MISCELLANEOUS AND TECHNICAL CORRECTIONS.

SEC. 135. MISCELLANEOUS AND TECHNICAL CORRECTIONS. (a) Updates to Payment Amounts.— (1) Subparagraph (A) of section 1834(a)(14) (42 U.S.C. 1395m(a)(14)) is amended to read as follows: “(A) for 1991 and 1992, the percentage increase in the consumer price index for all urban consumers (U.S. city average) for the 12-month period ending with June of the previous year reduced by 1 percentage point; and”. (2) The amendment made by paragraph (1) shall he effective on the date of the enactment of this Act. (b) Advance Determinations of Coverage.— (1) Effective on the date of the enactment of this Act section 1834(a)(15) (42 U.S.C. 1395m(a)(15)) is amended to read as follows: “(15) Advance determinations of coverage for certain items.— “(A) Development of lists of items by secretary.— The Secretary may develop and periodically update a list of items for which payment may he made under this subsection that the Secretary determines, on the basis of prior payment experience, are frequently subject to unnecessary utilization throughout a carrier’s entire service area or a portion of such area. “(B) Development of lists of suppliers by secretary.— The Secretary may develop and periodically108 STAT. 4423 update a list of suppliers of items for which payment may be made under this subsection with respect to whom— “(i) the Secretary has found that a substantial number of claims for payment under this part for items furnished by the supplier have been denied on the basis of the application of section 1862(a)(1); or “(ii) the Secretary has identified a pattern of overutilization resulting from the business practice of the supplier. “(C) Determinations of coverage in advance.— A carrier shall determine in advance of delivery of an item whether payment for the item may not be made because the item is not covered or because of the application of section 1862(a)(1) if— “(i) the item is included on the list developed by the Secretary under subparagraph (A); “(ii) the item is furnished by a supplier included on the list developed by the Secretary under subparagraph (B); or “(iii) the item is a customized item (other than inexpensive items specified by the Secretary) and the patient to whom the item is to be furnished or the supplier requests that such advance determination be made.”. (2) Effective for standards applied for contract years beginning after the date of the enactment of this Act, section 1842(c) (42 U.S.C. 1395u(c)), as amended by section 125(a), is amended by adding at the end the following new paragraph: “(5) Each contract under this section which provides for the disbursement of funds, as described in subsection (a)(1)(B), shall require the carrier to meet criteria developed by the Secretary to measure the timeliness of carrier responses to requests for payment of items described in section 1834(a)(15)(C).”. (3) Effective on the date of the enactment of this Act, section 1834(h)(3) (42 U.S.C. 1395m(h)(3)), as amended by section 133(b), is amended by striking “(12) and (17)” and inserting “(12), (15), and (17)”. (c) Study of Variations in Durable Medical Equipment Supplier Costs.— (1) Collection and analysis of supplier cost data.— The Administrator of the Health Care Financing Administration shall, in consultation with appropriate organizations, collect data on supplier costs of durable medical equipment for which payment may be made under part B of the medicare program, and shall analyze such data to determine the proportions of such costs attributable to the service and product components of furnishing such equipment and the extent to which such proportions vary by type of equipment and by the geographic region in which the supplier is located. (2) Development of geographic adjustment index; reports.— Not later than July 1, 1995— (A) the Administrator shall submit a report to the Committees on Energy and Commerce and Ways and Means of the House of Representatives and the Committee on Finance of the Senate on the data collected and the analysis conducted under paragraph (1), and shall include in such report the Administrator’s recommendations for108 STAT. 4424 a geographic cost adjustment index for suppliers of durable medical equipment under the medicare program and an analysis of the impact of such proposed index on payments under the medicare program; and (B) the Comptroller General shall submit a report to the Committees on Energy and Commerce and Ways and Means of the House of Representatives and the Committee on Finance of the Senate analyzing on a geographic basis the supplier costs of durable medical equipment under the medicare program. (d) Oxygen Retesting.— (1) Section 1834(a)(5)(E) (42 U.S.C. 1395m(a)(5)(E)) is amended by striking “55” and inserting “56”. (2) The amendment made by paragraph (1) shall be effective on the date of the enactment of this Act. (e) Other Miscellaneous and Technical Amendments.— (1) Section 4152(a)(3) of OBRA-1990 is amended by striking “amendment made by subsection (a)” and inserting “amendments made by this subsection”. (2) Section 4152(c)(2) of OBRA-1990 is amended by striking “1395m(a)(7)(A)” and inserting “1395m(a)(7)”. (3) Section 1834(a)(7)(A)(iii)(II) (42 U.S.C. 1395m(a)(7)(A)(iii)(II)) is amended by striking “clause (v)” and inserting “clause (vi)”. (4) Section 1834(a)(7)(C)(i) (42 U.S.C. 1395m(a)(7)(C)(i)) is amended by striking “or paragraph (3)”. (5) Section 1834(a)(3) (42 U.S.C. 1395m(a)(3)) is amended by striking subparagraph (D). (6) Section 4153(c)(1) of OBRA-1990 is amended by striking “1834(a)” and inserting “1834(h)”. (7) Section 4153(d)(2) of OBRA-1990 is amended by striking “Reconiliation” and inserting “Reconciliation”. (8) The amendments made by this subsection shall take effect as if included in the enactment of OBRA-1990.