PUBLIC LAW 101-508 —NOV. 5, 1990 104 STAT. 1388-75 "(I) for 1991, the local payment amount determined under clause (i) for such item or device for that year, except that the national limited pay- ment amount may not exceed 100 percent of the weighted average of all local payment amounts determined under such clause for such item for that year and may not be less than 85 percent of the weighted average of all local payment amounts determined under such clause for such item, and "(11) for each subsequent year, the amount determined under this clause for the preceding year increased by the covered item update for such subsequent year.". (2) MISCELLANEOUS ITEMS AND OTHER COVERED ITEMS.— Section 1834(a)(8) (42 U.S.C. 1395m(a)(8)) is amended— (A) in subparagraph (A)(ii)— (i) by striking "or" at the end of subclause (I); (ii) in subclause (II)— (I) by striking "1991 or", and (II) by striking "the percentage increase" and all that follows through the period and inserting "the covered item update for the year."; (iii) by redesignating subclause (II) as subclause (III); and (iv) by inserting after subclause (I) the following new subclause: "(II) in 1991, equal to the local purchase price computed under this clause for the previous year, increased by the covered item update for 1991, and decreased by the percentage by which the average of the reasonable charges for claims paid for all items described in paragraph (7) is lower than the average of the purchase prices submitted for such items during the final 9 months of 1988; or"; (B) by amending subparagraph (B) to read as follows: "(B) COMPUTATION OF NATIONAL LIMITED PURCHASE PRICE. —With respect to the furnishing of a particular item in a year, the Secretary shall compute a national limited purchase price— "(i) for 1991, equal to the local purchase price computed under subparagraph (A)(ii) for the item for the year, except that such national limited purchase price may not exceed 100 percent of the weighted average of all local purchase prices for the item computed under such subparagraph for the year, and may not be less than 85 percent of the weighted average of all local purchase prices for the item computed under such subparagraph for the year; and "(ii) for each subsequent year, equal to the amount determined under this subparagraph for the preceding year increeised by the covered item update for such subsequent year.; (C) in subparagraph (C)— (i) by striking "regional purchase price" each place it appears and inserting national limited purchase price", (ii) by striking "and subject to subparagraph (D)",
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