MISCELLANEOUS PROVISIONS.

SEC. 4009. MISCELLANEOUS PROVISIONS. (a) Responsibilities of Medicare Hospitals in Emergency Cases.— (1) Increase in civil monetary penalty.— Section 1867(d)(2) of the Social Security Act (42 U.S.C. 1395dd(d)(2)) is amended by striking “$25,000” and inserting “$50,000”. 101 STAT. 1330–57 (2) Exclusion from medicare program for violations— Section 1867(d)(1) of such Act is amended by adding at the end the following new sentence: “If a civil money penalty is imposed on a responsible physician under paragraph (2), the Secretary may impose the sanction described in section 1842(j)(2)(A) (relating to barring from participation in the medicare program) in the same manner as it is imposed under section 1842(j).”. (3) Effective date.— The amendments made by this subsection shall apply to actions occurring on or after the date of the enactment of this Act. (b) Designation of Pediatric Hospitals as Meeting Certification as Heart Transplant Facility.— For purposes of determining whether a pediatric hospital that performs pediatric heart transplants meets the criteria established by the Secretary of Health and Human Services for facilities in which the heart transplants performed will be considered to meet the requirement of section 1862(a)(1)(A) of the Social Security Act, the Secretary shall treat such a hospital as meeting such criteria if— (1) the hospital’s pediatric heart transplant program is operated jointly by the hospital and another facility that meets such criteria, (2) the unified program shares the same transplant surgeons and quality assurance program (including oversight committee, patient protocol, and patient selection criteria), and (3) the hospital demonstrates to the satisfaction of the Secretary that it is able to provide the specialized facilities, services, and personnel that are required by pediatric heart transplant patients. (c) Waiver of Inpatient Limitations for the Connecticut Hospice2525Copy read “limitations for the connecticut hospice.”..— Subsection (a) of section 9307 of the Omnibus Budget Reconciliation Act of 1986 is amended— (1) by striking “Temporary“ in the heading, and (2) by striking “for hospice care provided before October 1, 1988,”. (d) Revision of Appointment Process for Prospective Payment Assessment Commission.— (1) In general.— Section 1886(e)(6)(B) of the Social Security Act (42 U.S.C. 1395ww(e)(6)(B)) is amended— (A) in the first sentence, by striking “provide expertise and experience in the provision and financing of health care” and inserting “include individuals with national recognition for their expertise in health economics, hospital reimbursement, hospital financial management, and other related fields, who provide a mix of different professionals, broad geographic representation, and a balance between urban and rural representatives,”; and (B) by striking the last sentence. (2) Effective date.— The amendments made by paragraph (1) shall apply to appointments made after the date of the enactment of this Act. (e) Psychologists’ Services Furnished to Hospital Inpatients.— 101 STAT. 1330–58 (1) In general.— Section 1861(b)(3) of such Act (42 U.S.C. 1395x(b)(3)) is amended by inserting “(including clinical psychologist (as defined by the Secretary))” after “others” the first place it appears. (2) Effective date.— The amendment made by paragraph (1) shall apply with respect to services furnished on or after April 1, 1988. (f) Hospital Condition of Participation Related to Individual Responsible for Care of Patient.— Section 1861(e)(4) of such Act (42 U.S.C. 1395x(e)(4)) is amended by inserting “with respect to whom payment may be made under this title” after “patient”, (g) Delay in Requirements Relating to Hospital Standards for Organ Transplants and Standards for Organ Procurement Agencies.— (1) Section 9318(b)(2) of the Omnibus Budget Reconciliation Act of 1986, as amended by section 107(c) of the Balanced Budget and Emergency Deficit Control Reaffirmation Act of 1987, is amended by striking “November 21, 1987” and inserting “March 31, 1988”. (2) The amendment made by paragraph (1) shall be effective as if included in the enactment of the Omnibus Budget Reconciliation Act of 1986. (h) Propac Studies and Reports.— (1) Propac reports on study of drg rates for hospitals in rural and urban areas.— The Prospective Payment Assessment Commission shall evaluate the study conducted by the Secretary of Health and Human Services pursuant to section 603(a)(2)(C)(i) of the Social Security Amendments of 1983 (relating to the feasibility, impact, and desirability of eliminating or phasing out separate urban and rural DRG prospective payment rates) and report its conclusions and recommendations to the Congress not later than March 1, 1988. (2) Propac report on separate urban payment rates.— The Prospective Payment Assessment Commission shall evaluate the desirability of maintaining separate DRG prospective payment rates for hospitals located in large urban areas (as defined in section 1886(d)(2)(D)) of the Social Security Act) and in other urban areas, and shall report to Congress on such evaluation not later than January 1, 1989. (3) Report on adjustment for non-labor costs.— The Prospective Payment Assessment Commission shall perform an analysis to determine the feasibility and appropriateness of adjusting the non-wage-related portion of the adjusted average standardized amounts under section 1886(d)(3) of the Social Security Act based on area differences in hospitals’ costs (other than wage-related costs) and input prices. The Commission shall report to the Congress on such analysis by not later than October 1, 1989. (i) Special Rule.— In the case of New England county metropolitan areas, the Secretary of Health and Human Services shall apply the second sentence of section 1886(d)(2)(D) of the Social Security Act, as amended by section 4001(b) of this subtitle, as though 970,000 were substituted for 1,000,000. (j) Technical Corrections.— (1) Section 1886(a)(4) of the Social Security Act (42 U.S.C. 1395ww(a)(4)) is amended by inserting a comma after “educational activities”. 101 STAT. 1330–59 (2) Section 1886(d)(5)(C)(i)(II) of such Act (42 U.S.C. 1395ww(d)(5)(C)(i)(II)) is amended by inserting “index” after “case mix” both places it appears. (3) Section 1886(d)(5)(F) of such Act (42 U.S.C. 1395ww(d)(5)(F)) is amended— (A) in clause (i)(II), by striking “such revenues” the second place it appears and inserting “such net inpatient care revenues”, and (B) in clause (iv)(I), by striking “subclause (III)” and inserting “clause (v)”. (4) Section 1886(d)(9) of such Act (42 U.S.C. 1395ww(d)(9)) is amended by moving the matter in subparagraph (B) before clause (i) 2 ems to the left so the left margin of such matter is aligned with the left margin of the matter in subparagraph (A) (5) Section 1886(h)(4)(C) of such Act (42 U.S.C. 1395ww(h)(4)(C)) is amended by striking “subparagraph (E)” and inserting “subparagraph (D)”. (6) Effective as if included in the enactment of the Omnibus Budget Reconciliation Act of 1986— (A) subparagraph (B) of section 9307(c)(1) of such Act is amended to read as follows: “(B) in paragraph (2)— “(i) by striking subparagraphs (A) and (B), “(ii) in subparagraph (C), by striking ‘such subsection’ and inserting ‘of section 1886(d) of the Social Security Act (42 U.S.C. 1395ww(d)’ and by redesignating such subparagraph as subparagraph (A), and “(iii) by amending subparagraph (D) to read as follows: “ ‘(B) The amendments made by subparagraph (A) apply to discharges occurring on or after May 1, 1986.’ ”; (B) section 9302(a)(2)(C) of such Act is amended by striking “1866(e)(5)” and inserting “1886(e)(5)”; (C) section 9320(h)(1) of such Act is amended by striking “before the period” and inserting “before the semicolon”; (D) section 9321(c)(4) of such Act is amended by striking “second sentence” and all that follows through “operating costs” and inserting “second sentence of section 1886(a)(4) of the Social Security Act, from the term ‘operating costs”; (E) the second sentence of section 9335(d)(2) of such Act is amended by striking “establish” and inserting “designate”; and (F) section 9321(c)(3) of such Act is amended by inserting “section 1861(v)(1)(O) and 1886(g)(2) of the Social Security Act and” after “implementing”. (7) Section 218(v) of the Social Security Act (42 U.S.C. 418(v)) is amended by striking paragraph (3). (8) Effective as if included in the Tax Reform Act of 1986, section 1895(d)(6)(C) of such Act is amended by striking “603” and inserting “2203”.