Page:United States Statutes at Large Volume 101 Part 2.djvu/873

 PUBLIC LAW 100-203—DEC. 22, 1987

101 STAT. 1330-79

categories as benefit denials, results of appeals, and other relevant factors, and selectable by such categories and by fiscal intermediary, service provider, and region.". SEC. 4036. END-STAGE RENAL DISEASE AMENDMENTS. (a) IMPLEMENTATION OF PRIMARY PAYER REQUIREMENTS FOR ENDSTAGE RENAL DISEASE PROGRAM.—

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(1) Section 1862(b)(2)(A) of the Social Security Act (42 U.S.C. 1395y(b)(2)(A)) is amended by striking "(ii)" and all that follows through "under this title" and inserting "(ii) can reasonably be expected to be made under such a plan". (2) The amendment made by paragraph (1) shall apply with Effective date. respect to items and services furnished on or after 30 days after 42 USC 1395y note. the date of the enactment of this Act.

(b) LIMITATION OF MINIMUM UTIUZATION RATE REQUIREMENT FOR END-STAGE RENAL DISEASE TRANSPLANTATIONS.—The last sentence

of section 1881(b)(l) of such Act (42 U.S.C. 1395rr(b)(l)) is amended by striking "covered procedures and for self-dialysis training programs" and inserting "transplantations". (c) EXTENSION OF DEADLINE FOR ESTABLISHING PROTOCOLS ON REUSE OF DIALYSIS FILTERS AND OTHER DIALYSIS SUPPLIES AS IT RELATES TO THE REUSE OF BLOODUNES.—

(I)(A) Section 9335(k)(2) of the Omnibus Budget Reconciliation Act of 1986 is amended by inserting "(or July 1, 1988, with respect to protocols that relate to the reuse of bloodlines)" after "October 1, 1987". (B) The amendment made by subparagraph (A) shall be effective as if included in the enactment of section 9335(k)(2) of the Omnibus Budget Reconciliation Act of 1986. (2) Section 1881(fK7XB) of the Social Security Act (42 U.S.C. 1395rr(f)(7)(B)) is amended by inserting "(or July 1, 1988, with respect to protocols that relate to the reuse of bloodlines)" after "January 1, 1988". (d) STUDIES OF END-STAGE RENAL DISEASE PROGRAM.—

42 USC 1395rr note. 42 USC 1395rr note.

42 USC 1395rr note.

(1) The Secretary of Health and Human Services (in this sult)section referred to as the "Secretary") shall arrange for a study of the end-stage renal disease program within the medicare program. (2) Among other items, the study shall address— (A) access to treatment by both individuals eligible for medicare benefits and those not eligible for such benefits; (B) the quality of care provided to end-stage renal disease beneficiaries, as measured by clinical indicators, functional status of patients, and patient satisfaction; (C) the effect of reimbursement on quality of treatment; (D) major epidemiological and demographic changes in the end-stage renal disease population that may affect access to treatment, the quality of care, or the resource requirements of the program; and (E) the adequacy of existing data systems to monitor these matters on a continuing basis. (3) The Secretary shall submit to Congress, not later than 3 Reports. years after the date of the enactment of this Act, a report on the study. (4) The Secretary shall request the National Academy of Sciences, acting through the Institute of Medicine, to submit an application to conduct the study described in this section. If the

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