Page:United States Statutes at Large Volume 104 Part 2.djvu/447

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PUBLIC LAW 101-508—NOV. 5, 1990 104 STAT. 1388-39 diagnostic laboratory tests) or are other services related to the admission (as defined by the Secretary).". (b) EFFECTIVE DATE.—The amendment made by subsection (a) shall apply— (1) in the case of any services provided during the day immediately preceding the date of a patient's admission (without regard to whether the services are related to the admission), to services furnished on or after the date of the enactment of this Act and before October 1, 1991; (2) in the case of diagnostic services (including clinical diagnostic laboratory tests), to services furnished on or after January 1, 1991; and (3) in the case of any other services, to services furnished on or after October 1, 1991. (c) ISSUANCE OF INTERIM FINAL REGULATION.— The Secretary of Health and Human Services shall issue such regulations (on an interim or other basis) as may be necessary to implement this section. SEC. 4004. PAYMENTS FOR MEDICAL EDUCATION COSTS. (a) HOSPITAL GRADUATE MEDICAL EDUCATION RECOUPMENT. — (1) IN GENERAL.— The Secretary of Health and Human Services may not, before October 1, 1991, recoup payments from a hospital because of alleged overpayments to such hospital under part A of title XVIII of the Social Security Act due to a determination that the amount of pa5nnents made for graduate medical education programs exceeds the amount allowable under section 1886(h). (2) CAP ON ANNUAL AMOUNT OF RECOUPMENT. —With respect to overpayments to a hospital described in paragraph (1), the Secretary may not recoup more than 25 percent of the amount of such overpayments from the hospital during a fiscal year. (3) EFFECTIVE DATE. —Paragraphs (1) and (2) shall take effect October 1, 1990. (b) UNIVERSITY HOSPITAL NURSING EDUCATION. — (1) IN GENERAL.— The reasonable costs incurred by a hospital (or by an educational institution related to the hospital by common ownership or control) during a cost reporting period for clinical training (as defined by the Secretary) conducted on the premises of the hospital under approved nursing and allied health education programs that are not operated by the hospital shall be allowable as reasonable costs under part A of title XVIII of the Social Security Act and reimbursed under such part on a pass-through basis. (2) CONDITIONS FOR REIMBURSEMENT. — The reasonable costs incurred by a hospital during a cost reporting period shall be reimbursable pursuant to paragraph (1) only if^ (A) the hospital claimed and was reimbursed for such costs during the most recent cost reporting period that ended on or before October 1, 1989;

(B) the proportion of the hospital's total allowable costs that is attributable to the clinical training costs of the approved program, and allowable under (b)(1) during the cost reporting period does not exceed the proportion of total allowable costs that were attributable to the clinical training costs during the cost reporting period described in subparagraph (A); 42 USC 1395WW n ote. 42 USC 1395WW note. 42 USC 1395WW note.