Page:United States Statutes at Large Volume 107 Part 1.djvu/617

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PUBLIC LAW 103-66—AUG. 10, 1993 107 STAT. 591 42 USC 1395b-l note. (1) by striking "and" at the end of clause (iii), (2) by striking clause (iv) and inserting the following:

    • (iv) after December 31, 1990, and before January 1, 1994,

is equal to 88 percent of such median, "(v) after December 31, 1993, and before January 1, 1995, is equal to 84 percent of such median, "(vi) after December 31, 1994, and before January 1, 1996, is equal to 80 percent of such median, and "(vii) after December 31, 1995, is equal to 76 percent of such median.". SEC. 13562. EXTENSION OF ALZHEIMER'S DISEASE DEMONSTRATION PROJECTS. Section 9342 of OBRA-1986, as amended by section 4164(a)(2) of OBRA-1990, is amended— (1) in subsection (c)(D, by striking "4 years" and inserting "5 years"; and (2) in subsection (f)— (A) by striking "$55,000,000" and inserting "$58,000,000 ", and (B) by striking "$3,000,000" and inserting "$5,000,000". SEC. 13663. ORAL CANCER DRUGS. (a) NEW COVERAGE OF CERTAIN SELF-ADMINISTERED ANTICANCER DRUGS. —Section 1861(s)(2) (42 U.S.C. 1395(s)(2)) is 42 USC i395x. amended— (1) by striking "and" at the end of subparagraph (O); (2) by adding "and" at the end of subparagraph (P); and (3) by adding at the end the following new subparagraph: "(Q) an oral drug (which is approved by the Federal Food and Drug Administration) prescribed for use as an anticancer chemotherapeutic agent for a ^ven indication, and containing an active ingredient (or ingredients), which is the same indication and active ingredient (or ingredients) as a drug which the carrier determines would be covered pursuant to subparagraph (A) or (B) if the drug could not be self-administered;". (b) UNIFORM COVERAGE OF "OFF-LABEL" ANTICANCER DRUGS. — Section 1861(t) (42 U.S.C. 1395x(t)) is amended— (1) by inserting "(1)" after "(t)"; (2) by striking "(m)(5) of this section" and inserting "(m)(5) and paragraph (2r; and (3) by adding at the end the following new paragraph: "(2)(A) For purposes of paragraph (1), the term 'drugs' also includes any drugs or biologicals used in an anticancer chemotherapeutic regimen for a medically accepted indication (as described in subparagraph (B)). "(B) In subparagraph (A), the term 'medically accepted indication', with respect to the use of a drug, includes any use which has been approved by the Food and Drug Administration for the drug, and includes another use of the drug If— "(i) the drug has been approved by the Food and Drug Administration; and "(iiXD such use is supported by one or more citations which are included (or approved for inclusion) in one or more of the following compendia: the American Hospital Formulary Service-Drug Information, the American Mecucal Association Drug Evaluations, the United States Pharmacopoeia-Drug Information, and other authoritative compendia as identified