Page:United States Statutes at Large Volume 96 Part 1.djvu/379

 PUBLIC LAW 97-248—SEPT. 3, 1982

96 STAT. 337

in a physician's office, taking into account the extent to which overhead costs associated with such outpatient services have been included in the reasonable cost or charge of the facility". (b) The amendment made by subsection (a) made by this section Effective date. shall be effective with respect to services furnished on or after ^^ ^^^ l395u note. October 1, 1982. SINGLE REIMBURSEMENT LIMIT FOR HOME HEALTH AGENCIES

SEC. 105. (a) Section 1861(v)(l)(L) of the Social Security Act, as 42 USC I395x amended by section 101(a)(2) of this subtitle, is amended by inserting "free standing" after "75th percentile of such costs per visit for". (b) The amendment made by subsection (a) shall be effective with Effective date. respect to cost reporting periods beginning on or after the date of 42 USC 1395x note. the enactment of this Act. PROHIBITING PAYMENT FOR HILL-BURTON FREE CARE

SEC. 106. (a) Section 1861(v)(l) of the Social Security Act is amended by adding at the end the following new subparagraph: "(M) Such regulations shall provide that costs respecting care provided by a provider of services, pursuant to an assurance under title VI or XVI of the Public Health Service Act that the provider will make available a reasonable volume of services to persons unable to pay therefor, shall not be allowable as reasonable costs.". (b) The amendment made by subsection (a) shall be effective with respect to any costs incurred under title XVIII of the Social Security Act, except that it shall not apply to costs which have been allowed prior to the date of the enactment of this Act pursuant to the final court order affirmed by a United States Court of Appeals.

42 USC 1395x.

42 USC 291a, 300o. Effective date. 42 USC 1395x note. 42 USC 1395.

PROHIBITING PAYMENT FOR ANTI-UNIONIZATION ACTIVITIES

SEC. 107. (a) Section 1861(v)(l) of the Social Security Act, as amended by section 106(a) of this subtitle, is further amended by adding after subparagraph (M) the following new subparagraph: "(N) In determining such reasonable costs, costs incurred for activities directly related to influencing employees respecting unionization may not be included.". (b) The amendment made by subsection (a) shall be effective with respect to costs incurred after the date of the enactment of this Act.

Effective date. 42 USC 1395x note.

REIMBURSEMENT OF PROVIDER-BASED PHYSICIANS

SEC 108. (a) Title XVIII of the Social Security Act is amended by adding after section 1886 of the Social Security Act (as added by section lOl(a)(l) of this subtitle) the following new section: PAYMENT OF PROVIDER-BASED PHYSICIANS

"SEC. 1887. (a)(1) The Secretary shall by regulation determine 42 USC i395xx. criteria for distinguishing those services (including inpatient and outpatient services) rendered in hospitals or skilled nursing facilities— "(A) which constitute professional medical services, which are personally rendered for an individual patient by a physician and which contribute to the diagnosis or treatment of an indi-

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