Page:United States Statutes at Large Volume 111 Part 1.djvu/436

 Ill STAT. 412 PUBLIC LAW 105-33 —AUG. 5, 1997 the midpoint of the period for such data through the midpoint of fiscal year 2000 and by an increase factor (described in subparagraph (C)) specified by the Secretary for subsequent fiscal years up to the fiscal year involved; "(ii) by reducing such rates by a factor equal to the proportion of payments under this subsection (as estimated by the Secretary) based on prospective pay- ment amounts which are additional payments described in paragraph (4) (relating to outlier and related payments); "(iii) for variations among rehabilitation facilities by area under paragraph (6); "(iv) by the weighting factors established under paragraph (2)(B); and "(v) by such other factors as the Secretary determines are necessary to properly reflect variations in necessary costs of treatment among rehabilitation facilities. "(B) BUDGET NEUTRAL RATES. —The Secretary shall establish the prospective payment amounts under this subsection for payment units during fiscal years 2001 and 2002 at levels such that, in the Secretary's estimation, the amount of total payments under this subsection for such fiscal years (including any payment adjustments pursuant to paragraphs (4) and (6)) shall be equal to 98 percent of the amount of payments that would have been made under this title during the fiscal years for operating and capital costs of rehabilitation facilities had this subsection not been enacted. In establishing such pa5anent amounts, the Secretary shall consider the effects of the prospective payment system established under this subsection on the total number of payment units from rehabilitation facilities and other factors described in subparagraph (A). "(C) INCREASE FACTOR.— For purposes of this subsection for payment units in each fiscal year (beginning with fiscal year 2001), the Secretary shall establish an increase factor. Such factor shall be based on an appropriate percentage increase in a market basket of goods and services comprising services for which payment is made under this subsection, which may be the market basket percentage increase described in subsection (b)(3)(B)(iii). " (4) OUTLIER AND SPECIAL PAYMENTS. — "(A) OUTLIERS.— "(i) IN GENERAL.— The Secretary may provide for an additional payment to a rehabilitation facility for patients in a case mix group, based upon the patient being classified as an outlier based on an unusual length of stay, costs, or other factors specified by the Secretary. " (ii) PAYMENT BASED ON MARGINAL COST OF CARE.— The amount of such additional pa3anent under clause (i) shall be determined by the Secretary and shall approximate the marginal cost of care beyond the cutoff point applicable under clause (i).

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