114 STAT. 2763A-490 PUBLIC LAW 106-554-APPENDEX: F (C) geographic areas in which telehealth services may be reimbursed that are in addition to the geographic areas where such services may be reimbursed under such section. (2) REPORT.— Not later than 2 years after the date of the enactment of this Act, the Secretary shall submit to Congress a report on the study conducted under paragraph (1) together with such recommendations for legislation that the Secretary determines are appropriate. (e) EFFECTIVE DATE. —The amendments made by subsections (b) and (c) shall be effective for services furnished on or after October 1, 200 L SEC. 224. EXPANDING ACCESS TO RURAL HEALTH CLINICS. (a) IN GENERAL.— The matter in section 1833(f) (42 U.S.C. 13951(f)) preceding paragraph (1) is amended by striking "rural hospitals" and inserting "hospitals". (b) EFFECTIVE DATE. —The amendment made by subsection (a) shall apply to services furnished on or after July 1, 2001. SEC. 225. MEDPAC STUDY ON LOW-VOLUME, ISOLATED RURAL HEALTH CARE PROVIDERS. (a) STUDY.— The Medicare Payment Advisory Commission shall conduct a study on the effect of low patient and procedure volume on the financial status of low-volume, isolated rural health care providers participating in the medicare program under title XVIII of the Social Security Act. (b) REPORT. —Not later than 18 months after the date of the enactment of this Act, the Commission shall submit to Congress a report on the study conducted under subsection (a) indicating— (1) whether low-volume, isolated rural health care providers are having, or may have, significantly decreased medicare margins or other financial difficulties resulting from any of the payment methodologies described in subsection (c); (2) whether the status as a low-volume, isolated rural health care provider should be designated under the medicare program and any criteria that should be used to qualify for such a status; and (3) any changes in the payment methodologies described in subsection (c) that are necessary to provide appropriate reimbursement under the medicare program to low-volume, isolated rural health care providers (as designated pursuant to paragraph (2)). (c) PAYMENT METHODOLOGIES DESCRIBED.— The payment methodologies described in this subsection are the following: (1) The prospective payment system for hospital outpatient department services under section 1833(t) of the Social Security Act (42 U.S.C. 13951(t)). (2) The fee schedule for ambulance services under section 1834(1) of such Act (42 U.S.C. 1395m(l)). (3) The prospective payment system for inpatient hospital services under section 1886 of such Act (42 U.S.C. 1395ww). (4) The prospective payment system for routine service costs of skilled nursing facilities under section 1888(e) of such Act (42 U.S.C. 1395yy(e)). (5) The prospective payment system for home health services under section 1895 of such Act (42 U.S.C. 1395fff).
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