PUBLIC LAW 101-239—DEC. 19, 1989 103 STAT. 2219 (B) by striking the period at the end of paragraph (13) and inserting "; and', (C) by redesignating paragraphs (14) and (15) as para- graphs (15) and (16), respectively, and (D) by inserting after paragraph (13) the following new paragraph; "(14) screening pap smear."; and (2) by adding at the end the following new subsection: "Screening Pap Smear "(nn) The term 'screening pap smear' means a diagnostic labora- tory test consisting of a routine exfoliative cytology test (Papani- colaou test) provided to a womcui for the purpose of early detection of cervicsil cancer and includes a physician's interpretation of the results of the test, if the individual involved has not had such a test during the preceding 3 years (or such shorter period as the Secretary may specify in the case of a woman who is at high risk of developing cervical cancer (as determined pursuant to factors identified by the Secretary)). ". (b) REVISION OP EXCLUSION GROUNDS.—Section 1862(a)(l)(F) of such Act (42 U.S.C. 1395y(a)(l)(F)) is amended by inserting before the semicolon at the end the following: ", and, in the case of screening pap smear, which is performed more frequently than is provided under 1861(nn)". (c) CONFORMING AMENDMENTS. —Sections 1864(a), 1865(a), 1902(a)(9)(C), and 1915(a)(l)(BXuXI) of such Act (42 U.S.C. 1395aa(a), 1395bb(a), 1396(a)(9)(C), 1396n(a)(l)(B)(iiXD) are each amended by striking "paragraphs (14) and (15)" and inserting "paragraphs (15) and (16)". (d) EFFECTIVE DATE.—The amendments made by this section shall apply to screening pap smears performed on or after July 1, 1990. SEC. 6116. COVERAGE UNDER, AND PAYMENT FOR, OUTPATIENT RURAL PRIMARY CARE HOSPITAL SERVICES UNDER PART B. (a) COVBSIAGE.^— (1) Section 1861(mm) of the Social Security Act (42 U.S.C. 1395x(mm)), as added by section 6003(g)(3)(A) of this subtitle, is amended by adding at the end the following: "(3) The term 'outpatient rural primary care hospital services' means medical and other health services furnished by a rural primary care hospital.". (2) Section 1832(a)(2) of such Act (42 U.S.C. 1395k(a)(2)) is amended— (A) in subparagraph (F), by striking "and" at the end, (B) in subpare^aph (G) by striking the period at the end and inserting "; and', and (C) by inserting after subparagraph (G) the following new subparagraph: "(H) outpatient rural primary care hospital services (as defined in section 1861(mmX3)).'\ (b) PAYMENT. — (1) Section 1833(a) of such Act (42 U.S.C. 13951(a)) is amended— (A) in paragraph (2). in the matter before subparagraph (A), by striking "and (G)" and inserting "(G), and (H)", (B) in paragraph (4), by striking "and" at the end, 42 USC 1396a. 42 USC 1395x note.
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