Page:United States Statutes at Large Volume 101 Part 2.djvu/858

 101 STAT. 1330-64

Appropriation authorization.

PUBLIC LAW 100-203—DEC. 22, 1987

thorized to conduct demonstration projects under this subsection for the purpose of testing alternative payment methodologies pertaining to capitation payments under title XVIII of the Social Security Act, including— (A) computing adjustments to the average per capita cost under section 1876 of such Act on the basis of health status or prior utilization of services, and .t\p /^ •r (B) accounting for geographic variations in cost in the adjusted average per capita costs applicable to an eligible organization under such section which differs from payments currently provided on a county-by-county basis. (2) No project may be conducted under this subsection— (A) with an entity which is not an eligible organization (as defined in section 1876(b) of the Social Security Act), and (B) unless the project meets all the requirements of subsections (c) and (i)(3) of section 1876 of such Act. (3) There are authorized to be appropriated to carry out projects Under this subsection $5,000,000 in each of fiscal years 1989 and 1990. (c) APPLICATION OF PROVISIONS.—The provisions of subsection (a)(2) and the first sentence of subsection (b) of section 402 of the Social Security Amendments of 1967 shall apply to the demonstration projects under this section in the same manner as they apply to experiments under subsection (a)(1) of that section.

42 USC 1320a-7a note.

SEC. 4016. DELAY IN EFFECTIVE DATE IN PHYSICIAN INCENTIVE RULES FOR HEALTH MAINTENANCE ORGANIZATIONS.

100 Stat. 2002.

Section 9313(c)(2)(B) of the Omnibus Budget Reconciliation Act of 1986 is amended by striking "April 1, 1989" and inserting "April 1, 1990".

42 USC 1395mm

SEC. 4017. GAO STUDY AND REPORTS ON MEDICARE CAPITATION.

Contracts.

(a) STUDY.—The Comptroller General shall conduct a study on medicare capitation rates that shall include an analysis and assessment of— (1) the current method for computing per capita rates of payment under section 1876 of the Social Security Act (including the method for determining the United States per capita cost); (2) the method for establishing relative costs for geographic areas and the data used to establish age, sex, and other weighting factors; (3) ways to refine the calculation of adjusted average per capita costs under section 1876 of such Act (including making adjustments for health status or prior utilization of services and improvements in the definition of geographic areas); (4) the extent to which individuals enrolled with organizations with a risk-sharing contract with the Secretary under section 1876 of such Act differ in utilization and cost from fee-forservice beneficiaries and ways for modifying enrollment patterns through program changes or for reflecting the differences in rates through group experience rating or other means; (5) approaches for limiting the liability of the contracting organization under section 1876 of such Act in catastrophic cases:

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