Page:United States Statutes at Large Volume 111 Part 1.djvu/388

 Ill STAT. 364 PUBLIC LAW 105-33—AUG. 5, 1997 flexible sigmoidoscopy services furnished on or after January 1, 1999, that— "(I) in accordance with regulations, may be performed in an ambulatory surgical center and for which the Secretary permits ambulatory surgical center payments under this part, and "(II) are performed in an ambulatory surgical center or hospital outpatient department, pa3mtient under this part shall be based on the lesser of the amount under the fee schedule that would apply to such services if they were performed in a hospital outpatient department in an area or the amount under the fee schedule that would apply to such services if they were performed in an ambulatory surgical center in the same area. "(ii) LIMITATION ON DEDUCTIBLE AND COINSUR- ANCE. — Notwithstanding any other provision of this title, in the case of a beneficiary who receives the services described in clause (i)— "(I) in computing the amount of any applicable deductible or copayment, the computation of such deductible or coinsurance shall be based upon the fee schedule under which payment is made for the services, and "(II) the amount of such coinsurance is equal to 25 percent of the payment amount under the fee schedule described in subclause (I). "(D) SPECIAL RULE FOR DETECTED LESIONS.— If during the course of such screening flexible sigmoidoscopy, a lesion or growth is detected which results in a biopsy or removal of the lesion or growth, payment under this part shall not be made for the screening flexible sigmoidoscopy but shall be made for the procedure classified as a flexible sigmoidoscopy with such biopsy or removal. "(E) FREQUENCY LIMIT. —No payment may be made under this part for a colorectal cancer screening test consisting of a screening flexible sigmoidoscopy— "(i) if the individual is under 50 years of age; or "(ii) if the procedure is performed within the 47 months after a previous screening flexible sigmoidoscopy. "(3) SCREENING COLONOSCOPY FOR INDIVIDUALS AT HIGH RISK FOR COLORECTAL CANCER. — "(A) FEE SCHEDULE.—With respect to colorectal cancer screening test consisting of a screening colonoscopy for individuals at high risk for colorectal c£incer (as defined in section 1861(pp)(2)), payment under section 1848 shall be consistent with payment amounts under such section for similar or related services. "(B) PAYMENT LIMIT.— In the case of screening colonoscopy services, payment under this part shall not exceed such amount as the Secretary specifies, based upon the rates recognized for diagnostic colonoscopy services. " (C) FACILITY PAYMENT LIMIT.— "(i) IN GENERAL.—Notwithstanding subsections (i)(2)(A) and (t) of section 1833, in the case of screening

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