PUBLIC LAW 97-35—AUG. 13, 1981 the judgment of the Secretary, such lower percentage or such comparable or lower limit as the Secretary may determine. The Secretary may provide for such exemptions and exceptions to such limitation as he deems appropriate.". (b)(1) Subject to paragraph (2), the amendment made by subsection (a) shall apply to costs reporting periods ending after September 80, 1981. (2) In the case of a cost reporting period beginning before October 1, 1981, any reduction in payments resulting from the amendment made by subsection (a) shall be imposed only in proportion to the part of the period that occurs after September 80, 1981.
95 STAT. 799
Effective date. 42 USC 1395x note.
LIMITS ON REIMBURSEMENT TO HOME HEALTH AGENCIES
SEC. 2144. (a) Subparagraph (L) of section 1861(v)(l) of the Social 42 USC I395x Security Act (added by section 2143 of this subtitle) is amended by inserting "(i)" after "(L)" and by adding at the end the following new clause: "(ii) The Secretary, in determining the amount of the payments that may be made under this title with respect to services furnished by home health agencies, may not recognize as reasonable (in the efficient delivery of such services) costs for the provision of such services by an agency to the extent these costs exceed (on the aggregate for the agency) the 75th percentile of such costs per visit for home health agencies, or, in the judgment of the Secretary, such lower percentile or such comparable or lower limit (based on or related to the mean of the costs of such agencies or otherwise) as the Secretary may determine. The Secretary may provide for such exemptions and exceptions to such limitation as he deems appropriate.". (b)(1) Subject to paragraph (2), the amendment made by subsection Effective date. (a) shall apply to cost reporting periods ending after September 30, 42 USC 1395x note. 1981. (2) In the case of a cost reporting period beginning before October 1, 1981, any reduction in payments resulting from the amendment made by subsection (a) shall be imposed only in proportion to the part of the period that occurs after September 30, 1981. INCENTIVE REIMBURSEMENT RATE FOR RENAL DIALYSIS SERVICES
SEC. 2145. (a) Section 1881(b) of the Social Security Act is 42 USC I395rr. amended— (1) by inserting "and consistent with any regulations promulgated under paragraph (7)" in paragraph (2)(B) after "section 1861(v))"; (2) by striking out the second sentence of paragraph (2)(B); (3) by inserting "(which effectively encourages the efficient delivery of dialysis services and provides incentives for the increased use of home dialysis)" in paragraph (3)(B) after "or other basis"; (4) by inserting "or on the basis of a method established under paragraph (7)" before the period at the end of paragraph (4); (5) by inserting "(except as may be provided in regulations under paragraph (7))" in the second sentence of paragraph (6) after "in no event" and by striking out "70 percent" in such sentence and inserting in lieu thereof "75 percent";
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