "(E) evaluations of patient outcomes, and "(F) evaluation of the effects on physicians' practice patterns of the dissemination to physicians and peer review organizations with contracts under part B of title XI of the findings of the research conducted under subparagraphs (B), (C), (D), ».. and (E). "(2) In selecting treatments and procedures to be studied, the Secretary shall give priority to those medical and surgical treatments and procedures— "(A) for which data indicate a highly (or potentially highly) variable pattern of utilization among beneficiaries under this XG title in different geographic areas, and