Page:United States Statutes at Large Volume 96 Part 1.djvu/378

 96 STAT. 336

42 USC 1395Z. 42 USC 1395x.

Ante, p. 331.

PUBLIC LAW 97-248—SEPT. 3, 1982 (B) by striking out "until the Secretary determines" in the second sentence and inserting in lieu thereof "until the first day of the seventh month beginning after the date the Secretary determines and notifies the Governor of the State". (2) Section 1833(a)(2)(B) of such Act is amended by inserting "and except as may be provided in section 1886" after "except those described in subparagraph (C) of this paragraph". (d) Section 1861(v)(7) of such Act is amended by inserting "(A)" after "(7)" and by adding at the end thereof the following new subparagraph: "(B) For further limitations on reasonable cost and determination of payment amounts for operating costs of inpatient hospital services and waivers for certain States, see section 1886.". SINGLE REIMBURSEMENT LIMIT FOR SKILLED NURSING FACILITIES

42 USC 1395x.

Effective date. 42 USC 1395x note.

SEC. 102. (a) Section 1861(v)(l) of the Social Security Act is amended— (1) in subparagraph (E), by striking out "; except that" and all that follows and inserting in lieu thereof a period; (2) in subparagraph (E), by striking out "(E)" and inserting in lieu thereof "(ii)"; and (3) by inserting after subparagraph (D) the following: "(E)(i) Such regulations shall provide that any determination of reasonable cost with respect to services provided by hospital-based skilled nursing facilities shall be made on the basis of a single standard based on the reasonableness of costs incurred by free standing skilled nursing facilities, subject to such adjustments as the Secretary may deem appropriate.". (b) The amendment made by subsection (a) shall be effective with respect to cost reporting periods beginning on or after October 1, 1982. ELIMINATION OF INPATIENT ROUTINE NURSING SALARY COST DIFFERENTIAL

95 Stat. 797. 42 USC 1395x. Effective date. 42 USC 1395x note. 42 USC 1395.

SEC. 103. (a) Subparagraph (J) of section 1861(v)(l) of the Social Security Act is amended to read as follows: "(J) Such regulations may not provide for any inpatient routine salary cost differential as a reimbursable cost for hospitals and skilled nursing facilities.". (b) The amendment made by subsection (a) shall be effective with respect to cost reporting periods ending after September 30, 1982, but in the case of any cost reporting period beginning before October 1, 1982, any reduction in payments under title XVIII of the Social Security Act to a hospital or skilled nursing facility resulting from such amendment shall be imposed only in proportion to the part of the period which occurs after September 30, 1982. ELIMINATION OF DUPLICATE OVERHEAD PAYMENTS FOR OUTPATIENT SERVICES

42 USC 1395U.

SEC. 104. (a) The last sentence of section 1842(b)(3) of the Social Security Act is amended by inserting after "1861(v)(l)(K)" the following: ", and in determining the reasonable charge for such services, the Secretary may limit such reasonable charge to a percentage of the amount of the prevailing charge for similar services furnished

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