Page:United States Statutes at Large Volume 104 Part 2.djvu/482

 104 STAT. 1388-74 PUBLIC LAW 101-508 —NOV. 5, 1990 surgical center on or after the date of the enactment of this Act and on or before December 31, 1992, shall be equal to $200, SEC. 4152. DURABLE MEDICAL EQUIPMENT. (a) PAYMENTS FOR SEAT-LIFT AND TENS. — (1) 15 PERCENT REDUCTION IN PAYMENTS FOR TRANSCUTANEOUS ELECTRICAL NERVE STIMULATORS. — Section 1834(a)(1)(D) of the Social Security Act (42 U.S.C. 1395m(a)(l)(D)) is amended by inserting before the period at the end the following: ", and, in the case of a transcutaneous electrical nerve stimulator furnished on or after January 1, 1991, the Secretary shall further reduce such payment amount (as previously reduced) by 15 percent". (2) SEAT-LIFTS. —Section 1861(n) of the Social Security Act (42 U.S.C. 1395x(n)) is amended by adding at the end the following: "With respect to a seat-lift chair, such term includes only the seat-lift mechanism and does not include the chair.". 42 USC 1395m (3) EFFECTIVE DATE.—The amendment made by subsection (a) note. shall apply to items furnished on or after January 1, 1991. (b) DEVELOPMENT AND APPLICATION OF NATIONAL LIMITS ON FEES.— (1) INEXPENSIVE AND ROUTINELY PURCHASED DURABLE MEDICAL EQUIPMENT AND ITEMS REQUIRING FREQUENT AND SUBSTANTIAL SERVICING. —Paragraphs (2) and (3) of section 1834(a) of such Act (42 U.S.C. 1395m(a)) are each amended— (A) in subparagraph (B)(i), by striking "or" at the end; (B) by striking clause (ii) of subparagraph (B) and inserting the following: "(ii) in 1991 is the sum of (I) 67 percent of the local payment amount for the item or device computed under subparagraph (C)(i)(I) for 1991, and (II) 33 percent of the national limited payment amount for the item or device computed under subparagraph (C)(ii) for 1991; "(iii) in 1992 is the sum of (I) 33 percent of the local payment amount for the item or device computed under subparagraph (CXDdD for 1992, and (II) 67 percent of the national limited payment amount for the item or device computed under subparagraph (C)(ii) for 1992; and "(iv) in 1993 and each subsequent year is the national limited pa3Tnent amount for the item or device computed under subparagraph (C)(ii) for that year."; and (C) by adding at the end the following new subparagraph: "(C) COMPUTATION OF LOCAL PAYMENT AMOUNT AND NA- TIONAL LIMITED PAYMENT AMOUNT.— For purposes of subparagraph (B)— "(i) the local payment amount for an item or device for a year is equal to— "(I) for 1991, the amount specified in subparagraph (B)(i) for 1990 increased by the covered item update for 1991, and "(II) for 1992, the amount determined under this clause for the preceding year increased by the covered item update for 1992; and "(ii) the national limited payment amount for an item or device for a year is equal to—

�