PUBLIC LAW 98-21 —APR. 20, 1983 97 STAT. 159 inpatient hospital services of hospitals (excluding payments made under section 1866(a)(1)(F)), 42 USC i395cc. are not greater or less than— "(ii) the target percentage (as defined in subsection (d)(l)(C)) of the payment amounts which would have been payable for such services for those same hospitals for that fiscal year under this section under the law as in effect before the date of the enact- ment of the Social Security Amendments of 1983 (excluding payments made under section 1866(a)(1)(F)); except that the adjustment made under this subparagraph shall apply only to subsection (d) hospitals and shall not apply for pur- poses of making computations under subsection (d)(2)(B)(ii) or sub- section (d)(3)(A). "(B) For discharges occurring in fiscal year 1984 or fiscal year 1985, the Secretary shall provide under subsections (d)(2)(F) and (d)(3)(C) for such equal proportional adjustment in each of the average standardized amounts otherwise computed for that fiscal year as may be necessary to assure that— "(i) the aggregate payment amounts otherwise provided under subsection (d)(l)(A)(i)(II) and (d)(5) for that fiscal year for operat- ing costs of inpatient hospital services of hospitals (excluding payments made under section 1866(a)(1)(F)), are not greater or less than— "(ii) the DRG percentage (as defined in subsection (d)(1)(C)) of the payment amounts which would have been payable for such services for those same hospitals for that fiscal year under this section under the law as in effect before the date of the enact- ment of the Social Security Amendments of 1983 (excluding payments made under section 1866(a)(1)(F)). "(2) The Director of the Congressional Office of Technology Assess- ment (hereinafter in this subsection referred to as the 'Director' and the 'Office', respectively) shall provide for appointment of a Prospec- tive Payment Assessment Commission (hereinafter in this subsec- tion referred to as the 'Commission'), to be composed of independent experts appointed by the Director. In addition to carrying out its functions under subsection (d)(4)(D), the Commission shall review the applicable percentage increase factor described in subsection (b)(3)(B) and make recommendations to the Secretary on the appro- priate percentage change which should be effected for hospital inpatient discharges under subsections (b) and (d) for fiscal years beginning with fiscal year 1986. In making its recommendations, the Commission shall take into account changes in the hospital market- basket described in subsection (b)(3)(B), hospital productivity, tech- nological and scientific advances, the quality of health care provided in hospitals (including the quality and skill level of professional nursing required to maintain quality care), and long-term cost- effectiveness in the provision of inpatient hospital services. "(3) The Commission, not later than the April 1 before the begin- Recommendations. ning of each fiscal year (beginning with fiscal year 1986), shall report its recommendations to the Secretary on an appropriate change factor which should be used (instead of the applicable per- centage increase described in subsection (b)(3)(B)) for inpatient hos- pitsl services for discharges in that fiscal year. "(4) Taking into consideration the recommendations of the Com- mission, the Secretary shall determine for each fiscal year (begin- ning with fiscal year 1986) the percentage change which will apply for purposes of this section as the applicable percentage increase
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