Page:United States Statutes at Large Volume 100 Part 3.djvu/213

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PUBLIC LAW 99-509—OCT. 21, 1986

100 STAT. 2021

rental equivalence or rental substitution factor for the housing component of the consumer price index. (3) ANNUALIZATION OF MEL—(A) The fourth sentence of section 1842(b)(3) of the Social Security Act (42 U.S.C. 1395u(b)(3)) is amended by inserting after "ending June 30, 1973," the following: "or (with respect to physicians services furnished in a year after 1987) the level determined under this sentence for the previous year", and inserting "year-to-year" before "economic changes". (B) The amendments made by subparagraph (A) shall apply to physicians' services furnished on or after January 1, 1988. (4) STUDY.—The Secretary shall conduct a study of the extent to which the MEI appropriately and equitably reflects economic changes in the provision of the physicians' services to medicare beneficiaries. In conducting such study the Secretary shall consult with appropriate experts. (5) LIMITATION ON CHANGES IN MEI METHODOLOGY.—The Secretary shall not change the methodology (including the basis and elements) used in the MEI from that in effect as of October 1, 1985, until completion of the study under paragraph (4). After the completion of the study, the Secretary may not change such methodology except after providing notice in the Federal Register and opportunity for public comment. (6) MEI DEFINED.—In this subsection, the term "MEI" means the economic index referred to in the fourth sentence of section 1842(b)(3) of the Social Security Act. (d) DEVELOPMENT AND USE OF H C F A COMMON PROCEDURE CODING SYSTEM.—

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42 USC 1395u note. 42 USC 1395u note.

Public information. 42 USC 1395u note.

42 USC 1395u note. 42 USC 1395u note. Public information.

(1) Not later than July 1, 1989, the Secretary of Health and Human Services (in this subsection referred to as the "Secretary"), after public notice and opportunity for public comment and after consulation with appropriate medical and other experts, shall group the procedure codes contained in any HCFA Common Procedure Coding System for payment purposes to minimize inappropriate increases in the intensity or volume of services provided as a result of coding distinctions which do not reflect substantial differences in the services rendered. (2) Not later than January 1, 1990, each carrier with which contracts. the Secretary has entered into a contract under section 1842 of the Social Security Act shall make payments under part B of 42 USC 1395U. title XVIII of such Act based on the grouping of procedure codes 42 USC 1395J. effected under paragraph (1). (e) RECOMMENDATIONS.—



(1) Section 1845(e) of the Social Security Act is amended by Ante, p. 192. adding at the end thereof the following new paragraph: "(4)(A) In making recommendations with respect to the ap5 plication of the relative value scale for purposes of establishing ,3. i a fee schedule, the Secretary shall— t "(i) develop and assess an appropriate index to be used for making adjustments to reflect justifiable differences in the -5'--costs of practice based upon geographic location without exacerbating the geographic maldistribution of physicians, and "(ii) assess the advisability and feasibility of developing ,^.»t:> an appropriate adjustment to assist in attracting and retaining physicians in medically underserved areas.

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