108 STAT. 4424 PUBLIC LAW 103-432—OCT. 31, 1994 Effective date. 42 USC 1395m note. 42 USC 1395m note. 42 USC 1395m. 42 USC 1395m note. 42 USC 1395CC note. Effective date. 42 USC 1395m note. a geographic cost adjustment index for suppliers of durable medical equipment under the medicare program and an analysis of the impact of such proposed index on payments under the medicare program; and (B) the Comptroller General shall submit a report to the Committees on Energy and Commerce and Ways and Means of the House of Representatives and the Committee on Finance of the Senate analyzing on a geographic basis the supplier costs of durable medical equipment under the medicare program. (d) OXYGEN RETESTING.—(1) Section 1834(a)(5)(E) (42 U.S.C. 1395m(a)(5)(E)) is amended by striking "55" and inserting "56". (2) The amendment made by paragraph (1) shall be effective on the date of the enactment of this Act. (e) OTHER MISCELLANEOUS AND TECHNICAL AMENDMENTS.— (1) Section 4152(a)(3) of OBRA-1990 is amended by striking "amendment made by subsection (a)" and inserting "amendments made by this subsection". (2) Section 4152(c)(2) of OBRA-1990 is amended by striking "1395m(a)(7)(A)" and inserting "1395m(a)(7)". (3) Section 1834(a)(7)(A)(iii)(II) (42 U.S.C. 1395m(a)(7)(A)(iii)(II)) is amended by striking "clause (v)" and inserting "clause (vi)". (4) Section 1834(a)(7)(C)(i) (42 U.S.C. 1395m(a)(7)(C)(i)) is amended by striking "or paragraph (3)". (5) Section 1834(a)(3) (42 U.S.C. 1395m(a)(3)) is amended by striking subparagraph (D). (6) Section 4153(c)(1) of OBRA-1990 is amended by striking "1834(a)" and inserting "1834(h)". (7) Section 4153(d)(2) of OBRA-1990 is amended by striking "Reconihation" and inserting "ReconciHation". (8) The amendments made by this subsection shall take effect as if included in the enactment of OBRA-1990. PART III—OTHER ITEMS AND SERVICES SEC. 141. AMBULATORY SURGICAL CENTEK SERVICES. (a) PAYMENT AMOUNTS FOR SERVICES FURNISHED IN AMBULA- TORY SURGICAL CENTERS.— (1) USE OF SURVEY TO DETERMINE INCURRED COSTS.—Sec- 42 USC 1395/. tion 1833(i)(2)(A)(i) (42 U.S.C. 13951(i)(2)(A)(i)) is amended by striking the comma at the end and inserting the following: ", as aetermined in accordance with a survey (based upon a representative sample of procedures and facilities) taken not later tiian January 1, 1995, and every 5 years thereafter, of the actual audited costs inciured by such centers in providing such services,". (2) AUTOMATIC APPLICATION OF INFLATION ADJUSTMENT.— 42 USC 1395/. Section 1833(i)(2) (42 U.S.C. 13951(i)(2)) is amended— (A) in the second sentence of subparagraph (A) and the second sentence of subparagraph (B), by striking "and may be adjusted by the Secretary, when appropriate,"; and (B) by adding at the end the following new subparagraph: "(C) Notwithstanding the second sentence of subparagraph (A) or the second sentence of subparagraph (B), if the Secretary has
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