Page:United States Statutes at Large Volume 101 Part 2.djvu/882

 101 STAT. 1330-88

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

PUBLIC LAW 100-203—DEC. 22, 1987

"(I) an adjustment under subsection (b)(8)(B) (relating to inherent reasonableness), "(II) a reduction under subsection (b)(10)(A) (relating to certain overpriced procedures), "(III) a reduction under subsection (b)(ll)(B) (relating to certain cataract procedures), and "(IV) an adjustment under section 1833(1)(3)(B) (relating to physician supervision of certified registered nurse anesthetists), "(iii) In clause (i), the term 'reduced payment allowance' means, with respect to an action— "(I) under subsection (b)(8)(B), the inherently reasonable charge established under subsection (b)(8); or "(II) under subsection (b)(10)(A) or (b)(ll)(B) or under section 1833(1)(3)(B), the prevailing charge for the service after the action, "(iv) If a physician knowingly and willfully imposes a charge in violation of clause (i) (whether or not such charge violates subparagraph (B)), the Secretary may apply sanctions against such physician in accordance with paragraph (2). "(v) Clause (i) shall not apply to items and services furnished after the earlier of (I) December 31, 1990, or (II) one-year after the date the Secretary reports to Congress, under section 1845(e)(3), on the development of the relative value scale under section 1845.". (2) CONFORMING AMENDMENTS.—(A) Section 1833(1)(6) of such Act (42 U.S.C. 13951(1)(6)) is amended— (i) in subparagraph (A), by striking "(subject to subparaV V graph (D))" and all that follows through the end and insert' I ing the following: "after the effective date of the reduction, the physician's actual charge is subject to a limit under, -section 1842(j)(l)(D)."; (ii) in subparagraph (A), by striking "(A)" after "(6)"; and (iii) by striking subparagraphs (B) through (D). (B) Section 1842(b)(ll)(B)(i) of such Act (42 U.S.C. 1395u(b)(ll)(B)(i)) is amended by striking "and shall be further reduced" and all that follows through "1988". (C) Section 9334(b)(2) of the Omnibus Budget Reconciliation Act of 1986 is amended by striking "1842(b)(10)" and inserting "18420X1)(D)". (d) EFFECTIVE DATE.—The amendments made by this section shall apply to items and services furnished on or after April 1, 1988, except the amendment made by subsection (c)(2)(B) shall apply to services furnished on or after January 1, 1988. SEC. 4046. LIMITS ON PAYMENT FOR OPHTHALMIC ULTRASOUND.

(a) IN GENERAL.—Section 1842 of the Social Security Act (42 U.S.C. 1395u), as previously amended by this subpart is amended— (1) in subsection (b)(ll)— (A) in subparagraph (C), as redesignated under section 4045(c)(l)(A)(ii) of this title, by inserting "or (C)" after "subparagraph (B)"; (B) by redesignating subparagraph (C) as subparagraph (D); and (C) by inserting after subparagraph (B) the following new subparagraph: "(C) The prevailing charge level determined with respect to Amode ophthalmic ultrsisound procedures may not exceed 5 percent

�