PUBLIC LAW 101-239—DEC. 19, 1989 103 STAT. 2179 h" than May 15 of the year, respecting the performance stand- ard rates of increase for the fiscal year beginning in that year. "(C) PUBLICATION OP PERFORMANCE STANDARD RATES OF INCREASE. —The Secretary shall cause to have published in the Federal Register, in the last 15 days of October of each year (beginning with 1990), the performance standard rates of increase for all physicians' services and for each category of physicians' services for the fiscal year beginning in that year. The Secretary shall cause to have published in the Federal Register, by not later than January 1, 1990, the performance standard rate of increase under subparagraph (D) for fiscal year 1990. "(D) PERFORMANCE STANDARD RATE OP INCREASE FOR FISCAL YEAR 1990.— The performance standard rate of in- crease for fiscal year 1990 is equal to the sum of— "(i) the Secretary's estimate of the weighted average percentage increase in the reasonable charges for physicians' services (as defined in subsection (fK5XA)) under this part for calendar years included in fiscal year 1990, "(ii) the Secretary's estimate of the percentage in- crease or decrease in the average number of individuals enrolled under this part (other than HMO enrollees) from fiscal year 1989 to fiscal year 1990, "(iii) the Secretary's estimate of the average annual percentage growth in volume and intensity of physi- cians' services under this part for the 5-fiscal-year period ending with fiscal year 1989 (based upon information contained in the most recent annual report made pursuant to section 18410>X2)), and "(iv) the Secretary's estimate of the percentage in- crease or decrease in expenditures for physicians serv- ices (as defined in subsection (f)(5)(A)) m fiscal year 1990 (compared with fiscal year 1989) which will result from changes in law or regulations and which is not taken into account in the percentage increase described in clause (i), reduced by Vz percent. "(2) SPECIFICATION OF PERFORMANCE STANDARD RATES OF IN- CREASE FOR SUBSEQUENT FISCAL YEARS.— "(A) IN GENERAL.—Unless Congress otherwise provides, subject to paragraph (4), each performance standard rate of increase for a fiscal year Obeginning with fiscal year 1991) shall be equal to the sum of— "(i) the Secretary's estimate of the weighted average percentage increase in the fees for physicians' services (as defined in subsection (f)(5)(A)) under this part for ', calendar years included in the fiscal year involved, "(ii) the Secretary's estimate of the percentage in- crease or decrease in the average number of individuals enrolled under this part (other than HMO enrollees) from the previous fiscal year to the fiscal year involved, V. "(iii) the Secretary's estimate of the average annual percentage growth in volume and intensity of physi- cians' services under this part for the 5-fiscal-year Federal Register, publication.
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