Page:United States Statutes at Large Volume 117.djvu/2251

 117 STAT. 2232

PUBLIC LAW 108–173—DEC. 8, 2003 ‘‘(C) APPLICATION OF UPDATE TO SPECIAL PAYMENT AMOUNT.—The covered item update under paragraph (14) for specified items and supplies for 2006 and each subsequent year shall be applied to the payment amount under subparagraph (A) unless payment is made for such items and supplies under section 1847.’’. (3) PROSTHETIC DEVICES AND ORTHOTICS AND PROSTHETICS.—Section 1834(h)(4)(A) (42 U.S.C. 1395m(h)(4)(A)) is amended— (A) in clause (vii), by striking ‘‘and’’ at the end; (B) in clause (viii), by striking ‘‘a subsequent year’’ and inserting ‘‘2003’’; and (C) by adding at the end the following new clauses: ‘‘(ix) for 2004, 2005, and 2006, 0 percent; and ‘‘(x) for a subsequent year, the percentage increase in the consumer price index for all urban consumers (United States city average) for the 12-month period ending with June of the previous year;’’. (d) CONFORMING AMENDMENTS.— (1) DURABLE MEDICAL EQUIPMENT; LIMITATION OF INHERENT REASONABLENESS AUTHORITY.—Section 1834(a) (42 U.S.C. 1395m(a)) is amended— (A) in paragraph (1)(B), by striking ‘‘The payment basis’’ and inserting ‘‘Subject to subparagraph (F)(i), the payment basis’’; (B) in paragraph (1)(C), by striking ‘‘This subsection’’ and inserting ‘‘Subject to subparagraph (F)(ii), this subsection’’; (C) by adding at the end of paragraph (1) the following new subparagraph: ‘‘(F) APPLICATION OF COMPETITIVE ACQUISITION; LIMITATION OF INHERENT REASONABLENESS AUTHORITY.—In the case of covered items furnished on or after January 1, 2009, that are included in a competitive acquisition program in a competitive acquisition area under section 1847(a)— ‘‘(i) the payment basis under this subsection for such items and services furnished in such area shall be the payment basis determined under such competitive acquisition program; and ‘‘(ii) the Secretary may use information on the payment determined under such competitive acquisition programs to adjust the payment amount otherwise recognized under subparagraph (B)(ii) for an area that is not a competitive acquisition area under section 1847 and in the case of such adjustment, paragraph (10)(B) shall not be applied.’’; and (D) in paragraph (10)(B), by inserting ‘‘in an area and with respect to covered items and services for which the Secretary does not make a payment amount adjustment under paragraph (1)(F)’’ after ‘‘under this subsection’’. (2) OFF-THE-SHELF ORTHOTICS; LIMITATION OF INHERENT REASONABLENESS AUTHORITY.—Section 1834(h) (42 U.S.C. 1395m(h)) is amended— (A) in paragraph (1)(B), by striking ‘‘and (E)’’ and inserting ‘‘, (E), and (H)(i)’’;

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