Page:United States Statutes at Large Volume 102 Part 1.djvu/743

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PUBLIC LAW 100-360—JULY 1, 1988

102 STAT. 705

drugs described in section 1861(t)(2)(A) used in immunosuppressive therapy and furnished, to an individual who receives an organ transplant for which payment is made under this title, withm 1 year after the date of the transplant. "(B) RESPONSE TO APPLICATION.—If the system described in section 1842(o)(4) has not been established and an individual applies to the Secretary to establish that the individual has met the requirement of subparagraph (A), the Secretary shall promptly notify the individual (and, if the application was submitted by or through a participating pharmacy, the pharmacy) as to the date (if any) as of which the individual has met such requirement. "(C) CATASTROPHIC DRUG DEDUCTIBLE AMOUNT.— "(i) IN GENERAL.—Subject to subparagraph (D), the

catastrophic drug deductible specified in tlus subparagraph for— "a) 1990 is $550, "(ID 1991 is $600, , "(m) 1992 is $652, and "(TV) any succeeding year, is such an amount as the Secretary determines will result in 16.8 percent of the average number of individuals covered under this part (other than individuals enrolled with an eligible organization under section 1876 or an organization described in section 1833(a)(l)(A)) during that succeeding year having incurred expenses for covered outpatient drugs sufficient to meet the catastrophic drug deductible so determined, "(ii) ROUNDING.—Any amount determined under this subparagraph which is not a multiple of $1 shall be rounded to the nearest multiple of $1. "(iii) PUBLICATiON.—Before May 1 of each year (beginning with 1992) the Secretary shall publish in the Federal Roister a proposed r^^ulation establishing the amount of the catastrophic drug deductible under this subparagraph for the following year. During the last 3 days of September of such year, the Secretary shall publish in the Federal Roister the final regulation establishing the amount of such deductible for the following year, which amount may not be greater than the amount specified in the proposed r^ulation. "(2) PAYMENT AMOUNT.—

"(A) IN GENERAL.—Subject to the catastrophic drug deductible established under paragraph (I)(A) and except as provided in subparagraph (C), the amounts payable under this part with respect to a covered outpatient drug is equal to the payment percent (specified in subparagraph (B)) of the lesser of— "(i) the actual charge for the drug, or "(ii) the applicable payment limit established under paragraph (3). "(B) PAYMENT PERCENT.—For purposes of subparagraph (A), the payment percent is I K percent minus the apC) plicable coinsurance percent (specified in subparagraph (C)).

Federal Register, publication. Regulations.

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