Page:United States Statutes at Large Volume 111 Part 1.djvu/466

 Ill STAT. 442 PUBLIC LAW 105-33 —AUG. 5, 1997 if so, what legislative changes, if any should be made to improve such contracts. 42 USC 1395a (c) EFFECTIVE DATE.— The amendment made by subsection (a) i^ote shall apply with respect to contracts entered into on and after January 1, 1998. Subchapter B—Other Health Care Professionals SEC. 4511. INCREASED MEDICARE REIMBURSEMENT FOR NURSE PRACTITIONERS AND CLINICAL NURSE SPECIALISTS. (a) REMOVAL OF RESTRICTIONS ON SETTINGS.— (1) IN GENERAL.— Clause (ii) of section 1861(s)(2)(K) (42 U.S.C. 1395x(s)(2)(K)) is amended to read as follows: "(ii) services which would be physicians' services if furnished by a physician (as defined in subsection (r)(l)) and which are performed by a nurse practitioner or clinical nurse specialist (as defined in subsection (aa)(5)) working in collaboration (as defined in subsection (aa)(6)) with a physician (as defined in subsection (r)(l)) which the nurse practitioner or clinical nurse specialist is legally authorized to perform by the State in which the services are performed, and such services and supplies furnished as an incident to such services as would be covered under subparagraph (A) if furnished incident to a physician's professional service, but only if no facility or other provider charges or is paid any amounts with respect to the furnishing of such services;". (2) CONFORMING AMENDMENTS. — (A) Section 1861(s)(2)(K) (42 U.S.C. 1395x(s)(2)(K)) is further amended— (i) in clause (i), by inserting "and such services and supplies furnished as incident to such services as would be covered under subparagraph (A) if furnished incident to a physician's professional service; and" after "are performed,"; and (ii) by striking clauses (iii) and (iv). (B) Section 1861(b)(4) (42 U.S.C. 1395x(b)(4)) is amended by striking "clauses (i) or (iii) of subsection (s)(2)(K)" and inserting "subsection (s)(2)(K)". (C) Section 1862(a)(14) (42 U.S.C. 1395y(a)(14)) is amended by striking "section 1861(s)(2)(K)(i) or 1861(s)(2)(K)(iii)" and inserting "section 1861(s)(2)(K)". (D) Section 1866(a)(1)(H) (42 U.S.C. 1395cc(a)(l)(H)) is amended by striking "section 1861(s)(2)(K)(i) or 1861(s)(2)(K)(iii)" and inserting "section 1861(s)(2)(K)". (E) Section 1888(e)(2)(A)(ii) (42 U.S.C. 1395yy(e)(2)(A)(ii)), as added by section 4432(a) (relating to prospective payment system for rehabilitation hospitals), is amended by striking "through (iii)" and inserting "and (ii)". (b) INCREASED PAYMENT.— (1) FEE SCHEDULE AMOUNT.— Subparagraph (O) of section 1833(a)(1) (42 U.S.C. 13951(a)(1)) is amended to read as follows: "(O) with respect to services described in section 1861(s)(2)(K)(ii) (relating to nurse practitioner or clinical nurse specialist services), the amounts paid shall be equal to 80 percent of (i) the lesser of the actual charge or 85 percent of the fee schedule amount provided under section 1848, or (ii) in the case of services as an assistant at surgery, the lesser of the actual charge or 85 percent of the amount that

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