Page:United States Statutes at Large Volume 117.djvu/2253

 117 STAT. 2234

PUBLIC LAW 108–173—DEC. 8, 2003 (1) ADJUSTMENT IN PRACTICE EXPENSE RELATIVE VALUE 1848(c)(2) (42 U.S.C. 1395w–4(c)(2)) is UNITS.—Section amended— (A) in subparagraph (B)— (i) in clause (ii)(II), by striking ‘‘The adjustments’’ and inserting ‘‘Subject to clause (iv), the adjustments’’; and (ii) by adding at the end of subparagraph (B), the following new clause: ‘‘(iv) EXEMPTION FROM BUDGET NEUTRALITY.—The additional expenditures attributable to— ‘‘(I) subparagraph (H) shall not be taken into account in applying clause (ii)(II) for 2004; ‘‘(II) subparagraph (I) insofar as it relates to a physician fee schedule for 2005 or 2006 shall not be taken into account in applying clause (ii)(II) for drug administration services under the fee schedule for such year for a specialty described in subparagraph (I)(ii)(II); and ‘‘(III) subparagraph (J) insofar as it relates to a physician fee schedule for 2005 or 2006 shall not be taken into account in applying clause (ii)(II) for drug administration services under the fee schedule for such year.’’; and (B) by adding at the end the following new subparagraphs: ‘‘(H) ADJUSTMENTS IN PRACTICE EXPENSE RELATIVE VALUE UNITS FOR CERTAIN DRUG ADMINISTRATION SERVICES BEGINNING IN 2004.— ‘‘(i) USE OF SURVEY DATA.—In establishing the

physician fee schedule under subsection (b) with respect to payments for services furnished on or after January 1, 2004, the Secretary shall, in determining practice expense relative value units under this subsection, utilize a survey submitted to the Secretary as of January 1, 2003, by a physician specialty organization pursuant to section 212 of the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 if the survey— ‘‘(I) covers practice expenses for oncology drug administration services; and ‘‘(II) meets criteria established by the Secretary for acceptance of such surveys. ‘‘(ii) PRICING OF CLINICAL ONCOLOGY NURSES IN PRACTICE EXPENSE METHODOLOGY.—If the survey described in clause (i) includes data on wages, salaries, and compensation of clinical oncology nurses, the Secretary shall utilize such data in the methodology for determining practice expense relative value units under subsection (c). ‘‘(iii) WORK RELATIVE VALUE UNITS FOR CERTAIN DRUG ADMINISTRATION SERVICES.—In establishing the relative value units under this paragraph for drug administration services described in clause (iv) furnished on or after January 1, 2004, the Secretary shall establish work relative value units equal to the work

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