114 STAT. 2763A-498 PUBLIC LAW 106-554—APPENDIX F (2) for the period beginning on April 1, 2001, and ending on September 30, 2001, shall be the rate that would have been determined under such section if "plus 1 percentage point" had been substituted for "minus 1 percentage point" under subclause (II) of such paragraph (as in effect on the day before the date of the enactment of this Act). (c) RELATION TO TEMPORARY INCREASE IN BBRA. — The increases provided under section 101 of BBRA (113 Stat. 150 lA- 325) shall be in addition to any increase resulting from the amendments made by subsection (a). (d) GAO REPORT ON ADEQUACY OF SNF PAYMENT RATES.— Not later than July 1, 2002, the Comptroller General of the United States shall submit to Congress a report on the adequacy of medicare payment rates to skilled nursing facilities and the extent to which medicare contributes to the financial viability of such facilities. Such report shall take into account the role of private payors, medicaid, and case mix on the financial performance of these facilities, and shall include an analysis (by specific RUG classification) of the number and characteristics of such facilities. (e) HCFA STUDY OF CLASSIFICATION SYSTEMS FOR SNF RESI- DENTS.— (1) STUDY.— The Secretary of Health and Human Services shall conduct a study of the different systems for categorizing patients in medicare skilled nursing facilities in a manner that accounts for the relative resource utilization of different patient t3T)es. (2) REPORT. —Not later than January 1, 2005, the Secretary shall submit to Congress a report on the study conducted under subsection (a). Such report shall include such recommendations regarding changes in law as may be appropriate. SEC. 312. INCREASE IN NURSING COMPONENT OF PPS FEDERAL RATE. (a) IN GENERAL.— The Secretary of Health and Human Services shall increase by 16.66 percent the nursing component of the casemix adjusted Federal prospective payment rate specified in Tables 3 and 4 of the final rule published in the Federal Register by the Health Care Financing Administration on July 31, 2000 (65 Fed. Reg. 46770) and as subsequently updated, effective for services furnished on or after April 1, 2001, and before October 1, 2002. (b) GAO AUDIT OF NURSING STAFF RATIOS. — (1) AUDIT.—The Comptroller General of the United States shall conduct an audit of nursing staffing ratios in a representative sample of medicare skilled nursing facilities. Such sample shall cover selected States and shall include broad representation with respect to size, ownership, location, and medicare volume. Such audit shall include an examination of payroll records and medicaid cost reports of individual facilities. (2) REPORT. —Not later than August 1, 2002, the Comptroller General shall submit to Congress a report on the audits conducted under paragraph (1). Such report shall include an assessment of the impact of the increased payments under this subtitle on increased nursing staff ratios and shall make recommendations as to whether increased payments under subsection (a) should be continued.
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