113 STAT. 1501A-352 PUBLIC LAW 106-113—APPENDIX F (2) EFFECTIVE DATE.— The amendment made by paragraph (1) shall take effect as if included in the enactment of section 4541 of BBA. (d) STUDY AND REPORT ON UTILIZATION.— (1) STUDY.— (A) IN GENERAL.—The Secretary of Health and Human Services shall conduct a study which compares— (i) utilization patterns (including nationwide patterns, and patterns by region, types of settings, and diagnosis or condition) of outpatient physical therapy services, outpatient occupational therapy services, and speech-language pathology services that are covered under the medicare program under title XVIII of the Social Security Act (42 U.S.C. 1395) and provided on or after January 1, 2000; with (ii) such patterns for such services that were provided in 1998 and 1999. (B) REVIEW OF CLAIMS. —In conducting the study under this subsection the Secretary of Health and Human Services shall review a statistically significant number of claims for reimbursement for the services described in subparagraph (A). (2) REPORT.— Not later than June 30, 2001, the Secretary of Health and Human Services shall submit a report to Congress on the study conducted under paragraph (1), together with any recommendations for legislation that the Secretary determines to be appropriate as a result of such study. SEC. 222. UPDATE IN RENAL DIALYSIS COMPOSITE RATE. (a) IN GENERAL. —Section 1881(b)(7) (42 U.S.C. 1395rr(b)(7)) is amended by adding at the end the following new flush sentence: 'The Secretary shall increase the amount of each composite rate payment for dialysis services furnished during 2000 by 1.2 percent above such composite rate payment amounts for such services furnished on December 31, 1999, and for such services furnished on or after January 1, 2001, by 1.2 percent above such composite rate payment amounts for such services furnished on December 31, 2000. ". (b) CONFORMING AMENDMENT.— The second sentence of section 9335(a)(1) of the Omnibus Budget Reconciliation Act of 1986 (42 U.S.C. 1395rr note) is amended by inserting "and before January 1, 2000," after "on or after January 1, 1991,". (c) STUDY ON PAYMENT LEVEL FOR HOME HEMODIALYSIS.— The Medicare Payment Advisory Commission shall conduct a study on the appropriateness of the differential in payment under the medicare program for hemodialysis services furnished in a facility and such services furnished in a home. Not later than 18 months after the date of the enactment of this Act, the Commission shall submit to Congress a report on such study and shall include recommendations regarding changes in medicare payment policy in response to the study. SEC. 223. IMPLEMENTATION OF THE INHERENT REASONABLENESS (IR) AUTHORITY. (a) LIMITATION ON USE.— The Secretary of Health and Human Services may not use, or permit fiscal intermediaries or carriers to use, the inherent reasonableness authority provided under section
�
