Ill STAT. 460 PUBLIC LAW 105-33 —AUG. 5, 1997 (1) OXYGEN. — The amendments made by subsection (a) shall apply to items furnished on and after January 1, 1998. (2) OTHER PROVISIONS.—The amendments made by this section other than subsection (a) shall take effect on the date of the enactment of this Act. SEC. 4553. REDUCTION IN UPDATES TO PAYMENT AMOUNTS FOR CLINI- CAL DIAGNOSTIC LABORATORY TESTS; STUDY ON LAB- ORATORY TESTS. (a) CHANGE IN UPDATE. —Section 1833(h)(2)(A)(ii)(IV) (42 U.S.C. 13951(h)(2)(A)(ii)(IV)) is amended by inserting "and 1998 through 2002" after "1995". (b) LOWERING CAP ON PAYMENT AMOUNTS.— Section 1833(h)(4)(B) (42 U.S.C. 13951(h)(4)(B)) is amended— (1) in clause (vi), by striking "and" at the end; (2) in clause (vii)— (A) by inserting "and before January 1, 1998," after "1995,", and (B) by striking the period at the end and inserting ", and"; and (3) by adding at the end the following new clause: "(viii) after December 31, 1997, is equal to 74 percent of such median.". 42 USC 1395/ (c) STUDY AND REPORT ON CLINICAL LABORATORY TESTS.— note. (1) IN GENERAL.— The Secretary shall request the Institute of Medicine of the National Academy of Sciences to conduct a study of payments under part B of title XVIII of the Social Security Act for clinical laboratory tests. The study shall include a review of the adequacy of the current methodology and recommendations regarding alternative payment systems. The study shall also analyze and discuss the relationship between such payment systems and access to high quality laboratory tests for medicare beneficiaries, including availability and access to new testing methodologies. (2) REPORT TO CONGRESS. —The Secretary shall, not later than 2 years after the date of enactment of this section, report to the Committees on Ways and Means and Commerce of the House of Representatives and the Committee on Finance of the Senate the results of the study described in paragraph (1), including any recommendations for legislation. 42 USC 1395 U.SEC. 4554. IMPROVEMENTS IN ADMINISTRATION OF LABORATORY note. TESTS BENEFIT. (a) SELECTION OF REGIONAL CARRIERS. — (1) IN GENERAL.— The Secretary of Health and Human Services (in this section referred to as the "Secretary") shall— (A) divide the United States into no more than 5 regions, and (B) designate a single carrier for each such region, for the purpose of pa3rtnent of claims under part B of title XVIII of the Social Security Act with respect to clinical diagnostic laboratory tests furnished on or after such date (not later than July 1, 1999) as the Secretary specifies. (2) DESIGNATION. —In designating such carriers, the Secretary shall consider, among other criteria— (A) a carrier's timeliness, quality, and experience in claims processing, and
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