Page:United States Statutes at Large Volume 100 Part 3.djvu/221

 PUBLIC LAW 99-509—OCT. 21, 1986

100 STAT. 2029

on page 35693 of volume 51 of the Federal Register on October 7, 1986, relating to reasonable charge payment limits for anesthesia services under the medicare program. (2) PATIENT PROTECTIONS.—In the case of any reduction in the Health care reasonable charge for physicians' services effected under the professionals. regulation described in paragraph (1), the provisions of section 1842(b)(10) of the Social Security Act (added by the amendment 42 USC 1395u. made by subsection (a)(3)) shall apply in the same manner and to the same extent as they apply to a reduction in the reasonable charge for a physicians' service effected under section 1842(b)(8) of such Act. (c) EFFECTIVE DATE.—The amendments made by this section shall 42 USC 1395u note. apply to services furnished on or after January 1, 1987. SEC. 9335. PAYMENT RATES FOR RENAL SERVICES AND IMPROVEMENTS IN ADMINISTRATION OF END STAGE RENAL DISEASE NETWORKS AND PROGRAM. 42 USC 1395rr note.

(a) COMPOSITE RATES FOR DIALYSIS SERVICES.—

(1) IN GENERAL.—Effective with respect to dialysis services provided on or after October 1, 1986, and before October 1, 1988, the Secretary of Health and Human Services shall establish the base rate for routine dialysis treatment in a free-standing facility and in a hospital-based facility under section 1881(b)(7) of the Social Security Act at a level equal to the respective rate in 42 USC 1395rr. effect as of May 13, 1986, reduced by $2.00. (2)

' ,^ ^ ' •i.

ASSURING

PROMPT

CONSIDERATION

^ 5 ' 5 '

EXCEPTION

REQUESTS.—Section 1881(b)(7) of the Social Security Act (42 U.S.C. 1395rr(b)(7)) is amended— (A) in the third sentence, by inserting "and of pediatric facilities" after "isolated, rural areas", and (B) by inserting after the third sentence the following new sentence: "Each application for such an exception shall be deemed to be approved unless the Secretary disapproves it by not later than 60 working days after the date the application is filed.". (3) EFFECTIVE DATE.—The amendments made by paragraph (2) 42 USC 1395rr shall apply to applications filed on or after the date of the note. enactment of this Act.

' (b) REPORT ON PAYMENT RATES.—

'^

OF

42 USC 1395rr note.

(1) IN GENERAL.—The Secretary of Health and Human Services shall provide for— (A) a study to evaluate the effects of reductions in the Health care rates of payment for facility and physicians' services under professionals. the medicare program for patients with end stage renal disease on their access to care or on the quality of care, and (B) a report to Congress on the results of the study by not Reports. later than January 1, 1988. (2) ARRANGEMENTS WITH INSTITUTE OF MEDICINE.—The Secretary shall request the National Academy of Sciences, acting through appropriate units, to submit an application to conduct the study described in paragraph (1). If the Academy submits an acceptable application, the Secretary shall enter into an appropriate arrangement with the Academy for the conduct of the study. If the Academy does not submit an acceptable application to conduct the study, the Secretary may request one or more appropriate nonprofit private entities to submit an application to conduct the study and may enter into an appropriate

�