103 STAT. 2214 PUBLIC LAW 101-239—DEC. 19, 1989 (2) in paragraph (4)(B)(i), by striking "or" at the end; (3) in paragraph (4)(B)(ii)— (A) by striking "and so long as a fee schedule for the test has not been established on a nationwide basis,", (B) by inserting "and before January 1, 1990," after "March 31, 1988,", and (C) by striking the period at the end and inserting ", and"; and (4) by adding at the end of paragraph (4)(B) the following new clause: ^ "(iii) after December 31, 1989, is equal to 93 percent of the ^ median of £dl the fee schedules established for that test for that laboratory setting under paragraph (1).". (b) RESTRICTION ON PAYMENT TO REFERRING LABORATORY. — (1) IN GENERAL. —Section 1833(h)(5)(A)(ii) of such Act (42 U.S.C. 13951(h)(5)(A)(ii)) is amended by striking "referring lab- oratory, and" and inserting "referring laboratory but only if— Rural areas. "(I) the referring laboratory is located in, or is part of, a rural hospital, "(II) the referring laboratory is a wholly-owned subsidi- ary of the entity performing such test, the referring labora- tory wholly owns the entity performing such test, or both the referring laboratory and the entity performing such test are wholly-owned by a third entity, or "(III) not more than 30 percent of the clinical diagnostic laboratory tests for which such referring laboratory sub- mits bills or requests for payment in any year are per- formed by another laboratory, and". 42 USC 1395/ (2) EFFECTIVE DATE.— The amendment made by paragraph (1) note. shall apply with respect to clinical diagnostic laboratory tests performed on or after January 1, 1990. SEC. 6112. DURABLE MEDICAL EQUIPMENT. (a) DELAY IN AND REDUCTION OF UPDATE FOR 1990. — (1) INEXPENSIVE AND ROUTINELY PURCHASED DURABLE MEDICAL EQUIPMENT AND ITEMS REQUIRING FREQUENT AND SUBSTANTIAL SERVICING. — Paragraphs (2)(B)(i) and (3)(B)(i) of section 1834(a) of the Social Security Act (42 U.S.C. 1395m(a)) are each amended by striking "in 1989" and inserting "in 1989 and in 1990". (2) MISCELLANEOUS DEVICES AND ITEMS AND OTHER COVERED ITEMS. — Paragraph (8)(A)(ii) of such section is amended— (A) in subclause (I), by striking "1989" and inserting "1989 and 1990", and (B) in subclause (II), by striking "1990, 1991," and insert- ing "1991". (3) OXYGEN AND OXYGEN EQUIPMENT.— Paragraph (9)(A)(ii) of such section is amended— (A) in subclause (I), by striking "1989" and inserting "1989 and 1990", and (B) in subclause 01), by striking "1990, 1991," and insert- ing "1991". (4) CONFORMING AMENDMENTS. —Such section is further amended— (A) in paragraph (7)(A)(i), by striking "this subparagraph" and inserting "this clause"; (B) in paragraph (7)(B)(i), by inserting "in" after "rental of the item"; and
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