Page:United States Statutes at Large Volume 103 Part 3.djvu/119

 PUBLIC LAW 101-239—DEC. 19, 1989 103 STAT. 2187 (8) COMMISSION STUDY OP PHYSICIAN FEES UNDER MEDICAID. — The Ph3rsician Payment Review Commission shall conduct a study on physician fees under State medicaid programs estab- lished under title XIX of the Social Security Act. The Commis- sion shall specifically examine in such study the adequacy of A physician reimbursement under such programs, physician participation in such programs, and access to care by medicaid beneficiaries. By no later than July 1, 1991, the Commission Reports, shall submit a report to Congress on such study and shall include such recommendations as the Commission deems appro- priate. (9) GAO STUDY ON PHYSICIAN ANTI-TRUST ISSUES. —The Comptroller General shall conduct a study of the effect of anti- trust laws on the ability of physicians to act in groups to educate and discipline peers of such physicians in order to reduce and eliminate ineffective practice patterns and inappro- priate utilization. The study shall further address anti-trust issues as they relate to the adoption of practice guidelines by third-party payers and the role that practice guidelines might play as a defense in malpractice cases. By no later than July 1, Reports. 1991, the Comptroller General shall submit a report to Congress on such study and shall make such recommendations as the Comptroller General deems appropriate, (e) MISCELLANEOUS CONFORMING AMENDMENTS.— (1) REFERENCE TO NEW PAYMENT RULES.—Section 1833(a)(l) of the Social Security Act (42 U.S.C. 13951(a)(l)) is amended— (A) by striking "and" before clause (M), and (B) by inserting before the semicolon the following new clause: "and (N) with respect to expenses incurred for physicians' services (as defined in section 1848(j)(3)), the amounts paid shall be 80 percent of the payment basis determined under section 1848(a)(l)". (2) CHANGING REFERENCE TO MAXIMUM ALLOWABLE ACTUAL CHARGES.— Section 1842(b)(3)(G) of such Act (42 U.S.C. 1395u(b)(3)(G)) is amended by striking "maximum allowable actual charges (established under subsection (j)(l)(C))" and inserting "limiting charges established under subsection (j)(l)(C)". (3) DIFFERENTIAL FOR PARTICIPATING PHYSICIANS. —Effective Effective date. for physicians' services furnished on or after January 1, 1992, the first sentence of section 1842(b)(4)(A)(iv) of such Act (42 U.S.C. 1395u(b)(4)(A)(iv)) is amended by inserting "and before January 1, 1992," after "January 1, 1987,". (4) PAYMENT FOR PHYSICIAN ASSISTANTS. —Section 1842(b)(12XAXiiXII) of such Act (42 U.S.C. 1395u(b)(12XAXiiXII)) is amended by inserting "(or, for services furnished on or after January 1, 1992, the fee schedule amount specified in section 1848, as the case may be)" after "prevailing charge rate for such services". (5) PAYMENT FOR CERTIFIED REGISTERED NURSE ANESTHETISTS.— Section 1833(a)(l)(H) of such Act (42 U.S.C. 13951(a)(l)(H)) is amended by inserting "(or, for services furnished on or after January 1, 1992, the fee schedule amount provided under sec- tion 1848, as the case may be)" after "prevailing charge that would be recognized".

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