103 STAT. 2164 PUBLIC LAW 101-239—DEC. 19, 1989 42 USC 1395i-2 note. 42 USC 1395WW note. 42 USC 1395WW note. 42 USC 1395f note. same extent as they apply to qualified medicare beneficiaries en- rolled, pursuant to such agreement, in part B. "(B) For purposes of this subsection, section 1843(d)(l) shall be applied by substituting 'section 1818' for 'section 1839' and 'subsec- tion (c) (with reference to subsection (b) of section 1839/ for 'subsec- tion (b).'.". (b) CONFORMING AMENDMENT. —Section 1843 of such Act (42 U.S.C. 1395v) is amended by adding at the end the following: "(i) For provisions relating to enrollment of qualified medicare beneficiaries under part A, see section lSlS(g)". (c) E^FFEcnvB DATE.—The amendments made by this section shall become effective January 1, 1990. SEC 6014. PBOPAC STUDY ON MEDICARE-DEPENDENT HOSPITALS. (a) STUDY.—The Prospective Payment Assessment Commission shall conduct a study of the appropriateness of making an adjust- ment to the methodology for determining the amount of payment to hospitals for which individuals entitled to benefits under part A of title XVm of the Social Security Act represent a high proportion of discharges. (b) Rra>ORT.—Not later than June 1, 1990, the Commission shall include a report on the study conducted under subsection (a) in its annual report submitted to Congress. SEC 6015. PROVISIONS RELATING TO TARGET AMOUNT ADJUSTMENTS, (a) INCLUDING NEW BASE PERIOD IN TARGET ADJUSTMENTS. — Sec- tion 1886(b)(4)(A) of the Social Security Act (42 U.S.C. 1395ww(b)(4)(A)) is amended by striking "deems appropriate," and inserting "deems appropriate, including the assignment of a new base period which is more representative, as determined by the Secretary, of the reasonable and necessary cost of inpatient services and". (b) PUBLICATION OF INSTRUCTIONS RELATING TO EXCEPTIONS AND ADJUSTMENTS IN TARGET AMOUNTS. — By not later than 180 days after the date of enactment of this Act, the Secretary of Health and Human Services shall publish instructions specifying the applica- tion process to be used in providing exceptions and adjustments under section 18860bX4XA) of the Social Security Act. (c) ElFFEcnvE DATE.—The amendment made by subsection (a) shall become effective with respect to cost reporting periods beginning on or after April 1, 1990. SEC 6016. STUDY OF METHODS TO COMPENSATE HOSPICES FOR HIGH- COST CARE. (a) STUDY.—The Secretary of Health and Human Services shall— (1) conduct a study of high-cost hospice care provided to medicare beneficiaries under the medicare program, and evalu- ate the ability of hospice programs participating in the medi- care program to provide such high-cost care to such patients; and (2) based on such study, develop methods to compensate such programs for providing such high-cost care. (b) RQ>ORT TO CONGRESS.— Not later than April 1, 1991, the Sec- retary shall submit a report to the Committee on Ways and Means of the House of Representatives and the Committee on Finance of the Senate on the study conducted under subsection (a) and shall include in the report any recommendations developed by the Sec-
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