REVISIONS TO PAYMENT RULES FOR DURABLE MEDICAL EQUIPMENT.

SEC. 13542. REVISIONS TO PAYMENT RULES FOR DURABLE MEDICAL EQUIPMENT. (a) Basing National Payment Limits on Median of Local Payment Amounts.— (1) Inexpensive and routinely purchased items; items requiring frequent and substantial servicing.— (A) Paragraphs (2)(C)(i)(II) and (3)(C)(i)(I)) of section 1834(a) (42 U.S.C. 1395m(a)) are each amended— (i) by striking “1992” the first place it appears and inserting “1992,1993, and 1994”; and (ii) by striking “1992” the second place it appears and inserting “the year”. (B) Paragraphs (2)(C)(ii) and (3)(C)(ii) of section 1834(a) (42 U.S.C. 1395m(a)) are each amended— (i) by striking “and” at the end of subclause (I); (ii) by redesignating subclause (II) as subclause (IV); and 107 STAT. 588 (iii) by inserting after subclause (I) the following new subclauses: “(II) for 1992 and 1993, the amount determined under this clause for the preceding year increased by the covered item update for such subsequent year, “(III) for 1994, the local payment amount determined under clause (i) for such item or device for that year, except that the national limited payment amount may not exceed 100 percent of the median of all local payment amounts determined under such clause for such item for that year and may not be less than 85 percent of the median of all local payment amounts determined under such clause for such item or device for that year, and”. (2) Miscellaneous devices and items.— Section 1834(a)(8) (42 U.S.C. 1395m(a)(8)) is amended— (A) in subparagraph (A)(ii)(III), by striking “1992” and inserting “1992,1993, and 1994”; and (B) in subparagraph (B)— (i) by striking “and” at the end of clause (i), (ii) by redesignating clause (ii) as (iv), and (iii) by inserting after clause (i) the following new clauses: “(ii) for 1992 and 1993, the amount determined under this subparagraph for the preceding year increased by the covered item update for such subsequent year, “(iii) for 1994, the local purchase price computed under subparagraph (A)(ii) for the item for the year, except that such national limited purchase price may not exceed 100 percent of the median of all local purchase prices computed for the item under such subparagraph for the year and may not be less than 85 percent of the median of all local purchase prices computed under such subparagraph for the item for the year; and”. (3) Oxygen and oxygen equipment.— Section 1834(a)(9) (42 U.S.C. 1395m(a)(9)) is amended— (A) in subparagraph (A)(ii)(II), by striking “1991 and 1992” and inserting “1991, 1992, 1993, and 1994”; and (B) in subparagraph (B)— (i) by striking “and” at the end of clause (i), (ii) by redesignating clause (ii) as (iv), and (iii) by inserting after clause (i) the following new clauses: “(ii) for 1992 and 1993, the amount determined under this subparagraph for the preceding year increased by the covered item update for such subsequent year, “(iii) for 1994, the local monthly payment rate computed under subparagraph (A)(ii) for the item for the year, except that such national limited monthly payment rate may not exceed 100 percent of the median of all local monthly payment rates computed for the item under such subparagraph for the year 107 STAT. 589and may not be less than 85 percent of the median of all local monthly payment rates computed for the item under such subparagraph for the year; and”. (b) Effective Date.— The amendments made by this section shall apply to items furnished on or after January 1, 1994.