Page:United States Statutes at Large Volume 102 Part 1.djvu/746

 102 STAT. 708

PUBLIC LAW 100-360—JULY 1, 1988 the first month of the previous payment calculation period. "(iv) GEOGRAPHIC BASIS.—The Secretary shall make such determination, and calculate the payment limits under this paragraph, on a national basis; except that the Secretary may make such determination, and calculate such payment limits, on a regional basis to take account of limitations on the availability of drug products and variations among regions in the average wholesale prices for a drug product. "(4) ADMINISTRATIVE ALLOWANCE FOR PURPOSES OF PAYMENT LIMITS.—

"(A) IN GENERAL.—Except as provided in subparagraph (B), for drugs dispensed in— "(i) 1990 or 1991, the administrative allowance under this paragraph is— "(I) $4.50 for drugs dispensed by a participating pharmacy, or "(II) $2.50 for drugs dispensed by another pharmacy; or "(ii) a subsequent year, the administrative allowance under this paragraph is the administrative allowemce under this paragraph for the preceding year increased by the percentage increase (if any) in the implicit price deflator for gross national product (as published by the Department of Commerce in its 'Survey of Current Business') over the 12-month period ending with August of such preceding year. Any allowance determined under the clause (ii) which is not a multiple of 1 cent shall be rounded to the nearest multiple of 1 cent. "(B) ADJUSTMENT IN ALLOWANCE FOR MAIL SERVICE PHAR-

MACIES.—The Secretary may, by regulation and after consultation with pharmacists, elderly groups, and private insurers, reduce the administrative allowances established under subparagraph (A) for any drug dispensed by a mail service pharmacy (as defined by the Secretary) based on differences between such pharmacies and other pharmacies with respect to operating costs and other economies. "(5) ASSURING APPROPRIATE PRESCRIBING AND DISPENSING PRACTICES.—

Healthcare professionals,

Safety.

"(A) IN GENERAL.—The Secretary shall establish a program to identify (and to educate physicians and pharmacists concerning)— "(i) instamces or patterns of unnecessary or inappropriate prescribing or dispensing practices for covered outpatient drugs, "(ii) instances or patterns of substandard care with respect to such drugs, and (iii) potential adverse reactions. "(B) STANDARDS.—In carrying out the program under subparagraph (A), the Secretary shall establish for each covered outpatient drug standards for the prescribing of the drug which are based on accepted medical practice. In establishing such standards, the Secretary shall incorporate standards from such current authoritative compendia as the Secretary may select; except that the Secretary may

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