Page:United States Statutes at Large Volume 101 Part 2.djvu/887

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101 STAT. 1330-93
PUBLIC LAW 100-000—MMMM. DD, 1987
101 STAT. 1330-93

PUBLIC LAW 100-203—DEC. 22, 1987

101 STAT. 1330-93

(1) a relative value scale to serve as the basis for the payment for physician pathology services under part B of title XVIII of the Social Security Act, (2) using such scale and appropriate conversion factors, proposed fee schedules (on a regional, statewide, or carrier service area basis) for payment for physician pathology services under such part, that could be implemented for such services furytf nished during 1990, and (3) an appropriate index to be applied to updating such fee schedules annually for physician pathology services furnished in years after 1990. (b) CONSULTATION.—In carrying out subsection (a), the Secretary shall regularly consult closely with the Physician Payment Review Commission, the College of American Pathologists, and other organizations representing physicians who furnish physician pathology services and shall share with them the data and data analysis being used to make the determinations under subsection (a), including data on variations in current medicare payments by geographic area, and by service and physician specialty. (c) CONSIDERATION.—In developing the fee schedules under subsection (a), the Secretary shall take into consideration variations in the cost of furnishing physician pathology services among geographic areas. (d) REPORT.—The Secretary shall report, not later than April 1, 1989, to the Committees on Energy and Commerce and Ways and Means of the House of Representatives and the Committee on Finance of the Senate on the relative value scale, fee schedules, and the index developed under this section. Such report shall include recommendations on how to protect medicare beneficiaries against excessive charges for physician pathology services above the payment amounts established by the fee schedules.

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SEC. 4051. ELIMINATION OF MARKUP FOR CERTAIN PURCHASED SERVICES.

(a) IN GENERAL.—Section 1842 of the Social Security Act (42 U.S.C. 42 USC I395u. 1935u) is amended by adding at the end the following new subsection: "(n)(l) If a physician's bill or a request for payment for services billed by a physician includes a charge to a patient for a diagnostic test described in section 1861(s)(3) (other than a clinical diagnostic » J ic) laboratory test) for which payment does not indicate that the billing physician personally performed or supervised the performance of the test or that another physician with whom the physician who shares his practice personally performed or supervised the test, the amount payable with respect to the test shall be determined as follows: "(A) If the bill or request for payment indicates that the test was performed by a supplier, identifies the supplier, and indicates the amount the supplier charged the billing physician, ' i ^•"'." "^ t J payment for the test (less the applicable deductible and coinsurance amounts) shall be the actual acquisition costs (net of any r discounts) or, if lower, the [ ] [ ] [ ] [ ]

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]32a enrolled under [ ] [ ] [ ] [ ] - [ ].^* "(B) If the bill or request for payment (i) does not indicate who performed the test, or (ii) indicates that the test was performed by a supplier but does not identify the supplier or include the '" Copy not legible.