Page:United States Statutes at Large Volume 111 Part 1.djvu/471

From Wikisource
Jump to navigation Jump to search
This page needs to be proofread.

PUBLIC LAW 105-33—AUG. 5, 1997 111 STAT. 447 "(ii) SUBSEQUENT YEARS. —Subject to paragraph (8)(B), the Secretary shall establish a conversion factor for covered OPD services furnished in subsequent years in an amount equal to the conversion factor established under this subparagraph and applicable to such services furnished in the previous year increased by the OPD fee schedule increase factor specified under clause (iii) for the year involved. "(iii) OPD FEE SCHEDULE INCREASE FACTOR. — For purposes of this subparagraph, the 'OPD fee schedule increase factor' for services furnished in a year is equal to the market basket percentage increase applicable under section 1886(b)(3)(B)(iii) to hospital discharges occurring during the fiscal year ending in such year, reduced by 1 percentage point for such factor for services furnished in each of 2000, 2001, and 2002. In applying the previous sentence for years beginning with 2000, the Secretary may substitute for the market basket percentage increase an annual percentage increase that is computed and applied with respect to covered OPD services furnished in a year in the same manner as the market basket percentage increase is determined and applied to inpatient hospital services for discharges occurring in a fiscal year. "(D) CALCULATION OF MEDICARE OPD FEE SCHEDULE AMOUNTS. — The Secretary shall compute a medicare OPD fee schedule amount for each covered OPD service (or group ^ of such services) furnished in a year, in an amount equal to the product of— "(i) the conversion factor computed under subparagraph (C) for the year, and "(ii) the relative payment weight (determined under paragraph (2)(C)) for the service or group. "(E) PRE-DEDUCTIBLE PAYMENT PERCENTAGE.—The predeductible payment percentage for a covered OPD service (or group of such services) furnished in a year is equal to the ratio of— "(i) the medicare OPD fee schedule amount established under subparagraph (D) for the year, minus the unadjusted copa5ment amount determined under subparagraph (B) for the service or group, to "(ii) the medicare OPD fee schedule amount determined under subparagraph (D) for the year for such service or group. "(4) MEDICARE PAYMENT AMOUNT.—The amount of payment made from the Trust Fund under this part for a covered OPD service (and such services classified within a group) furnished in a year is determined as follows: "(A) FEE SCHEDULE ADJUSTMENTS. —The medicare OPD fee schedule amount (computed under paragraph (3)(D)) for the service or group and year is adjusted for relative differences in the cost of labor and other factors determined by the Secretary, as computed under paragraphs (2)(D) and (2)(E). " (B) SUBTRACT APPLICABLE DEDUCTIBLE.— Reduce the adjusted amount determined under subparagraph (A) by