note. 104 STAT. 1388-58 PUBLIC LAW 101-508—NOV. 5, 1990 age prevailing charge the amount provided under such section.", (h) EXTENSION OF SPUT BILLING RULE FOR INTERVENTIONAL RADI- OLOGISTS.— Section 6105(c) of the Omnibus Budget Reconciliation Act 42 USC 1395m of 1989 is amended by inserting "or 1991" after "1990" each place it note. appears. 42 USC 1395m (i) EFFECTIVE DATES. — (1) Except as otherwise provided, the amendments made by this section shall apply to services furnished on or after January 1, 1991. (2) The amendment made by subsection (f) shall be effective as if included in the enactment of the Omnibus Budget Reconciliation Act of 1987. SEC. 4103. ANESTHESIA SERVICES. (a) REDUCTION IN FEE SCHEDULE. —Section 1842(q)(l) (42 U.S.C. 1395u(q)(l)) is amended— (1) by inserting "(A)" after "(q)(l)", and (2) by adding at the end the following new subparagraph: "(B) For physician anesthesia services furnished under this part during 1991, the prevailing charge conversion factor used in a locality under this subsection shall be determined as follows: "(i) The Secretary shall estimate the national weighted average of the prevailing charge conversion factors used under this subsection for services furnished during 1990 after March 31, using the best available data. "(ii) The national weighted average estimated under clause (i) shall be reduced by 7 percent. "(iii) Subject to clause (iv), the prevailing charge conversion factor to be applied in a locality is the sum of— "(I) the product of (a) the portion of the reduced national weighted average prevailing charge 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 prevailing charge 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, 70 percent of the prevailing charge conversion factor shall be considered to be attributable to physician work. "(iv) The prevailing charge conversion factor to be applied to a locality under this subparagraph shall not be reduced by more than 15 percent below the prevailing charge conversion factor applied in the locality for the period during 1990 after March 31, but in no case shall the prevailing charge conversion factor be less than 60 percent of the national weighted average of the prevailing charge conversion factors (computed under clause (i)).". (b) EXTENSION OF REDUCTION FOR SUPERVISION OF CONCURRENT SERVICES.— Section 1842(b)(13) (42 U.S.C. 1395u(b)(13)) is amended by striking "1991" each place it appears and inserting "1996".
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