Page:United States Statutes at Large Volume 113 Part 2.djvu/859

 PUBLIC LAW 106-113—APPENDIX F 113 STAT. 1501A-341 (i) No IMPACT ON COPAYMENT.— Section 1833(t)(7) (42 U.S.C. 13951(t)(7)), as redesignated by subsection (a), is amended by adding at the end the following new subparagraph: " (D) COMPUTATION IGNORING OUTLIER AND PASS- THROUGH ADJUSTMENTS. —The copayment amount shall be computed under subparagraph (A) as if the adjustments under paragraphs (5) and (6) (and any adjustment made under paragraph (2)(E) in relation to such adjustments) had not occurred.". (j) TECHNICAL CORRECTION IN REFERENCE; RELATING TO HOS- PITAL-BASED AMBULANCE SERVICES. —Section 1833(t)(9) (42 U.S.C. 13951(t)(9)), as redesignated by subsection (a), is amended by striking "the matter in subsection (a)(1) preceding subparagraph (A)" and inserting "section 1861(v)(l)(U)". (k) EXTENSION OF PAYMENT PROVISIONS OF SECTION 4522 OF BBA UNTIL IMPLEMENTATION OF PPS.— Section 1861(v)(l)(S)(ii) (42 U.S.C. 1395x(v)(l)(S)(ii)) is amended in subclauses (I) and (II) by striking "and during fiscal year 2000 before January 1, 2000" and inserting "and until the first date that the prospective payment system under section 1833(t) is implemented" each place it appears. (1) CONGRESSIONAL INTENTION REGARDINI]^ BASE AMOUNTS IN APPLYING THE HOPD PPS. —With respect to determining the amount of copayments described in paragraph (3)(A)(ii) of section 1833(t) of the Social Security Act, as added by section 4523(a) of BBA, Congress finds that such amount should be determined without regard to such section, in a budget neutral manner with respect to aggregate payments to hospitals, and that the Secretary of Health and Human Services has the authority to determine such amount without regard to such section. (m) EFFECTIVE DATE. — Except as provided in this section, the amendments made by this section shall be effective as if included in the enactment of BBA. (n) STUDY OF DELIVERY OF INTRAVENOUS IMMUNE GLOBULIN (IVIG) OUTSIDE HOSPITALS AND PHYSICIANS' OIFFICESJ— (1) STUDY. —The Secretary of Health and Human Services shall conduct a study of the extent to which intravenous immune globulin (IVIG) could be delivered and reimbursed under the medicare program outside of a hospital or physician's office. In conducting the study, the Secretary shall— (A) consider the sites of service that other payors, including Medicare+Choice plans, use for these drugs and biologicals; (B) determine whether covering the delivery of these drugs and biologicals in a medicare patient's home raises any additional safety and health concerns for the patient; (C) determine whether covering the delivery of these drugs and biologicals in a patient's home can reduce overall spending under the medicare program; and (D) determine whether changing the site of setting for these services would affect beneficiary access to care. (2) REPORT. —The Secretary shall submit a report on such study to the Committees on Ways and Means and Commerce of the House of Representatives and the Committee on Finance of the Senate within 18 months after the date of the enactment of this Act. The Secretary shall include in the report recommendations regarding the appropriate? manner and settings under which the medicare program should pay for these drugs

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