Page:United States Statutes at Large Volume 103 Part 3.djvu/106

 103 STAT. 2174 PUBLIC LAW 101-239—DEC. 19, 1989 Federal Register, publication. Reports. "(1) the average percentage division for the mal- practice component for each physician specialty (determined under subparagraph (B)), multiplied by "(11) by the proportion (determined under subparagraph (A)) of such service (or services) per- formed by physicians in that specialty. "(D) PERIODIC RECOMPUTATION.— The Secretary may, from time to time, provide for the recomputation of work percentages, practice expense percentages, and malpractice percentages determined under this paragraph. "(3) ANCILLARY POUCIES.—The Secretary may establish an- cillary policies (with respect to the use of modifiers, local codes, and other matters) as may be necessary to implement this subsection. "(4) CODING.— The Secretary shall establish a uniform proce- dure coding system for the coding of all physicians' services. The Secretary shall provide for an appropriate coding structure for visits and consultations. The Secretary may incorporate the use of time in the coding for visits and consultations only for services furnished on or after January 1, 1993. The Secretary, in establishing such coding system, shall consult with the Physi- cian Pa)mient Review (Commission and other organizations rep- resenting physicians. "(5) No VARIATION FOR SPECIALISTS. — The Secretary may not vary the conversion factor or the number of relative value units for a physicians' service based on whether the physician fur- nishing the service is a specialist or based on the type of specialty of the physician. ' (d) CONVERSION FACTORS. — r "(1) HlSTABUSHMENT. — "(A) IN GENERAL.—The conversion factor for each year shall be the conversion factor established under this subsec- tion for the previous year (or, in the case of 1992, specified in subparagraph (B)) adjusted by the update (established under subparagraph (O) for the year involved. "(B) SPECIAL PROVISION FOR 1992,— For purposes of subparagraph (A), the conversion factor specified in this subparagraph is a conversion factor (determined by the Secretary) which, if this section were to apply during 1991 using such conversion factor, would result in the same aggregate amount of payments under this part for physi- cians' services as the estimated aggregate amount of the payments under this part for such services in 1991. (C) PUBLICATION.— The Secretary shall cause to have published in the Federal Register, during the last 15 days of October of— "(i) 1991, the conversion factor (or factors) which will apply to physicians' services for 1992, and the update (or updates) determined under paragraph (3) for 1992; and "(ii) each succeeding year, the update (or updates) determined under paragraph (3) for the following year. "(2) RECOMMENDATION OF UPDATE, — "(A) IN GENERAL. — Not later than April 15 of each year (beginning with 1991), the Secretary shall transmit to the Congress a report that includes a recommendation on the

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