120 STAT. 42
PUBLIC LAW 109–171—FEB. 8, 2006 (2) by adding at the end the following new subclause: ‘‘(II) In the case of a hospital located in a rural area and that has not more than 100 beds and that is not a sole community hospital (as defined in section 1886(d)(5)(D)(iii)), for covered OPD services furnished on or after January 1, 2006, and before January 1, 2009, for which the PPS amount is less than the preBBA amount, the amount of payment under this subsection shall be increased by the applicable percentage of the amount of such difference. For purposes of the previous sentence, with respect to covered OPD services furnished during 2006, 2007, or 2008, the applicable percentage shall be 95 percent, 90 percent, and 85 percent, respectively.’’. SEC. 5106. UPDATE TO THE COMPOSITE RATE COMPONENT OF THE BASIC CASE-MIX ADJUSTED PROSPECTIVE PAYMENT SYSTEM FOR DIALYSIS SERVICES.
Section 1881(b)(12) of the Social Security Act (42 U.S.C. 1395rr(b)(12)) is amended— (1) in subparagraph (F), in the flush matter at the end, by striking ‘‘Nothing’’ and inserting ‘‘Except as provided in subparagraph (G), nothing’’; (2) by redesignating subparagraph (G) as subparagraph (H); and (3) by inserting after subparagraph (F) the following new subparagraph: ‘‘(G) The Secretary shall increase the amount of the composite rate component of the basic case-mix adjusted system under subparagraph (B) for dialysis services furnished on or after January 1, 2006, by 1.6 percent above the amount of such composite rate component for such services furnished on December 31, 2005.’’. SEC. 5107. REVISIONS TO PAYMENTS FOR THERAPY SERVICES.
Deadline.
42 USC 1395l note.
VerDate 14-DEC-2004
10:20 Jul 12, 2007
(a) EXCEPTION TO CAPS FOR 2006.— (1) IN GENERAL.—Section 1833(g) of the Social Security Act (42 U.S.C. 1395l(g)) is amended— (A) in each of paragraphs (1) and (3), by striking ‘‘paragraph (4)’’ and inserting ‘‘paragraphs (4) and (5)’’; and (B) by adding at the end the following new paragraph: ‘‘(5) With respect to expenses incurred during 2006 for services, the Secretary shall implement a process under which an individual enrolled under this part may, upon request of the individual or a person on behalf of the individual, obtain an exception from the uniform dollar limitation specified in paragraph (2), for services described in paragraphs (1) and (3) if the provision of such services is determined to be medically necessary. Under such process, if the Secretary does not make a decision on such a request for an exception within 10 business days of the date of the Secretary’s receipt of the request, the Secretary shall be deemed to have found the services to be medically necessary.’’. (2) TIMELY IMPLEMENTATION.—The Secretary of Health and Human Services shall waive such provisions of law and regulation (including those described in section 110(c) of Public Law 108–173) as are necessary to implement the amendments made by paragraph (1) on a timely basis and, notwithstanding any other provision of law, may implement such amendments by
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