Page:United States Statutes at Large Volume 104 Part 2.djvu/450

 104 STAT. 1388-42 PUBLIC LAW 101-508 —NOV. 5, 1990 the case of fiscal year 1989, 66 percent of reconsiderations) and 90 percent of reconsiderations within 90 days, and "(ii) the extent to which such agency or organization's determinations are reversed on appeal; and "(B) with respect to applications for an exemption from or exception or adjustment to the target amount applicable under section 1886(b) to a hospital that is not a subsection (d) hospital (as defined in section 1886(d)(1)(B))— application, whether such agency or organization is able to process such application not later than 75 days after the application is filed, and "(ii) if such agency or organization receives an incomplete application, whether such agency or organization is able to return the application with instructions on how to complete the application not later than 60 days after the application is filed. ". (B) Section 1886(b)(4)(A) (42 U.S.C. 1395ww(b)(4)(A)) is amended by adding at the end the following new sentence: "The Secretary shall announce a decision on any request for an exemption, exception, or adjustment under this paragraph not later than 180 days after receiving a completed application from the intermediary for such exemption, exception, or adjustment, and shall include in such decision a detailed explanation of the grounds on which such request was approved or denied.". (2) STANDARDS FOR ASSIGNMENT OF NEW BASE PERIOD. — Section 188603)(4) (42 U.S.C. 1395ww(b)(4)) is amended— (A) by redesignating subparagraph (B) as subparagraph (C);and (B) by inserting after subparagraph (A) the following new subparagraph: "(B) In determining under subparagraph (A) whether to assign a new base period which is more representative of the reasonable and necessary cost to a hospital of providing inpatient services, the Secretary shall take into consideration— "(i) changes in applicable technologies and medical practices, or differences in the severity of illness among patients, that increase the hospital's costs; "(ii) whether increases in wages and wage-related costs for hospitals located in the geographic area in which the hospital is located exceed the average of the increases in such costs paid by hospitals in the United States; and "(iii) such other factors as the Secretary considers appropriate in determining increases in the hospital's costs of providing inpatient services.". 42 USC 1395WW (3) GUIDANCE TO INTERMEDIARIES AND HOSPITALS.— The note. Administrator of the Health Care Financing Administration J shall provide guidance to agencies and organizations performing functions pursuant to section 1816 of the Social Security Act and to hospitals that are not subsection (d) hospitals (as defined in section 1886(d)(1)(B) of such Act) to assist such agencies, organizations, and hospitals in filing complete applications with the Administrator for exemptions, exceptions, and adjustments under section 1886(b)(4)(A) of such Act. 42 USC 1395WW (4) EFFECTIVE DATES. —The amendments made by paragraph note. (1) shall take effect on the date of the enactment of this Act, and the amendments made by paragraph (2) shall take effect as if
 * '(i) if such agency or organization receives a completed
 * So in original. Probably should be " "(i)".

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