114 STAT. 2763A-486 PUBLIC LAW 106-554—APPENDIX F (2) in subclause (I), by striking "target amount otherwise applicable" and all that follows through "target amount')" and inserting "the amount otherwise applicable to the hospital under subsection (d)(5)(D)(i) (referred to in this clause as the 'subsection (d)(5)(D)(i) amount')"; and (3) in each of subclauses (II) and (III), by striking "subparagraph (C) target amount" and inserting "subsection (d)(5)(D)(i) amount". (b) EFFECTIVE DATE. —The amendments made by this section shall take effect as if included in the enactment of section 405 of BBRA(113 Stat. 1501A-372). SEC. 214. MEDPAC ANALYSIS OF IMPACT OF VOLUME ON PER UNIT COST OF RURAL HOSPITALS WITH PSYCHIATRIC UNITS. The Medicare Payment Advisory Commission, in its study conducted pursuant to subsection (a) of section 411 of BBRA (113 Stat. 1501A-377), shall include— (1) in such study an analysis of the impact of volume on the per unit cost of rural hospitals with psychiatric units; and (2) in its report under subsection (b) of such section a recommendation on whether special treatment for such hospitals may be warranted. Subtitle C—Other Rural Provisions SEC. 221. ASSISTANCE FOR PROVIDERS OF AMBULANCE SERVICES IN RURAL AREAS. (a) TRANSITIONAL ASSISTANCE IN CERTAIN MILEAGE RATES.— Section 1834(1) (42 U.S.C. 1395m(l)) is amended by adding at the end the following new paragraph: " (8) TRANSITIONAL ASSISTANCE FOR RURAL PROVIDERS.— In the case of ground ambulance services furnished on or after July 1, 2001, and before January 1, 2004, for which the transportation originates in a rural area (as defined in section 1886(d)(2)(D)) or in a rural census tract of a metropolitan statistical area (as determined under the most recent modification of the Goldsmith Modification, originally published in the Federal Register on February 27, 1992 (57 Fed. Reg. 6725)), the fee schedule established under this subsection shall provide that, with respect to the payment rate for mileage for a trip above 17 miles, and up to 50 miles, the rate otherwise established shall be increased by not less than Vi of the additional payment per mile established for the first 17 miles of such a trip originating in a rural area.". (b) GAO STUDIES ON THE COSTS OF AMBULANCE SERVICES FUR- NISHED IN RURAL AREAS. — (1) STUDY. —The Comptroller General of the United States shall conduct a study on each of the matters described in paragraph (2). (2) MATTERS DESCRIBED. —The matters referred to in paragraph (1) are the following: (A) The cost of efficiently providing ambulance services for trips originating in rural areas, with special emphasis on collection of cost data from rural providers.
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