Page:United States Statutes at Large Volume 100 Part 3.djvu/197

 PUBLIC LAW 99-509—OCT. 21, 1986

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100 STAT. 2005

to conduct the study and may enter into an appropriate arrangement for the conduct of the study by the entity which submits the best acceptable application. (B) In developing plans for the conduct of the study, the Secretary shall assure that consumer and provider groups, peer review organizations, the Joint Commission on Accreditation of Hospitals, professional societies, and private purchasers of care with experience and expertise in the monitoring of the quality of care are consulted. (5) COORDINATION.—The Secretary shall designate an office with responsibilities for coordinating studies, under this subsection and other authority, relating to the quality of services furnished to medicare and medicaid beneficiaries, in particular studies relating to the evaluation of the prospective payment system on the quality of health care provided to medicare beneficiaries. These responsibilities shall include assessing the feasibility and costs of alternative studies in relation to their importance, overseeing and coordinating access to needed data, and maintaining a clearinghouse for both public and private sector studies.

SEC. 9314. DIRECT COSTS OF GRADUATE MEDICAL EDUCATION. (a) CLARIFYING COUNTING OF TIME SPENT IN OUTPATIENT SET-

TINGS.—Section 1886(h)(4) of such Act, as amended by section 1895(b) 42 USC 1395WW. of the Tax Reform Act of 1986, is amended by adding at the end the Post, p. 2095. following new subparagraph: "(E)

COUNTING TIME SPENT IN OUTPATIENT SETTINGS.—

Health care facilities.

Such rules shall provide that only time spent in activities relating to patient care shall be counted and that all the ^ time so spent by a resident under an approved medical residency training program shall be counted towards the determination of full-time equivalency, without regard to ! the setting in which the activities are performed, if the hospital incurs all, or substantially all, of the costs for the training program in that setting.". (b) EFFECTIVE DATE.—The amendments made by subsection (a) 42 USC 1395WW shall apply to payments for approved residency training programs note. asof July 1, 1987. SEC. 9315. PAYMENTS FOR HOME HEALTH SERVICES. (a) LIMITATIONS ON PAYMENT FOR HOME HEALTH SERVICES.—Sec-

tion 1861(v)(l)(L) of the Social Security Act (42 U.S.C. 1395x(v)(l)(L)) is amended— . (1) by inserting "(i)" after "(L)", and (2) by striking "the 75th percentile" and all that follows through "as the Secretary may determine." and inserting in lieu thereof "for cost reporting periods beginning on or after— "(I) July 1, 1985, and before July 1, 1986, 120 percent, "(II) July 1, 1986, and before July 1, 1987, 115 percent, or .> •^• "(III) July 1, 1987,112 percent, of the mean of the labor-related and nonlabor per visit costs for free standing home health agencies. "(ii) Effective for cost reporting periods beginning on or after Effective date. July 1, 1986, such limitations shall be applied on an aggregate basis for the agency, rather than on a discipline specific basis, with appropriate adjustment for administrative and general costs of hospital-based agencies.". -

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