Page:United States Statutes at Large Volume 101 Part 2.djvu/892

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101 STAT. 1330-98
101 STAT. 1330-98
PUBLIC LAW 100-000—MMMM. DD, 1987

101 STAT. 1330-98 42 USC 1395/ note.

PUBLIC LAW 100-203—DEC. 22, 1987

SEC. 4054. APPLYING COPAYMENT AND DEDUCTIBLE TO CERTAIN OUTPATIENT PHYSICIANS' SERVICES.

Notwithstanding any other provision of law, payment under part B of title XVIII of the Social Security Act for physicians' services specified in section 1833(i)(l) of such Act and furnished on or after April 1, 1988, in an ambulatory surgical center or hospital outpatient department on an assignment-related basis shall be subject to the deductible under section 1833(b) of such Act and 20 percent coinsurance. SEC. 4055. PHYSICIAN PAYMENT STUDIES. 42 USC 1395u

note. .4j

(a) DEFINITIONS OF M E D I C A L AND SURGICAL PROCEDURES.— (1) REPORT ON VARIATIONS IN CARRIER PAYMENT PRACTICE.—

The Secretary of Health and Human Services (in this section referred to as the "Secretary") shall conduct a study of variations in payment practices for physicians' services among the different carriers under section 1842 of the Social Security Act. Such study shall examine carrier variations in the services included in global fees and pre- and post-operative services included in payment for the operation. The Secretary shall report to Congress on such study by not later than May 1, 1988. (2) UNIFORM DEFINITIONS OF PROCEDURES FOR PAYMENT PUR-

POSES.—The Secretary shall develop, in consultation with appropriate national medical specialty societies and by not later than July 1, 1989, uniform definitions of physicians' services (including appropriate classification scheme for procedures) which could serve as the basis for making payments for such services under part B of title XVIII of the Social Security Act. In developing such list, to the extent practicable— (A) ancillary services commonly performed in conjunction with a major procedure would be included with the major procedure; (B) pre- and post-procedure services would be included in the procedure; and (C) similar procedures would be listed together if the procedures are similar in resource requirements. 42 USC 1395W-1 note.

i#x

Reports. Reports.

(b) EXPANSION OF RELATIVE VALUE SCALE (RVS) STUDY.— (1) ADDITIONAL SERVICES.—The Secretary shall expand

the study being conducted, under section 1845(e) of the Social Security Act, to develop a relative value scale for physicians' services to include physicians' services in the fields of cardiology, dermatology, emergency medicine, gastroenterology, hematology, infectious disease, nephrology, neurology, neurosurgery, nuclear medicine, oncology, physical medicine and rehabilitation, plastic surgery, pulmonary medicine, and radiation therapy, and for physicians who specialize in osteopathic procedures. (2) No DELAY IN CURRENT STUDY.—The expansion under paragraph (1) shall not be conducted in a manner that delays the completion of the current study or the report to Congress required under section 1845(e)(3) of the Social Security Act. The Secretary shall report to Congress on the services described in paragraph (1) by not later than October 1, 1989. (3) PROMPT SUBMITTAL OF STUDY RESULTS TO PHYSICIAN PAYMENT REVIEW COMMISSION.—The Secretary shall submit to the Physician Payment Review Commission a copy of any report submitted to the Secretary pursuant to a cooperative agreement in the fulfillment of the requirement of section 1845(e) of such