Page:United States Statutes at Large Volume 102 Part 3.djvu/461

 PUBLIC LAW 100-486—OCT. 13, 1988

102 STAT. 2413

"(B) in 1987 the hospital had a volume of sui^gical procedures (including inpatient and outpatient procedures) requiring anesthesia services that did not exceed 250 (or such higher number as the Secretary determines to be appropriate), and "(C) each certified roistered nurse anesthetist employed Contracts. by, or under contract with, the hospital has agreed not to bill under part B of title XVIII of such Act for professional services furnished by the anesthetist at the hospital. "(2) Paragraph (1) shall not apply in 1990 or 1991 to a hospital unless the hospital establishes, before the beginning of each respective year, that the hospital has had a volume of surgical procedures (including inpatient and outpatient procedures) requiring anesthesia services in the previous year that did not exceed 250 (or such higher number as the Secretary determines to be appropriate). "(3) l l i e Secretary shall implement this subsection in such a manner as to maintain budget neutraUty consistent with section 1833aX3) of the Social Security Act.", (d) MISCELLANEOUS TECHNICAL (CORRECTIONS TO VARIOUS PROVISIONS IN THE MEDICARE CATASTROPHIC COVERAGE ACT OF 1988

("MOCA").— (1) ABBREVIATIONS USED.—In this subsection: (A) The term "MCCA" refers to the Medicare Catastrophic Coverage Act of 1988 (Public Law 100-360). (B) The term "OBRA" refers to the Omnibus Budget Reconciliation Act of 1987 (Public Law 100-203). (2) SECTION I03.—The second sentence of section 1818(d)(l) of the Social Security Act, as amended by section 103 of MCCA, is amended by striking "entire". (3) SECTION IO4.—Section 104 of MCJCA is amended— (A) in subsection (a)(l), by striking "paragraphs (2) and 42 USC 1395d note. (3)" and inserting "paragraph (2) and subsection (b)"; (B) in subsection 0)X1)—42 USC 1395e (i) by striking "(1) the amendment made to section note. 1813(a)(l) of such Act" and inserting "(I)(A) section 1813(a)(l) of such Act (as amended by this subtitle)", and (ii) by adding at the end the following new subparagraph: "(B) if that individual begins a period of hospitalization (as Health and defined in such section) during 1989 or 1990 after the end of that medical care. spell of illness, the first period of hospitalization during 1989 or 1990 that b^ins after that spell of illness shall be considered to be (for purposes of such section) the first period of hospitalization that begins during that year; and"; (C) in subsections (c)(1) and (c)(2), by striking "by medi- 42 USC 1395WW care beneficiaries" and inserting "by (or on behalf of) medi- note. care beneficiaries"; (D) in subsection (c)(2), by striking "cost reporting periods beginning on or after October 1, 1988" and inserting "portions of cost reporting periods occurring on or after January 1, 1989"; (E) in subsection (c)(2), by inserting before the period at the end the following: ", without regard to whether such a hospital is paid on the basis described in subparagraph (A) or (B) of section 1886(b)(l) of such Act";

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