114 STAT. 2763A-502 PUBLIC LAW 106-554—APPENDIX F Subtitle D—Other Provisions SEC. 331. RELIEF FROM MEDICARE PART A LATE ENROLLMENT PEN- ALTY FOR GROUP BUY-IN FOR STATE AND LOCAL RETIR- EES. (a) IN GENERAL.—Section 1818 (42 U.S.C. 1395i-2) is amended— (1) in subsection (c)(6), by inserting before the semicolon at the end the following: "and shall be subject to reduction in accordance with subsection (d)(6)"; and (2) by adding at the end of subsection (d) the following new paragraph: "(6)(A) In the case where a State, a political subdivision of a State, or an agency or instrumentality of a State or political subdivision thereof determines to pay, for the life of each individual, the monthly premiums due under paragraph (1) on behalf of each of the individuals in a qualified State or local government retiree group who meets the conditions of subsection (a), the amount of any increase otherwise applicable under section 1839(b) (as applied and modified by subsection (c)(6) of this section) with respect to the monthly premium for benefits under this part for an individual who is a member of such group shall be reduced by the total amount of taxes paid under section 3101(b) of the Internal Revenue Code of 1986 by such individual and under section 3111(b) by the employers of such individual on behalf of such individual with respect to employment (as defined in section 3121(b) of such Code). "(B) For purposes of this paragraph, the term 'qualified State or local government retiree group' means all of the individuals who retire prior to a specified date that is before January 1, 2002, from employment in one or more occupations or other broad classes of employees of— "(i) the State; "(ii) a political subdivision of the State; or "(iii) an agency or instrumentality of the State or political subdivision of the State.". (b) EFFECTIVE DATE. —The amendments made by subsection (a) shall apply to premiums for months beginning with January 1, 2002. TITLE IV—PROVISIONS RELATING TO PARTE Subtitle A—Hospital Outpatient Services SEC. 401. REVISION OF HOSPITAL OUTPATIENT PPS PAYMENT UPDATE. (a) IN GENERAL.—Section 1833(t)(3)(C)(iii) (42 U.S.C. 13951(t)(3)(C)(iii)) is amended by striking "in each of 2000, 2001, and 2002" and inserting "in each of 2000 and 2002". (b) ADJUSTMENT FOR CASE MIX CHANGES.— (1) IN GENERAL.—Section 1833(t)(3)(C) (42 U.S.C. 13951(t)(3)(C)) is amended— (A) by redesignating clause (iii) as clause (iv); and (B) by inserting after clause (ii) the following new clause:
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