102 STAT. 700
Contracts.
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PUBLIC LAW 100-360-JULY 1, 1988
(1) in subsection (c)— (A) by striking "subsections (a) and (b)" and inserting "subsection (a) through (c)", (B) by redesignating paragraphs (1) and (2) as subparagraphs (A) and (B), (C) by striking "this subsection" and inserting "this paragraph, and (D) by striking "(c)" and inserting "(d)(D"; (2) by redesi^ating subsection (d) as paragraph (2); (3) in subsection (g), by striking "(a) and (b)" and inserting "(a) through (c)"; and (4) by inserting after subsection (b) the following new subsection: "(c)(1) Notwithstanding subsections (a) and (b), if an individual has incurred out-of-pocket part B cost sharing (as defined in paragraph (2)) in a calendair year (bc^ginning with 1990) in an amount equal to the part B catastrophic limit (established under paragraph (3)) for the year, payment under this part with respect to any additional incurred expenses in the calendar year shall be made as if— "(A) the deduction described in the second sentence of subsection (b) (relating to blood) no longer applied, and "(B) '100 percent' and '0 percent' were substituted for '80 percent' and *20 percent', respectively, each place either appears in subsections (a) and (i)(2), in sections 1834(a)(l)(A), 1834(e)(l)(C), 1835(b)(2), and 1866(a)(2)(A), and in subsections (b)(2) and (b)(3) of section 1881, except as such provisions may apply to in-home care. "(2) Li this subsection, the term 'out-of-pocket part B cost sharing' means, with respect to an individual covered under this part, the amounts of expenses that the individual incurs that are attributable to— "(A) the deductions established under subsection (b), and "(B) the difference between the payment amount provided under this part and the payment amount that would be provided if '100 percent' and '0 percent' were substituted for *80 percent' and '20 percent', respectively, each place either appears in subsections (a) and (i)(2), in sections 1834(a)(l)(A), 1834(e)(l)(C), 1835(b)(2), and 1866(a)(2)(A), and in subsections 01)X2) and (b)(3) of section 1881. "(3)(A) The part B catastrophic limit for 1990 is $1,370. The part B catastrophic limit for any succeeding year shall be such an amount (rounded to the nearest multiple of $1) as the Secretary estimates will result, in that succeeding year, in 7 percent of the average number of individuals enrolled under this part (other than individuals enrolled with an eligible organization under section 1876 or an organization described in subsection (a)(l)(A)) during the year becoming entitled to benefits under this subsection. "(B) Not later than September 1 of each year (begmnii^ with 1990), the Secretary shall promulgate the part B catastrophic limit under this paragraph for the succeeding year. "(4) In the case of an organization receiving payment under clause (A) of subsection (a)(l) or under a reasonable cost reimbursement contract under section 1876, in applying paragraph (1), the Secretary s h ^ provide for an appropriate adjustment in the payment amounts otherwise made to reflect the aggr^ate increase in payments that would otherwise be made with respect to enrollees in
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