Page:United States Statutes at Large Volume 101 Part 2.djvu/910

 101 STAT. 1330-116

PUBLIC LAW 100-203—DEC. 22, 1987

SEC. 4071. COVERAGE OF INFLUENZA VACCINE AND ITS ADMINISTRATION.

(a) IN GENERAL.—Section 1861(s)(10)(A) of the Social Security Act (42 U.S.C. 1395x(a)(10)(A)) is amended by inserting before the semicolon the following: "and influenza vaccine and its administration". 42 USC 1395x

(b) CONTINGENT EFFECTIVE D A T E; DEMONSTRATION PROJECT.—

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(1) The provisions of subsection (e) of section 4072 of this subpart shall apply to this section in the same manner as it applies to section 4072. (2) In conducting the demonstration project pursuant to paragraph (1), in order to determine the cost effectiveness of including influenza vaccine in the medicare program, the Secretary of Health and Human Services is required to conduct a demonstration of the provision of influenza vaccine as a service for medicare beneficiaries and to expend $25,000,000 each year of the demonstration project for this purpose. In conducting this demonstration, the Secretary is authorized to purchase in bulk influenza vaccine and to distribute it in a manner to make it widely available to medicare beneficiaries, to develop projects to provide vaccine in the same manner as other covered medicare services in large scale demonstration projects, including statewide projects, and to engage in other appropriate use of moneys to provide influenza vaccine to medicare beneficiaries and evaluate the cost effectiveness of its use. In determining cost effectiveness, the Secretary shall consider the direct cost of the vaccine, the utilization of vaccine which might otherwise not have occurred, the costs of illnesses and nursing home days avoided, and other relevant factors, except that extended life for beneficiaries shall not be considered to reduce the cost effectiveness of the vaccine.

SEC. 4072. PAYMENT FOR THERAPEUTIC SHOES FOR INDIVIDUALS WITH SEVERE DIABETIC FOOT DISEASE.

(a) COVERAGE UNDER PART B.—Section 1861(s) of the Social Security Act (42 U.S.C. 1395x(s)) is amended— (1) by redesignating paragraphs (12) through (15) as paragraphs (13) through (16), respectively, bi (2) by striking out "and" at the end of paragraph (10), k (3) by striking out the period at the end of paragraph (11) and inserting "; and", and ai (4) by inserting after paragraph (11) the following new paraift graph: & "(12) extra-depth shoes with inserts or custom molded shoes for an individual with diabetes, if— "(A) the physician who is managing the individual's diaXMIJ.?<>•''•.. betic condition (i) documents that the individual has peripheral neuropathy with evidence of callus formation, a history of pre-ulcerative calluses, a history of previous ulceration, foot deformity, or previous amputation, or poor circulation, and (ii) certifies that the individual needs such shoes under I' a comprehensive plan of care related to the individual's diabetic condition; .«''41 03; yi o^c^o* "(B) the particular t3T)e of shoes are prescribed by a '' •' podiatrist or other qualified physician (as established by the 'Sl:7~T Secretary); and @ ' "(C) the shoes are fitted and furnished by a podiatrist or t other qualified individual (such as a pedorthist or orthotist, as established by the Secretary) who is not the physician

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