PUBLIC LAW 101-508—NOV. 5, 1990 104 STAT. 1388-59 SEC. 4104. PHYSICIAN PATHOLOGY SERVICES. (a) REDUCTION IN PAYMENTS FOR PHYSICIAN PATHOLOGY SERV- ICES.— Subsection (f) of section 1834 (42 U.S.C. 1395m) is amended to read as follows: "(f) REDUCTION IN PAYMENTS FOR PHYSICIAN PATHOLOGY SERVICES DURING FISCAL YEAR 1991. — "(1) IN GENERAL.— For physician pathology services furnished under this part during 1991, the prevailing charges used in a locality under this part shall be 7 percent below the prevailing charges used in the locality under this part in 1990 after March 31. "(2) LIMITATION.— The prevailing charge for the technical and professional components of an physician pathology service furnished by a physician through an independent laboratory shall not be reduced pursuant to paragraph (1) to the extent that such reduction would reduce such prevailing charge below 115 percent of the prevailing charge for the professional component of such service when furnished by a hospital-based physician in the same locality. For purposes of the preceding sentence, an independent laboratory is a laboratory that is independent of a hospital and separate from the attending or consulting physicians' office.". (b) CONFORMING AMENDMENTS. — (1) Section 1833(a)(l)(J) of such Act (42 U.S.C. 13951(a)(1)) is amended by striking "or physician pathology services" and by striking "or section 1834(f), respectively". (2) Section 1848(a)(1) of such Act (42 U.S.C. 1395w-4(a)(l)) is amended by striking "or 1834(f)". (3) Section 4050 of the Omnibus Budget Reconciliation Act of 1987 is repealed. (c) ANCILLARY POLICY.— The Secretary of Health and Human Services, in establishing ancillary policies under section 1848(c)(3) of the Social Security Act, shall consider an appropriate adjustment to reflect the technical component of furnishing physician pathology services through a laboratory that is independent of a hospital and separate from an attending or consulting physician's office. (d) EFFECTIVE DATE. —The amendments made by this section shall apply to services furnished on or after January 1, 1991. SEC. 4105. UPDATE FOR PHYSICIANS'SERVICES. (a) PERCENTAGE INCREASE IN MEI FOR 1991. — (1) IN GENERAL.— Section 1842(b)(4)(E) (42 U.S.C. 1395u(b)(4)(E)) is amended by adding at the end the following new clause: "(v) For purposes of this part for items and services furnished in 1991, the percentage increase in the MEI is— "(I) 0 percent for services (other than primary care services), and "(II) 2 percent for primary care services (as defined in subsection (i)(4)). ". (2) CUSTOMARY CHARGES FOR 1991.— Section 184203)(4)(B) (42 U.S.C. 1395u(b)(4)(B)) is amended by adding at the end the following new clause: "(iv) In determining the reasonable charge under paragraph (3) for physicians' services (other than primary care services, as defined in subsection (i)(4)) furnished during 1991, the customary charges shall be the same customary charges as were recognized under this 42 USC 1395/ note. 42 USC 1395W-4 note. 42 USC 1395Z note.