Page:United States Statutes at Large Volume 117.djvu/2334

 PUBLIC LAW 108–173—DEC. 8, 2003

117 STAT. 2315

the bundling of payment for drugs and biologicals into the basic case-mix adjusted payment system under this paragraph.’’. (2) Paragraph (7) of such section is amended in the first sentence by striking ‘‘The Secretary’’ and inserting ‘‘Subject to paragraph (12), the Secretary’’. (3) Paragraph (11)(B) of such section is amended by inserting ‘‘subject to paragraphs (12) and (13)’’ before ‘‘payment for such item’’. (e) DEMONSTRATION OF BUNDLED CASE-MIX ADJUSTED PAYMENT SYSTEM FOR ESRD SERVICES.— (1) IN GENERAL.—The Secretary shall establish a demonstration project of the use of a fully case-mix adjusted payment system for end stage renal disease services under section 1881 of the Social Security Act (42 U.S.C. 1395rr) for patient characteristics identified in the report under subsection (f) that bundles into such payment rates amounts for— (A) drugs and biologicals (including erythropoietin) furnished to end stage renal disease patients under the medicare program which are separately billed by end stage renal disease facilities (as of the date of the enactment of this Act); and (B) clinical laboratory tests related to such drugs and biologicals. (2) FACILITIES INCLUDED IN THE DEMONSTRATION.—In conducting the demonstration under this subsection, the Secretary shall ensure the participation of a sufficient number of providers of dialysis services and renal dialysis facilities, but in no case to exceed 500. In selecting such providers and facilities, the Secretary shall ensure that the following types of providers are included in the demonstration: (A) Urban providers and facilities. (B) Rural providers and facilities. (C) Not-for-profit providers and facilities. (D) For-profit providers and facilities. (E) Independent providers and facilities. (F) Specialty providers and facilities, including pediatric providers and facilities and small providers and facilities. (3) TEMPORARY ADD-ON PAYMENT FOR DIALYSIS SERVICES FURNISHED UNDER THE DEMONSTRATION.— (A) IN GENERAL.—During the period of the demonstration project, the Secretary shall increase payment rates that would otherwise apply under section 1881(b) of such Act (42 U.S.C. 1395rr(b)) by 1.6 percent for dialysis services furnished in facilities in the demonstration site. (B) RULES OF CONSTRUCTION.—Nothing in this subsection shall be construed as— (i) as an annual update under section 1881(b) of the Social Security Act (42 U.S.C. 1395rr(b)); (ii) as increasing the baseline for payments under such section; or (iii) requiring the budget neutral implementation of the demonstration project under this subsection. (4) 3-YEAR PERIOD.—The Secretary shall conduct the demonstration under this subsection for the 3-year period beginning on January 1, 2006. (5) USE OF ADVISORY BOARD.—

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