Page:United States Statutes at Large Volume 94 Part 2.djvu/1363

 PUBLIC LAW 96-499—DEC. 5, 1980

94 STAT. 2641

Subpart II—Administrative Changes and Miscellaneous Provisions PRESUMED COVERAGE PROVISIONS

SEC. 941. (a) Section 1814 of the Social Security Act is amended by 42 USC I395f. striking out subsections (h) and (i) and by redesignating subsection (j) as subsection (h). (b) Section 1814(c) of such Act is amended by striking out "subsec- 42 USC 1395f note. tion (j)" and inserting in lieu thereof "subsection (h)". (c) The amendments made by this section shall take effect on January 1, 1981. PAYMENT TO PROVIDERS OP SERVICES

SEC. 942. Section 1833(a) of such Act is amended by striking out paragraphs (2) and (3) and inserting in lieu thereof the following: "(2) in the case of services described in section 1832(a)(2) (except those services described in subparagraphs (D), (E), and (F) of such section and in paragraph (5) of this subsection and unless otherwise specified in section 1881)— "(A) with respect to home health services, the reasonable cost of such services, as determined under section 1861(v); "(B) with respect to other services (except those described in subparagraph (C) of this paragraph), the reasonable costs of such services, as so determined, less the amount a provider may charge as described in clause (ii) of section 1866(a)(2)(A), but in no case may the payment for such other services exceed 80 percent of such costs; and "(C) with respect to services described in the second sentence of section 1861(p), 80 percent of the reasonable charges for such services; "(3) in the case of services described in subparagraphs (D) and (E) of section 1832(a)(2), the costs which are reasonable and related to the cost of furnishing such services or which are based on such other tests of reasonableness as the Secretary may prescribe in regulations, including those authorized under section 1861(v)(l)(A), less the amount a provider may charge as described in clause (ii) of section 1866(a)(2)(A), but in no case may the payment for such services exceed 80 percent of such costs; "(4) in the case of facility services described in subparagraph (F) of section 1832(a)(2), the applicable amount described in paragraph (2) of section 1833(i); and "(5) in the case of preadmission diagnostic services described in section 1861(s)(2)(C) which are furnished to an individual by the outpatient department of a hospital within 7 days of such individual's admission to the same hospital as an inpatient or (to the extent practicable as determined by regulations prescribed by the Secretary) to another hospital, the reasonable costs for such services.".

42 USC 1395/. 42 USC I395k. 42 USC I395rr. 42 USC I395x.

42 USC I395cc. 42 USC I395x. 42 USC I395k.

42 USC I395x. 42 USC I395cc. 42 USC I395k. ^^^e, p. 2637. 42 USC I395x.

LIMITATION ON PAYMENTS TO RADIOLOGISTS AND PATHOLOGISTS

SEC. 943. (a) Subsections (a)(1)(B) and (b)(2) of section 1833 of the 42 USC 1395/. Social Security Act are each amended by inserting after "pathology" the following: "who has in effect an agreement with the Secretary by which the physician agrees to accept an assignment (as provided for in section 1842(b)(3)(B)(ii)) for all physicians' services furnished by 42 USC I395u. him to hospital inpatients enrolled under this part".

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