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ommendations (and data on which the recommenda-
tions are based); 
‘‘(iv) taking into account the comments and rec-
ommendations (and accompanying data) received at 
such meeting, develops and makes available to the 
public (through an Internet site and other appro-
priate mechanisms) a list of proposed determinations 
with respect to the appropriate basis for establishing 
a payment amount under this subsection for each 
such code, together with an explanation of the rea-
sons for each such determination, the data on which 
the determinations are based, and a request for pub-
lic written comments on the proposed determination; 
and 
‘‘(v) taking into account the comments received 
during the public comment period, develops and 
makes available to the public (through an Internet 
site and other appropriate mechanisms) a list of 
final determinations of the payment amounts for 
such tests under this subsection, together with the 
rationale for each such determination, the data on 
which the determinations are based, and responses 
to comments and suggestions received from the pub-
lic.
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‘‘(C) Under the procedures established pursuant to 
subparagraph (A), the Secretary shall—
‘‘(i) set forth the criteria for making determina-
tions under subparagraph (A); and 
‘‘(ii) make available to the public the data 
(other than proprietary data) considered in making 
such determinations. 
‘‘(D) The Secretary may convene such further public 
meetings to receive public comments on payment amounts 
for new tests under this subsection as the Secretary deems 
appropriate. 
‘‘(E) For purposes of this paragraph: 
‘‘(i) The term ‘HCPCS’ refers to the Health 
Care Procedure Coding System. 
‘‘(ii) A code shall be considered to be ‘substan-
tially revised’ if there is a substantive change to the 
definition of the test or procedure to which the code 
applies (such as a new analyte or a new methodology 
for measuring an existing analyte-specific test).’’. 
(c) GAO STUDY ON IMPROVEMENTS IN EXTERNAL 
DATA COLLECTION FOR USE IN THE MEDICARE INPA-
TIENT PAYMENT SYSTEM.—
(1) STUDY.—The Comptroller General of the 
United States shall conduct a study that analyzes 
which external data can be collected in a shorter
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time frame by the Centers for Medicare & Medicaid 
Services for use in computing payments for inpatient 
hospital services. The study may include an evalua-
tion of the feasibility and appropriateness of using 
of quarterly samples or special surveys or any other 
methods. The study shall include an analysis of 
whether other executive agencies, such as the Bu-
reau of Labor Statistics in the Department of Com-
merce, are best suited to collect this information. 
(2) REPORT.—By not later than October 1, 
2004, the Comptroller General shall submit a report 
to Congress on the study under paragraph (1). 
(d) PROCESS
FOR ADOPTION
OF ICD CODES
AS 
DATA STANDARD.—Section 1172(f) (42 U.S.C. 1320d–
1(f)) is amended by inserting after the first sentence the 
following: ‘‘Notwithstanding the first sentence of this sub-
section, if the National Committee on Vital and Health 
Statistics has not made a recommendation to the Sec-
retary, within 1 year after the date of the enactment of 
this sentence, with respect to the adoption of the Inter-
national Classification of Diseases, 10th Revision, Proce-
dure Coding System (‘ICD–10–PCS’) and the Inter-
national Classification of Diseases, 10th Revision, Clinical 
Modification (‘ICD–10–CM’) as a standard under this
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part, then the Secretary may adopt ICD–10–PCS and 
ICD–10–CM as such a standard.’’. 
SEC. 943. TREATMENT OF HOSPITALS FOR CERTAIN SERV-
ICES UNDER MEDICARE SECONDARY PAYOR 
(MSP) PROVISIONS. 
(a) IN GENERAL.—The Secretary shall not require 
a hospital (including a critical access hospital) to ask ques-
tions (or obtain information) relating to the application 
of section 1862(b) of the Social Security Act (relating to 
medicare secondary payor provisions) in the case of ref-
erence laboratory services described in subsection (b), if 
the Secretary does not impose such requirement in the 
case of such services furnished by an independent labora-
tory. 
(b) 
REFERENCE
LABORATORY
SERVICES
DE-
SCRIBED.—Reference laboratory services described in this 
subsection are clinical laboratory diagnostic tests (or the 
interpretation of such tests, or both) furnished without a 
face-to-face encounter between the individual entitled to 
benefits under part A or enrolled under part B, or both, 
and the hospital involved and in which the hospital sub-
mits a claim only for such test or interpretation. 
SEC. 944. EMTALA IMPROVEMENTS. 
(a) PAYMENT FOR EMTALA-MANDATED SCREEN-
ING AND STABILIZATION SERVICES.—
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(1) IN
GENERAL.—Section 1862 (42 U.S.C. 
1395y) is amended by inserting after subsection (c) 
the following new subsection: 
‘‘(d) For purposes of subsection (a)(1)(A), in the case 
of any item or service that is required to be provided pur-
suant to section 1867 to an individual who is entitled to 
benefits under this title, determinations as to whether the 
item or service is reasonable and necessary shall be made 
on the basis of the information available to the treating 
physician or practitioner (including the patient’s pre-
senting symptoms or complaint) at the time the item or 
service was ordered or furnished by the physician or prac-
titioner (and not on the patient’s principal diagnosis). 
When making such determinations with respect to such 
an item or service, the Secretary shall not consider the 
frequency with which the item or service was provided to 
the patient before or after the time of the admission or 
visit.’’. 
(2) EFFECTIVE DATE.—The amendment made 
by paragraph (1) shall apply to items and services 
furnished on or after January 1, 2004. 
(b) NOTIFICATION OF PROVIDERS WHEN EMTALA 
INVESTIGATION CLOSED.—Section 1867(d) (42 U.S.C. 42 
U.S.C. 1395dd(d)) is amended by adding at the end the 
following new paragraph: