169
(b) CONTINUATION OF CERTAIN DEMONSTRATION
PROJECTS.—Notwithstanding the amendment made by
subsection (a), with respect to demonstration projects im-
plemented by the Secretary under section 1847 of the So-
cial Security Act (42 U.S.C. 1395w–3) (relating to the es-
tablishment of competitive acquisition areas) that was in
effect on the day before the date of the enactment of this
Act, each such demonstration project may continue under
the same terms and conditions applicable under that sec-
tion as in effect on that date.
(c) REPORT
ON DIFFERENCES
IN PAYMENT
FOR
LABORATORY SERVICES.—Not later than 18 months after
the date of the enactment of this Act, the Comptroller
General of the United States shall submit to Congress a
report that analyzes differences in reimbursement between
public and private payors for clinical diagnostic laboratory
services.
(d) MEDPAC REPORT ON IMPACT OF DEMONSTRA-
TION PROJECTS
ON BENEFICIARY ACCESS
TO SERV-
ICES.—Not later than 1 year after the date of the enact-
ment of this Act, the Medicare Pyament Advisory Com-
mission shall submit to Congress a report that analyzes
the impact of demonstration projects carried out under
section 1847 of the Social Security Act, as in effect on
June 1, 2002, on access by medicare beneficiaries to dura-
170
ble medical equipment for which payment was made under
the demonstration project.
SEC. 512. PAYMENT FOR AMBULANCE SERVICES.
(a) PHASE-IN PROVIDING FLOOR USING BLEND OF
FEE SCHEDULE AND REGIONAL FEE SCHEDULES.—Sec-
tion 1834(l) (42 U.S.C. 1395m(l)) is amended—
(1) in paragraph (2)(E), by inserting ‘‘con-
sistent with paragraph (10)’’ after ‘‘in an efficient
and fair manner’’;
(2) by redesignating the paragraph (8) added
by section 221(a) of BIPA as paragraph (9); and
(3) by adding at the end the following new
paragraph:
‘‘(10) PHASE-IN
PROVIDING
FLOOR
USING
BLEND
OF
FEE
SCHEDULE
AND
REGIONAL
FEE
SCHEDULES.—In carrying out the phase-in under
paragraph (2)(E) for each level of service furnished
in a year before January 1, 2007, the portion of the
payment amount that is based on the fee schedule
shall not be less than the following blended rate of
the fee schedule under paragraph (1) and of a re-
gional fee schedule for the region involved:
‘‘(A) For 2003, the blended rate shall be
based 20 percent on the fee schedule under
171
paragraph (1) and 80 percent on the regional
fee schedule.
‘‘(B) For 2004, the blended rate shall be
based 40 percent on the fee schedule under
paragraph (1) and 60 percent on the regional
fee schedule.
‘‘(C) For 2005, the blended rate shall be
based 60 percent on the fee schedule under
paragraph (1) and 40 percent on the regional
fee schedule.
‘‘(D) For 2006, the blended rate shall be
based 80 percent on the fee schedule under
paragraph (1) and 20 percent on the regional
fee schedule.
For purposes of this paragraph, the Secretary shall
establish a regional fee schedule for each of the 9
Census divisions using the methodology (used in es-
tablishing the fee schedule under paragraph (1)) to
calculate a regional conversion factor and a regional
mileage payment rate and using the same payment
adjustments and the same relative value units as
used in the fee schedule under such paragraph.’’.
(b) ADJUSTMENT IN PAYMENT FOR CERTAIN LONG
TRIPS.—Section 1834(l), as amended by subsection (a),
172
is further amended by adding at the end the following new
paragraph:
‘‘(11) ADJUSTMENT IN PAYMENT FOR CERTAIN
LONG
TRIPS.—In the case of ground ambulance
services furnished on or after January 1, 2003, and
before January 1, 2008, regardless of where the
transportation originates, the fee schedule estab-
lished under this subsection shall provide that, with
respect to the payment rate for mileage for a trip
above 50 miles the per mile rate otherwise estab-
lished shall be increased by 1⁄4 of the payment per
mile otherwise applicable to such miles.’’.
(c) EFFECTIVE DATE.—The amendments made by
this section shall apply to ambulance services furnished
on or after January 1, 2003.
SEC. 513. 5-YEAR EXTENSION OF MORATORIUM ON THER-
APY CAPS; PROVISIONS RELATING TO RE-
PORTS.
(a) 5-YEAR EXTENSION OF MORATORIUM ON THER-
APY CAPS.—Section 1833(g)(4) (42 U.S.C. 1395l(g)(4))
is amended by striking ‘‘and 2002’’ and inserting ‘‘2002,
2003, 2004, 2005, 2006, and 2007’’.
(b) PROMPT SUBMISSION OF OVERDUE REPORTS ON
PAYMENT AND UTILIZATION OF OUTPATIENT THERAPY
SERVICES.—Not later than December 31, 2002, the Sec-
173
retary shall submit to Congress the reports required under
section 4541(d)(2) of the Balanced Budget Act of 1997
(relating to alternatives to a single annual dollar cap on
outpatient therapy) and under section 221(d) of the Medi-
care, Medicaid, and SCHIP Balanced Budget Refinement
Act of 1999 (relating to utilization patterns for outpatient
therapy).
(c) IDENTIFICATION OF CONDITIONS AND DISEASES
JUSTIFYING WAIVER OF THERAPY CAP.—
(1) STUDY.—The Secretary shall request the
Institute of Medicine of the National Academy of
Sciences to identify conditions or diseases that
should justify conducting an assessment of the need
to waive the therapy caps under section 1833(g)(4)
of the Social Security Act (42 U.S.C. 1395l(g)(4)).
(2) REPORTS TO CONGRESS.—Not later than
July 1, 2003, the Secretary shall submit to Congress
a preliminary report on the conditions and diseases
identified under paragraph (1) and not later than
September 1, 2003, a final report on the conditions
and diseases so identified.
(d) GAO STUDY OF PATIENT ACCESS TO PHYSICAL
THERAPIST SERVICES.—
(1) STUDY.—The Comptroller General of the
United States shall conduct a study on access to