Page:United States Statutes at Large Volume 111 Part 1.djvu/461

 PUBLIC LAW 105-33 —AUG. 5, 1997 111 STAT. 437 "(II) the number of practice expense relative value units (determined for 1998) exceeds 110 percent of the number of work relative value units (determined for such year). "(iii) EXCLUDED SERVICES.—For purposes of clause (ii), the services described in this clause are services which the Secretary determines at least 75 percent of which are provided under this title in an office setting. "(iv) LIMITATION ON AGGREGATE REALLOCATION. — If the application of clause (i)(I) would result in an aggregate amount of reductions under such clause in excess of $390,000,000, such clause shall be applied by substituting for 110 percent such greater percentage as the Secretary estimates will result in the aggregate amount of such reductions equaling $390,000,000. "(v) No REDUCTION FOR CERTAIN SERVICES.— Practice expense relative value units for a procedure performed in an office or in a setting out of an office shall not be reduced under clause (i) if the in-office or out-of-office practice expense relative value, respectively, for the procedure would increase under the proposed rule on resource-based practice expenses issued by the Secretary on June 18, 1997 (62 Federal Register 33158 et seq.).". (f) APPLICATION OF RESOURCE-BASED METHODOLOGY TO MAL- PRACTICE RELATIVE VALUE UNITS. — (1) IN GENERAL. —Section 1848(c)(2)(C)(iii) (42 U.S.C. 1395w-4(c)(2)(C)(iii)) is amended— (A) in paragraph (2)(C)(iii)— (i) by inserting "for the service for years before 2000" before "equal", and (ii) by striking the period at the end and inserting a comma and by adding at the end the following flush matter: "and for years beginning with 2000 based on the malpractice expense resources involved in furnishing the service."; and (B) in paragraph (3)(C)(iii), by striking "The malpractice" and inserting "For years before 1999, the malpractice". (2) APPLICATION OF CERTAIN BUDGET NEUTRALITY PROVI- SIONS. —In implementing the amendment made by paragraph (l)(A)(ii), the provisions of clauses (ii)(II) and (iii) of section 1848(c)(2)(B) of the Social Security Act (42 U.S.C. 1395w- 4(c)(2)(B)) shall apply in the same manner as they apply to adjustments under clause (ii)(I) of such section. SEC. 4506. DISSEMINATION OF INFORMATION ON HIGH PER DIS- CHARGE RELATIVE VALUES FOR IN-HOSPITAL PHYSI- CIANS' SERVICES. (a) DETERMINATION AND NOTICE CONCERNING HOSPITAL-SPE- CIFIC PER DISCHARGE RELATIVE VALUES.— (1) IN GENERAL.—For 1999 and 2001 the Secretary of Health and Human Services shall determine for each hospital— (A) the hospital-specific per discharge relative value under subsection (b); and 42 USC 1395w^ note. 42 USC 1395WW note.

�