Page:United States Statutes at Large Volume 120.djvu/72

 PUBLIC LAW 109–171—FEB. 8, 2006

120 STAT. 41

(1) in paragraph (4)(B), in the matter preceding clause (i), by striking ‘‘paragraph (5)’’ and inserting ‘‘paragraphs (5) and (6)’’; and (2) by adding at the end the following new paragraph: ‘‘(6) UPDATE FOR 2006.—The update to the single conversion factor established in paragraph (1)(C) for 2006 shall be 0 percent.’’. (b) NOT TREATED AS CHANGE IN LAW AND REGULATION IN SUSTAINABLE GROWTH RATE DETERMINATION.—The amendments made by subsection (a) shall not be treated as a change in law for purposes of applying section 1848(f)(2)(D) of the Social Security Act (42 U.S.C. 1395w–4(f)(2)(D)). (c) MEDPAC REPORT.— (1) IN GENERAL.—By not later than March 1, 2007, the Medicare Payment Advisory Commission shall submit a report to Congress on mechanisms that could be used to replace the sustainable growth rate system under section 1848(f) of the Social Security Act (42 U.S.C. 1395w–4(f)). (2) REQUIREMENTS.—The report required under paragraph (1) shall— (A) identify and examine alternative methods for assessing volume growth; (B) review options to control the volume of physicians’ services under the Medicare program while maintaining access to such services by Medicare beneficiaries; (C) examine the application of volume controls under the Medicare physician fee schedule under section 1848 of the Social Security Act (42 U.S.C. 1395w–4); (D) identify levels of application of volume controls, such as group practice, hospital medical staff, type of service, geographic area, and outliers; (E) examine the administrative feasibility of implementing the options reviewed under subparagraph (B), including the availability of data and time lags; (F) examine the extent to which the alternative methods identified and examined under subparagraph (A) should be specified in such section 1848; and (G) identify the appropriate level of discretion for the Secretary of Health and Human Services to change payment rates under the Medicare physician fee schedule or otherwise take steps that affect physician behavior. Such report shall include such recommendations on alternative mechanisms to replace the sustainable growth rate system as the Medicare Payment Advisory Commission determines appropriate. (3) FUNDING.—Out of any funds in the Treasury not otherwise appropriated, there are appropriated to the Medicare Payment Advisory Commission $550,000, to carry out this subsection.

42 USC 1395w–4 note.

SEC. 5105. THREE-YEAR TRANSITION OF HOLD HARMLESS PAYMENTS FOR SMALL RURAL HOSPITALS UNDER THE PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL OUTPATIENT DEPARTMENT SERVICES.

Section 1833(t)(7)(D)(i) of the Social Security Act (42 U.S.C. 1395l(t)(7)(D)(i)) is amended— (1) by inserting ‘‘(I)’’ before ‘‘In the case’’; and

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