Page:United States Statutes at Large Volume 111 Part 1.djvu/468

 Ill STAT. 444 PUBLIC LAW 105-33 —AUG. 5, 1997 42 USC 1395/ note. 42 USC 1395X note. 42 USC 1395x note. 42 USC 1395/ note. (B) by striking "nurse practitioner or clinical nurse specialist services" and inserting "services furnished by physician assistants, nurse practitioners, or clinic nurse specialists". (2) CONFORMING AMENDMENT. —Paragraph (12) of section 1842(b) (42 U.S.C. 1395u(b)) is repealed. (c) REMOVAL OF RESTRICTION ON EMPLOYMENT RELATIONSHIP.— Section 1842(b)(6) (42 U.S.C. 1395u(b)(6)), as amended by section 4205, is amended by adding at the end the following new sentence: "For purposes of subparagraph (C) of the first sentence of this paragraph, an employment relationship may include any independent contractor arrangement, and employer status shall be determined in accordance with the law of the State in which the services described in such clause are performed.". (d) EFFECTIVE DATE. —The amendments made by this section shall apply with respect to services furnished and supplies provided on and after January 1, 1998. SEC. 4513. NO X-RAY REQUIRED FOR CHIROPRACTIC SERVICES. (a) IN GENERAL.—Section 1861(r)(5) (42 U.S.C. 1395x(r)(5)) is amended by striking "demonstrated by X-ray to exist". (b) EFFECTIVE DATE. —The amendment made by subsection (a) applies to services furnished on or after January 1, 2000. (c) UTILIZATION GUIDELINES.— The Secretary of Health and Human Services shall develop and implement utilization guidelines relating to the coverage of chiropractic services under part B of title XVIII of the Social Security Act in cases in which a subluxation has not been demonstrated by X-ray to exist. CHAPTER 2—PAYMENT FOR HOSPITAL OUTPATIENT DEPARTMENT SERVICES SEC. 4521. ELIMINATION OF FORMULA-DRIVEN OVERPAYMENTS (FDO) FOR CERTAIN OUTPATIENT HOSPITAL SERVICES. (a) ELIMINATION OF FDO FOR AMBULATORY SURGICAL CENTER PROCEDURES.— Section 1833(i)(3)(B)(i)(II) (42 U.S.C. 13951(i)(3)(B)(i)(II)) is amended— (1) by striking "of 80 percent"; and (2) by striking the period at the end and inserting the following: ", less the amount a provider may charge as described in clause (ii) of section 1866(a)(2)(A).". (b) ELIMINATION OF FDO FOR RADIOLOGY SERVICES AND DIAG- NOSTIC PROCEDURES. — Section 1833(n)(l)(B)(i) (42 U.S.C. 13951(n)(l)(B)(i)) is amended— (1) by striking "of 80 percent", and (2) by inserting before the period at the end the following: ", less the amount a provider may charge as described in clause (ii) of section 1866(a)(2)(A)". (c) EFFECTIVE DATE. —The amendments made by this section shall apply to services furnished during portions of cost reporting periods occurring on or after October 1, 1997. SEC. 4522. EXTENSION OF REDUCTIONS IN PAYMENTS FOR COSTS OF HOSPITAL OUTPATIENT SERVICES. (a) REDUCTION IN PAYMENTS FOR CAPITAL-RELATED COSTS.— Section 1861(v)(l)(S)(ii)(I) (42 U.S.C. 1395x(v)(l)(S)(ii)(I)) is amended by striking "through 1998" and inserting "through 1999 and during fiscal year 2000 before January 1, 2000".

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