Page:United States Statutes at Large Volume 114 Part 5.djvu/560

 114 STAT. 2763A-520 PUBLIC LAW 106-554—APPENDIX F (b) SPECIAL RULE FOR PAYMENT FOR 2001.— Notwithstanding the amendments made by subsection (a), for purposes of making payments for prosthetic devices and orthotics and prosthetics (as defined in subparagraphs (B) and (C) of paragraph (4) of section 1834(h) of the Social Security Act (42 U.S.C. 1395m(h)) under such section, the payment basis recognized for 2001 under paragraph (2) of such section— (1) for items furnished on or after January 1, 2001, and before July 1, 2001, shall be the payment basis for 2001 as determined under the provisions of law in effect on the day before the date of the enactment of this Act; and (2) for items furnished on or after July 1, 2001, and before January 1, 2002, shall be the payment basis that is determined under such section taking into account the amendments made by subsection (a), increased by a transitional percentage allowance equal to 2.6 percent (to account for the timing of implementation of the CPI update). SEC. 427. ESTABLISHMENT OF SPECIAL PAYMENT PROVISIONS AND REQUIREMENTS FOR PROSTHETICS AND CERTAIN CUS- TOM-FABRICATED ORTHOTIC ITEMS. (a) IN GENERAL.— Section 1834(h)(1) (42 U.S.C. 1395m(h)(l)) is amended by adding at the end the following: "(F) SPECIAL PAYMENT RULES FOR CERTAIN PROSTHETICS AND CUSTOM-FABRICATED ORTHOTICS. — "(i) IN GENERAL. — No payment shall be made under this subsection for an item of custom-fabricated orthotics described in clause (ii) or for an item of prosthetics unless such item is— "(I) furnished by a qualified practitioner; and "(II) fabricated by a qualified practitioner or a qualified supplier at a facility that meets such criteria as the Secretary determines appropriate, "(ii) DESCRIPTION OF CUSTOM-FABRICATED ITEM.— "(I) IN GENERAL. —An item described in this clause is an item of custom-fabricated orthotics that requires education, training, and experience to custom-fabricate and that is included in a list established by the Secretary in subclause (II). Such an item does not include shoes and shoe inserts. "(II) LIST OF ITEMS.—The Secretary, in consultation with appropriate experts in orthotics (including national organizations representing manufacturers of orthotics), shall establish and update as appropriate a list of items to which this subparagraph applies. No item may be included in such list unless the item is individually fabricated for the patient over a positive model of the patient. "(iii) QUALIFIED PRACTITIONER DEFINED.—In this subparagraph, the term 'qualified practitioner* means a physician or other individual who— "(I) is a qualified physiceJ therapist or a qualified occupational therapist; "(II) in the case of a State that provides for the licensing of orthotics and prosthetics, is

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