CLINICAL DIAGNOSTIC LABORATORY TESTS.

SEC. 4154. CLINICAL DIAGNOSTIC LABORATORY TESTS. (a) Limit on Annual Fee Schedule Increases.—Section 1833(h)(2)(A)(ii) (42 U.S.C. 13951(h)(2)(A)(ii)) is amended— (1) by striking “any other provision of this subsection” and inserting “clause (i)”; (2) by striking “and” at the end of subclause (I); (3) by striking the period at the end of subclause (II) and inserting “, and”, and 104 STAT. 1388–85 (4) by adding at the end the following new subclause: “(III) the annual adjustment in the fee schedules determined under clause (i) for each of the years 1991, 1992, and 1993 shall be 2 percent.”. (b) Reduction in National Cap on Fee Schedules.— (1) In general.— Section 1833(h)(4)(B) (42 U.S.C. 13951(h)(4)(B)) is amended— (A) in clause (ii), by striking “and” at the end; (B) in clause (iii)— (i) by inserting “and before January 1, 1991,” after “1989,”, and (ii) by striking the period at the end and inserting “, and”; and (C) by adding at the end the following new clause: “(iv) after December 31, 1990, is equal to 88 percent of the median of all the fee schedules established for that test for that laboratory setting under paragraph (1).”. (2) Effective date.—The amendments made by paragraph (1) shall apply to tests furnished on or after January 1, 1991. (c) Clarification of Mandatory Assignment for Clinical Diagnostic Laboratory Tests Performed by Physicians — (1) In general.— (A) Section 1833(h)(5)(C) of such Act (42 U.S.C. 1395101)(5)(C)) is amended by striking “test performed by a laboratory other than a rural health clinic” and inserting “test, including a test performed in a physician’s office but excluding a test performed by a rural health clinic”. (B) Section 1833(h)(5)(D) of such Act (42 U.S.C. 13951(i)(5)(D)) is amended by striking “test performed by a laboratory, other than a rural health clinic” and inserting “test, including a test performed in a physician’s office but excluding a test performed by a rural health clinic,”. (2) Effective date.—The amendment made by paragraph (1)(A) shall take effect as if included in the enactment of the Consolidated Omnibus Budget Reconciliation Act of 1985, and the amendment made by paragraph (1)(B) shall take effect as if included in the enactment of the Omnibus Budget Reconciliation Act of 1987. (d) Agreements with States to Determine Compliance of Clinical Laboratories with Program Requirements.— (1) In general.—Section 1864(a) (42 U.S.C. 1395aa(a)) is amended in the first sentence by striking “1861(s),” and inserting “ 1861(s) or (in the case of a laboratory that does not participate or seek to participate in the medicare program) the requirements of section 353 of the Public Health Service Act,”. (2) Effective date.—The amendment made by paragraph (1) shall take effect as if included in the enactment of the Clinical Laboratory Improvement Amendments of 1988. (e) Technical Corrections.— (1) Section 1833(h)(5)(A)(ii) of such Act (42 U.S.C. 13951(h)(5)(A)(ii)) is amended- (A) in subclause (II), by striking “a wholly-owned subsidiary of” and inserting “wholly owned by”; (B) in subclause (III), by striking “laboratory” and inserting “laboratory (but not including a laboratory described in subclause (ID),”, and (C) in subclause (III), by striking “submits bills or re-quests for payment in any year” and inserting “receives 104 STAT. 1388–86 requests for testing during the year in which the test is performed”. (2) The heading of section 1846 of such Act is amended by striking “of” and inserting “or suppliers of”. (3) Effective as if included in the enactment of the Omnibus Budget Reconciliation Act of 1986, section 9339(b) of the Omnibus Budget Reconciliation Act of 1986 is amended by striking paragraph (3). (4) Section 6111(b)(2) of the Omnibus Budget Reconciliation Act of 1989 is amended by striking “January 1, 1990” and inserting “May 1, 1990”. (5) The amendments made by paragraphs (1)(A)1515So in original. Probably should be “(1)(A),”. (1)(B), (2), and (4) shall take effect as if included in the enactment of the Omnibus Budget Reconciliation Act of 1989, and the amendment made by paragraph (1)(0 shall take effect January 1, 1991.