PAYMENTS TO HOSPITAL OUTPATIENT DEPARTMENTS FOR RADIOLOGY.

SEC. 4066. PAYMENTS TO HOSPITAL OUTPATIENT DEPARTMENTS FOR RADIOLOGY. (a) Amounts Payable.— Section 1833 of the Social Security Act (42 U.S.C. 13951) is amended— (1) in subsection (a)(2)— (A) by striking “and” in subparagraph (C), (B) by adding “and” at the end of subparagraph (D), and (C) by adding at the end thereof the following new subparagraph: “(E) with respect to— “(i) outpatient hospital radiology services (including diagnostic and therapeutic radiology, nuclear medicine and CAT scan procedures, magnetic resonance imaging, and ultrasound and other imaging services), and “(ii) effective for procedures performed on or after October 1, 1989, diagnostic procedures (as defined by the Secretary) described in section 1861(s)(3) (other than diagnostic x-ray tests and diagnostic laboratory tests), the amount determined under subsection (n);”; and (2) by adding at the end, as previously amended, the following new subsection: “(n) (1) (A) The aggregate amount of the payments to be made for all or part of a cost reporting period beginning on or after October 1, 1988 under this part for services described in subsection (a)(2)(E) shall be equal to the lesser of— “(i) the amount determined with respect to such services under subsection (a)(2)(B), or “(ii) the blend amount for radiology services and diagnostic procedures determined in accordance with subparagraph (B). “(B) (i) The blend amount for radiology services and diagnostic procedures for a cost reporting period is the sum of— “(I) the cost proportion (as defined in clause (ii)) of the amount described in subparagraph (A)(i); and “(II) the charge proportion (as defined in clause (ii)(II) of 62 percent (for services described in subsection (a)(2)(E)(i)), or (for procedures described in subsection (a)(2)(E)(ii)), 42 percent or101 STAT. 1330–113 such other percent established by the Secretary (or carriers acting pursuant to guidelines issued by the Secretary) based on prevailing charges established with actual charge data, of 80 percent of the prevailing charge for participating physicians for the same services as if they were furnished in a physician’s office in the same locality as determined under section 1842(b). “(ii) In this subparagraph: “(I) The term ‘cost proportion’ means 65 percent for all or any part of cost reporting periods which occur in fiscal year 1989 and 50 percent for other cost reporting periods. “(II) The term ‘charge proportion’ means 35 percent for all or any parts of cost reporting periods which occur in fiscal year 1989 and 50 percent for other cost reporting periods.”. (b) Conforming Amendment.— Section 1833(a)(2)(B) of such Act (42 U.S.C. 13951(a)(2)(B)) is amended in the matter preceding clause (i) by striking “(C) or (D)” and inserting “(C), (D), or (E)”. (c) Effective Date.— The amendments made by subsection (a) shall apply with respect to outpatient hospital radiology services furnished on or after October 1, 1988, and other diagnostic procedures performed on or after October 1, 1989.