STATEWIDE FEE SCHEDULE AREAS FOR PHYSICIANS’ SERVICES.

SEC. 4117. STATEWIDE FEE SCHEDULE AREAS FOR PHYSICIANS’ SERVICES. (a) In General.—Notwithstanding section 1848(j)(2) of the Social Security Act (42 U.S.C. 1395w-4(j)(2)), in the case of the States of Nebraska and Oklahoma, if the respective State meets the require-104 STAT. 1388–66 ments specified in subsection (b) on or before April 1, 1991, the Secretary of Health and Human Services {Secretary) shall treat the State as a single fee schedule area for purposes of determining— (1) the adjusted historical payment basis (as defined in section 1848(a)(2)(D) of such Act (42 U.S.C. 1395w–4(a)(2)(D))), and (2) the fee schedule amount (as referred to in section 1848(a) (42 U.S.C. 1395w-4(a)) of such Act), for physicians’ services (as defined in section 1848(j)(3) of such Act (42 U.S.C. 139oW“4(j)(3))) furnished on or after January 1, 1992. (b) Requirements.—The requirements specified in this subsection are that (on or before April 1, 1991) there are written expressions of support for treatment of the State as a single fee schedule area (on a budget-neutral basis) from— (1) each member of the congressional delegation from the State, and (2) organizations representing urban and rural physicians in the State. (c) Budget Neutrality.—Notwithstanding section 1842(b)(3) of such Act (42 U.S.C. 1395u(b)(3)), the Secretary shall provide for treatment of a State as a single fee schedule area (as described in subsection (a)) in a manner that ensures that total payments for physicians’ services (as so defined) furnished by physicians in the State during 1992 are not greater or less than total payments for such services would have been but for such treatment. (d) Construction.—Nothing in this section shall be construed as limiting the availability (to the Secretary, the appropriate agency or organization with a contract under section 1842, or physicians in a State) of otherwise applicable administrative procedures for modifying the fee schedule area or areas in the State after implementation of subsection (a) with respect to the State.