Page:United States Statutes at Large Volume 103 Part 3.djvu/86

 103 STAT. 2154 PUBLIC LAW 101-239—DEC. 19, 1989 (III) in subsection (w)(2), by striking "hospital" each place it appears and inserting "hospital or rural pri- mary care hospital", (xi) Section 1862(a)(14) of such Act (42 U.S.C. 1395y(a)(14)) is amended by striking "hospital" each place it appears and inserting "hospital or rural primary care hospital. (xii) Section 1866(a)(1) of such Act (42 U.S.C. 1395cc(a)(l)) is amended— (I) in subparagraph (F)(ii), by inserting "rural pri- '•• mary care hospitals, after "hospitals,"; ' (II) in subparagraph (H), by inserting after "this title" the first place it appears the following: "and in the case of rural primary care hospitals which provide rural primary care hospital services"; (III) in subparagraph (I), by inserting "and in the case of a rural primary care hospital" after "hospitgd"; and (IV) in subparagraph (N), by striking "hospitals" and "hospital," and inserting "hospitals and rural primary care hospitals" and "hospital or rural primary care hospital,, respectively. (xiii) Section 1866(a)(3) of such Act (42 U.S.C. 1395cc(a)(3)) is amended— (I) by striking "hospital," each place it appears in ,, subparagraphs (A) and (B) and inserting hospital, rured primary care hospital,", and (II) in subparagraph (C)(ii)(II), by striking "facilities" each place it appears and inserting "facilities, rural primary care hospitals,". (xiv) Section 1867(e) of such Act (42 U.S.C. 1395dd(e)) is amended by adding at the end the following new paragraph: "(6) The term 'hospital' includes a rural primary care hospital (as defined in section 1861(mmXl)).". (4) AVOIDING DUPUCATIVE PAYMENTS TO HOSPITALS PARTICIPAT- ING IN RURAL HEALTH CARE TRANSITION GRANTS.— Section 1886 of the Social Security Act (42 U.S.C. 1395ww) is amended by adding at the end the following new subsection: "(i) AVOIDING DUPUCATIVE PAYMENTS TO HOSPITALS PARTICIPATING IN RURAL DEMONSTRATION PROGRAMS.—The Secretary shall reduce any payment amounts otherwise determined under this section to the extent necessary to avoid duplication of any payment made under section 4005(e) of the Omnibus Budget Reconciliation Act of 1987. ". (h) GEOGRAPHIC CLASSIFICATION OF HOSPITALS. — (1) ESTABLISHMENT OF MEDICARE GEOGRAPHICAL CLASSIFICATION BOARD.— Section 1886(d) of the Social Security Act (42 U.S.C. 1395ww(d)) is amended by adding at the end the following new paragraph: " (lOXA) There is hereby established the Medicare Geographical Classification Review Board (hereinafter in this paragraph referred to as the 'Board'). "(B)(i) The Board shall be composed of 5 members appointed by the Secretary without regard to the provisions of title 5, United States Code, governing appointments in the competitive service. Two of such members shall be representatives of subsection (d) hospitals located in a rural area under paragraph (2)(D). At least 1 member shall be a member of the Prospective Payment Assessment

�