Page:United States Statutes at Large Volume 103 Part 3.djvu/101

 PUBLIC LAW 101-239—DEC. 19, 1989 103 STAT. 2169 Act) through March 31, 1990, with respect to payments for items and services under part B of such title. SEC. 6102. PHYSICIAN PAYMENT REFORM. (a) IN GENERAL. —Part B of title XVIII of the Social Security Act is amended by adding at the end the following new section: "PAYMENT FOR PHYSICIANS' SERVICES » "SEC. 1848. (a) PAYMENT BASED ON FEE SCHEDULE. — 42 USC i395w-4. " (1) IN GENERAL. —Effective for all physicians' services (as defined in subsection (j)(^)) furnished under this part during a year (beginning with 1992) for which payment is otherwise made on the basis of a reasonable charge or on the basis of a fee schedule under section 1834(b) or 1834(f), payment under this part shall instead be based on the lesser of— "(A) the actual charge for the service, or "(B) subject to the succeeding provisions of this subsec- tion, the amount determined under the fee schedule estab- lished under subsection (b) for services furnished during that year (in this subsection referred to as the 'fee schedule amount'). "(2) TRANSITION TO FULL FEE SCHEDULE.— "(A) LIMITING REDUCTIONS AND INCREASES TO 15 PERCENT IN 1992.— "(i) LIMIT ON INCREASE. —In the case of a service in a fee schedule area (as defined in subsection (j)(2)) for which the adjusted historical payment basis (as defined o in subparagraph (D)) is less than 85 percent of the fee schedule amount for services furnished in 1992, there shall be substituted for the fee schedule amount an amount equal to the adjusted historical payment basis plus 15 percent of the fee schedule amount otherwise established (without regard to this paragraph). "(ii) LIMIT IN REDUCTION.—In the case of a service in a fee schedule area for which the adjusted historical payment basis exceeds 115 percent of the fee schedule amount for services furnished in 1992, there shall be substituted for the fee schedule amount an amount _ equal to the adjusted historical payment bsisis minus 15 C. percent of the fee schedule amount otherwise estab- lished (without regard to this paragraph). "(B) SPECIAL RULE FOR 1993, 1994, AND 1995. —If a physi- cians' service in a fee schedule area is subject to the provi- sions of subparagraph (A) in 1992, for physicians' services furnished in the area— "(i) during 1993, there shall be substituted for the fee schedule amount an amount equal to the sum of— "(I) 75 percent of the fee schedule amount deter- mined under subparagraph (A), adjusted by the update established under subsection (d)(3) for 1993, and "(II) 25 percent of the fee schedule amount deter- mined under paragraph (1) for 1993 without regard to this paragraph; "(ii) during 1994, there shall be substituted for the fee schedule amount an amount equal to the sum of—

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