Page:United States Statutes at Large Volume 114 Part 5.djvu/564

 114 STAT. 2763A-524 PUBLIC LAW 106-554—APPENDIX F (i) the method and amount of reimbursement for similar drugs and biologicals made by large group health plans; (ii) as a result of any revised payment methodology, the potential for patients to receive inpatient or outpatient hospital services in lieu of services in a physician's office; and (iii) the effect of any revised payment methodology on the delivery of drug therapies by hospital outpatient departments. (D) COORDINATION WITH BBRA STUDY.—In making recommendations under this paragraph, the Comptroller General shall conclude and take into account the results of the study provided for under section 213(a) of BBRA (113 Stat. 1501A-350). (b) IMPLEMENTATION OF NEW PAYMENT METHODOLOGY. — (1) IN GENERAL.— Notwithstanding any other provision of law, based on the recommendations contained in the report under subsection (a), the Secretary of Health and Human Services, subject to paragraph (2), shall revise the payment methodology under section 1842(o) of the Social Security Act (42 U.S.C. 1395u(o)) for drugs and biologicals furnished under part B of the medicare program. To the extent the Secretary determines appropriate, the Secretary may provide for the adjustments to payments amounts referred to in subsection (a)(3)(A)(i) or additional payments referred to in subsection (a)(2)(A)(ii). (2) LIMITATION.—In revising the payment methodology under paragraph (1), in no case may the estimated aggregate payments for drugs and biologicals under the revised system (including additional payments referred to in subsection (a)(3)(A)(ii)) exceed the aggregate amount of payment for such drugs and biologicals, as projected by the Secretary, that would have been made under the payment methodology in effect under such section 1842(o). (c) MORATORIUM ON DECREASES IN PAYMENT RATES. — Notwithstanding any other provision of law, effective for drugs and biologicals furnished on or after January 1, 2001, the Secretary may not directly or indirectly decrease the rates of reimbursement (in effect as of such date) for drugs and biologicals under the current medicare payment methodology (provided under section 1842(o) of the Social Security Act (42 U.S.C. 1395u(o))) until such time as the Secretary has reviewed the report submitted under subsection (a)(2). SEC. 430. CONTRAST ENHANCED DIAGNOSTIC PROCEDURES UNDER HOSPITAL PROSPECTIVE PAYMENT SYSTEM. (a) SEPARATE CLASSIFICATION.—Section 1833(t)(2) (42 U.S.C. 13951(t)(2)) is amended— (1) by striking "and" at the end of subparagraph (E); (2) by striking the period at the end of subparagraph (F) and inserting "; and"; and (3) by inserting after subparagraph (F) the following new subparagraph: "(G) the Secretary shall create additional groups of covered OPD services that classify separately those procedures that utilize contrast agents from those that do not.".

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