Page:United States Statutes at Large Volume 100 Part 3.djvu/232

 100 STAT. 2040 ' '

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PUBLIC LAW 99-509—OCT. 21, 1986

"(B)(i) The blend amount for a cost reporting period is the sum of— "(I) the cost proportion (as defined in clause (ii)(I)) of the amount described in subparagraph (A)(i), and "(ID the ASC proportion (as defined in clause (ii)(II)) of 80 percent of the standard overhead amount payable with respect to the same surgical procedure as if it were provided in an ambulatory surgical center in the same area, as determined under paragraph (2)(A). "(ii) In this paragraph: "(I) The term 'cost proportion' means 75 percent for cost reporting periods beginning in fiscal year 1988, and 50 percent for other cost reporting periods. "(II) The term 'ASC proportion' means 25 percent for cost reporting periods beginning in fiscal year 1988, and 50 percent for other cost reporting periods.". (2) CONFORMING AMENDMENT.—Section 1833(b)(3) of such Act is amended by striking "or (i)(4)" and inserting in lieu thereof "or (i)(5)".

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42 USC 1395/.

(b) UPDATING ASC RATES.—

(1) RATE UPDATE.—Subparagraphs (A) and (B) of section

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1833(i)(2) of such Act are each amended by striking "shall be reviewed periodically" and inserting in lieu thereof "shall be reviewed and updated not later than July 1, 1987, and annually thereafter". (2) ASC usT UPDATE.—Section 1833(i)(l) of such Act is amended by adding at the end (after and below subparagraph (B)) the following: "The lists of procedures established under subparagraphs (A) and (B) shall be reviewed and updated not less often than every 2 years.". (c) PREVENTING SERVICES TarmstroBot (talk) 02:35, 27 June 2011 (UTC)

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Health care facilities.

Ante, pp. 2003, 2008.

UNBUNDLING

OF

HOSPITAL

OUTPATIENT

(1)'Section 1862(a)(14) of such Act (42 U.S.C. 1395y{a)(14)) is amended by striking "inpatient" and inserting "patient". (2) Section 1866(a)(1)(H) of such Act (42 U.S.C. 1395cc(a)(l)(H)) is amended— (A) by striking "inpatient hospital", and (B) by striking "an inpatient" and inserting "a patient". '•••*-' (3) Section 1866 of such Act (42 U.S.C. 1395cc) is further amended by adding at the end the following new subsection: "(g) Except as permitted under subsection (a)(2), any person who knowingly and willfully presents, or causes to be presented, a bill or request for payment for a hospital outpatient service for which payment may be made under part B and such bill or request violates an arrangement under subsection (a)(1)(H), is subject to a civil monetary penalty of not to exceed $2,000. Such a penalty shall be imposed in the same manner as civil monetary penalties are imposed under section 1128A with respect to actions described in subsection (a) of that section.". (d) PRO REVIEW.—

(1) Section 1154(a)(1) of the Social Security Act (42 U.S.C. 1320c-3(a)(l)) is amended by inserting "and subject to the requirements of subsection (d)" after "subject to the terms of the contract". (2) Section 1154 of such Act is amended by adding at the end the following new subsection:

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