Page:United States Statutes at Large Volume 122.djvu/2578

 12 2 STA T . 2 5 55 PUBLIC LA W 11 0– 2 7 5 —J UL Y 15, 200 8‘ ‘ (i i )Aprov i de ro fs ervi c esorre nal dial y sis facili t y m ay ma k e a one - time election to b ee x cl u ded from t h e phase-in under clause (i) and be paid entirely based on the payment amount under the payment system under this para g raph .S uch an election shall be made prior to J anuary 1,20 11, in a form and manner specified by the Secretary, and is final and may not be rescinded. ‘‘(iii) T he Secretary shall make an ad j ustment to the payments under this paragraph for years during w hich the phase-in under clause (i) is applicable so that the estimated total amount of pay- ments under this paragraph, including payments under this subparagraph, shall e q ual the estimated total amount of payments that would otherwise occur under this paragraph without such phase-in. ‘‘( F )(i) Subject to clause (ii), beginning in 2012, the Secretary shall annually increase payment amounts established under this paragraph by an E S RD market basket percentage increase factor for a bundled payment system for renal dialysis services that reflects changes over time in the prices of an appropriate mix of goods and services included in renal dialysis services minus 1.0 percentage point. ‘‘(ii) For years during which a phase-in of the payment system pursuant to subparagraph (E) is applicable, the following rules shall apply to the portion of the payment under the system that is based on the payment of the composite rate that would otherwise apply if the system under this paragraph had not been enacted

‘‘( I ) The update under clause (i) shall not apply. ‘‘(II) The Secretary shall annually increase such composite rate by the ESRD market basket percentage increase factor described in clause (i) minus 1.0 percentage point. ‘‘( G ) There shall be no administrative or judicial review under section 1 869, section 18 7 8, or otherwise of the determination of payment amounts under subparagraph (A), the establishment of an appropriate unit of payment under subparagraph ( C ), the identi- fication of renal dialysis services included in the bundled payment, the adjustments under subparagraph (D), the application of the phase-in under subparagraph (E), and the establishment of the market basket percentage increase factors under subparagraph (F). ‘‘( H ) Erythropoiesis stimulating agents and other drugs and biologicals shall be treated as prescribed and dispensed or adminis- tered and available only under part B if they are — ‘‘(i) furnished to an individual for the treatment of end stage renal disease and ‘‘(ii) included in subparagraph (B) for purposes of payment under this paragraph. ’ ’. (2) PROHIB I T IO N O FU NBUN DL IN G .—Section 1862(a) of the Social Security Act ( 4 2 U .S.C. 1 3 9 5 y(a)), as amended by section 135(a)(2), is amended— (A) in paragraph (22), by striking ‘‘or’’ at the end; (B) in paragraph (23), by striking the period at the end and inserting ‘‘; or’’; and (C) by inserting after paragraph (23) the following new paragraph: ‘‘(24) where such expenses are for renal dialysis services (as defined in subparagraph (B) of section 1881(b)(14)) for which payment is made under such section unless such payment is made under such section to a provider of services or a renal dialysis facility for such services.’’. Ef f ectiv e da te .D ead l i n e.

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