Sec. 542. TREATMENT OF CERTAIN PHYSICIAN PATHOLOGY SERVICES UNDER MEDICARE

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## SEC. 542 TREATMENT OF CERTAIN PHYSICIAN PATHOLOGY SERVICES UNDER MEDICARE **[**[42 U.S.C. 1395W–4 Note](/us/usc/t42/s1395W–4)**]** ###

(a)In General When an independent laboratory furnishes the technical component of a physician pathology service to a fee-for-service medicare beneficiary who is an inpatient or outpatient of a covered hospital, the Secretary of Health and Human Services shall treat such component as a service for which payment shall be made to the laboratory under section 1848 of the Social Security Act (42 U.S.C. 1395w-4) and not as an inpatient hospital service for which payment is made to the hospital under section 1886(d) of such Act (42 U.S.C. 1395ww(d)) or as an outpatient hospital service for which payment is made to the hospital under section 1833(t) of such Act (42 U.S.C. 1395l(t)). ###

(b)Definitions For purposes of this section: ####

(1)Covered hospital The term “**covered hospital**” means, with respect to an inpatient or an outpatient, a hospital that had an arrangement with an independent laboratory that was in effect as of July 22, 1999, under which a laboratory furnished the technical component of physician pathology services to fee- for-service medicare beneficiaries who were hospital inpatients or outpatients, respectively, and submitted claims for payment for such component to a medicare carrier (that has a contract with the Secretary under section 1842 of the Social Security Act, 42 U.S.C. 1395u) and not to such hospital. ####

(2)Fee-for-service medicare beneficiary The term “**fee-for-service medicare beneficiary**” means an individual who— #####

(A)is entitled to benefits under part A, or enrolled under part B, or both, of such title; and #####

(B)is not enrolled in any of the following: ######

(i)A Medicare+Choice plan under part C of such title. ######

(ii)A plan offered by an eligible organization under section 1876 of such Act (42 U.S.C. 1395mm). ######

(iii)A program of all-inclusive care for the elderly

(PACE)under section 1894 of such Act (42 U.S.C. 1395eee). ######

(iv)A social health maintenance organization

(SHMO)demonstration project established under section 4018(b) of the Omnibus Budget Reconciliation Act of 1987 (Public Law 100-203). ###

(c)Effective Date This section shall apply to services furnished during the 2-year period beginning on January 1, 2001, and for services furnished during 2005, 2006, 2007, 2008, 2009, 2010, 2011, and the first six months of 2012. ###

(d)GAO Report ####

(1)Study The Comptroller General of the United States shall conduct a study of the effects of the previous provisions of this section on hospitals and laboratories and access of fee-for-service medicare beneficiaries to the technical component of physician pathology services. ####

(2)Report Not later than April 1, 2002, the Comptroller General shall submit to Congress a report on such study. The report shall include recommendations about whether such provisions should be extended after the end of the period specified in subsection

(c)for either or both inpatient and outpatient hospital services, and whether the provisions should be extended to other hospitals. * * * * * * * # TITLE VIII ERIE CANALWAY NATIONAL HERITAGE CORRIDOR

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