Page:United States Statutes at Large Volume 104 Part 2.djvu/464

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104 STAT. 1388-56 PUBLIC LAW 101-508—NOV. 5, 1990 "(iii) COMPUTATION OF 1990 LOCALITY INDEX RELATIVE TO NATIONAL AVERAGE.— The Secretary shall establish an index which reflects, for each locality, the ratio of the conversion factor used in the locality under this subsection to the national weighted average estimated under clause (i). "(iv) LOCAL ADJUSTMENT. —Subject to clause (vii), the conversion factor to be applied to the professional or technical component of a service in a locality is the sum of ¥2 of the locally-adjusted amount determined under clause (v) and VT. of the GPCI-adjusted amount determined under clauses (vi). "(v) LOCALLY-ADJUSTED AMOUNT.—For purposes of clause (iv), the locally adjusted amount determined under this clause is the product of (I) the national weighted average conversion factor computed under clause (ii), and (II) the index value established under clause (iii) for the locality. "(vi) GPCI-ADJUSTED AMOUNT.— For purposes of clause (iv), the GPCI-adjusted amount determined under this clause is the sum of— "(I) the product of (a) the portion of the reduced national weighted average conversion factor computed under clause (ii) which is attributable to physician work and (b) the geographic work index value for the locality (specified in Addendum C to the Model Fee Schedule for Physician Services (published on September 4, 1990, 55 Federal Register pp. 36238-36243)); and "(II) the product of (a) the remaining portion of the reduced national weighted average conversion factor computed under clause (ii), and (b) the geographic practice cost index value specified in section 1842(b)(14)(C)(iv) for the locality. In applying this clause with respect to the professional component of a service, 80 percent of the conversion factor shall be considered to be attributable to physician work and with respect to the technical component of the service, 0 percent shall be considered to be attributable to physician work. "(vii) LIMITS ON CONVERSION FACTOR. —The conversion factor to be applied to a locality under this subparagraph to the professional or technical component of a service shall not be more than 9.5 percent below the conversion factor applied in the locality under subparagraph (C) to such component, but in no case shall the conversion factor be less than 60 percent of the national weighted average of the conversion factors (computed under clause (i)).". (b) SPECIAL RULE FOR TRANSITION FOR RADIOLOGY SERVICES. — Section 1848(a)(2)(C) (42 U.S.C. 1395w-4(a)(2)(C)) is amended— (1) by inserting "AND RADIOLOGY" after "SPECIAL RULE FOR ANESTHESIA", and (2) by adding at the end the following: "With respect to radiology services, '109 percent' and '9 percent' shall be substituted for '115 percent' and '15 percent', respectively, in subparagraph (A)(ii).