PUBLIC LAW 106-554^APPENDIX F 114 STAT. 2763A-487 (B) The means by which rural areas with low population densities can be identified for the purpose of designating areas in which the cost of providing ambulance services would be expected to be higher than similar services provided in more heavily populated areas because of low usage. Such study shall also include an analysis of the additional costs of providing ambulance services in areas designated under the previous sentence. (3) REPORT.— Not later than June 30, 2002, the Comptroller General shall submit to Congress a report on the results of the studies conducted under paragraph (1) and shall include recommendations on steps that should be taken to assure access to ambulance services in rural areas. (c) ADJUSTMENT IN RURAL RATES. —In providing for adjustments under subparagraph (D) of section 1834(1)(2) of the Social Security Act (42 U.S.C. 1395m(l)(2)) for years beginning with 2004, the Secretary of Health and Human Services shall take into consideration the recommendations contained in the report under subsection (b)(2) and shall adjust the fee schedule payment rates under such section for ambulance services provided in low density rural areas based on the increased cost (if any) of providing such services in such areas. (d) EFFECTIVE DATE.—The amendment made by subsection (a) shall apply to services furnished on or after July 1, 2001. In applying such amendment to services furnished on or after such date and before January 1, 2002, the amount of the rate increase provided under such amendment shall be equal to $1.25 per mile. SEC. 222. PAYMENT FOR CERTAB^ PHYSICIAN ASSISTANT SERVICES. (a) PAYMENT FOR CERTAIN PHYSICIAN ASSISTANT SERVICES. — Section 1842(b)(6)(C) (42 U.S.C. 1395u(b)(6)(C)) is amended— (1) by striking "for such services provided before January 1, 2003,"; and (2) by striking the semicolon at the end and inserting a comma. (b) EFFECTIVE DATE.—The amendments made by subsection (a) shall take effect on the date of the enactment of this Act. SEC. 223. REVISION OF MEDICARE REIMBURSEMENT FOR TELE- HEALTH SERVICES. (a) TIME LIMIT FOR BBA PROVISION.— Section 4206(a) of BBA (42 U.S.C. 13951 note) is amended by striking "Not later than January 1, 1999" and inserting "For services furnished on and after January 1, 1999, and before October 1, 2001". (b) EXPANSION OF MEDICARE PAYMENT FOR TELEHEALTH SERV- ICES.— Section 1834 (42 U.S.C. 1395m) is amended by adding at the end the following new subsection: "(m) PAYMENT FOR TELEHEALTH SERVICES.— "(1) IN GENERAL. —The Secretary shall pay for telehealth services that are furnished via a telecommunications system by a physician (as defined in section 186 l(r)) or a practitioner (described in section 1842(b)(18)(C)) to an eligible telehealth individual enrolled under this part notwithstanding that the individual physician or practitioner providing the telehealth , service is not at the same location as the beneficiary. For purposes of the preceding sentence, in the case of any Federal telemedicine demonstration program conducted in Alaska or Hawaii, the term 'telecommunications system' includes store-
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