103 STAT. 2180 PUBLIC LAW 101-239—DEC. 19, 1989 period ending with the preceding fiscal year (based upon information contained in the most recent annual report made pursuant to section 1841(b)(2)), and
- (iv) the Secretary's estimate of the percent^^e in-
crease or decrease in expenditures for physicians serv- ices (as defined in subsection (fKSXA)) in the fiscal year (compared with the preceding fiscal year) which will result from chemges in law or regulations and which is not taken into account in the percentage increase de- scribed in clause (i), reduced by the performance standard factor (specified in subparagraph (B)). In clause (i), the term 'fees' means, with respect to 1991, reasonable charges and, with respect to any succeeding year, fee schedule smiounts. " (B) PERFORMANCE STANDARD FACTOR.— For purposes of subparagraph (A), the performance standard factor— "(i) for 1991 is 1 percentage point, "(ii) for 1992 is 1 ¥2 percentage points, and "(iii) for each succeeding year is 2 percentage points. "(3) QUARTERLY REPORTING.—The Secretary shall establish procedures for providing, on a quarterly basis to the Physician Pajmient Review Commission, the Congressional Budget Office, the Congressional Research Service, the Committees on Ways and Means and Energy and Commerce of the House of Rep- resentatives, and the Committee on Finance of the Senate, information on compliance with performance standard rates of increase established under this subsection. "(4) SEPARATE GROUP-SPECIFIC PERFORMANCE STANDARD RATES OF INCREASE.— "(A) IMPLEMENTATION OF PLAN.—Subject to paragraph (B), the Secretary shall, after completion of the study re- quired under section 6102(e)(3) of the Omnibus Budget Rec- onciliation Act of 1989, but not before October 1, 1991, implement a plan under which qualified physician groups could elect annually separate performance standard rates of increase other than the performance standard rate of increase established for the year under paragraph (2) for such physicians. The Secretary shall develop criteria to determine which physician groups are eligible to elect to have applied to such groups separate performance standard rates of increase and the methods by which such group- specific performance standard rates of increase would be Reports. accomplished. The Secretary shall report to the Congress on the criteria and methods by April 15, 1991. The Physician Payment Review Commission shall review and comment on Federal such recommendations by May 15, 1991. Before implement- ^^^*®p ing group-specific performance standard rates of incresuse, publication. ^j^^ Secretary shall provide for notice and comment in the Federal Register and consult with organizations represent- ing physicians. "(B) APPROVAL.—The Secretary may not implement the plan described in subparagraph (A), unless Congress specifi- cally approves the plan. "(5) DEFINITIONS.—In this subsection: " (A) SERVICES INCLUDED IN PHYSICIANS' SERVICES. —The ) term 'physicians' services' includes other items and services (such as clinical diagnostic laboratory tests and radiology
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