PUBLIC LAW 105-33—AUG. 5, 1997 111 STAT. 367 4102, 4103, and 4104, is amended by inserting "(2)(S)," before " (3),". (3) CONSULTATION WITH ORGANIZATIONS IN ESTABLISHING 42 USC 1395W-4 PAYMENT AMOUNTS FOR SERVICES PROVIDED BY PHYSICIANS.— NOTE. In establishing payment amounts under section 1848 of the Social Security Act for physicians' services consisting of diabetes outpatient self-management training services, the Secretary of Health and Human Services shall consult with appropriate organizations, including such organizations representing individuals or medicare beneficiaries with diabetes. (b) BLOOD-TESTING STRIPS FOR INDIVIDUALS WITH DIABETES. — (1) INCLUDING STRIPS AND MONITORS AS DURABLE MEDICAL EQUIPMENT.— The first sentence of section 1861(n) (42 U.S.C. 1395x(n)) is amended by inserting before the semicolon the following: ", and includes blood-testing strips and blood glucose monitors for individuals with diabetes without regard to whether the individual has TVpe I or Tjrpe II diabetes or to the individual's use of insulin (as determined under standards established by the Secretary in consultation with the appropriate organizations)". (2) 10 PERCENT REDUCTION IN PAYMENTS FOR TESTING STRIPS.— Section 1834(a)(2)(B)(iv) (42 U.S.C. 1395m(a)(2)(B)(iv)) is amended by adding before the period the following: "(reduced by 10 percent, in the case of a blood glucose testing strip furnished after 1997 for an individual with diabetes)". (c) ESTABLISHMENT OF OUTCOME MEASURES FOR BENEFICLVRIES 42 USC i395x WITH DIABETES.— note- (1) IN GENERAL.—The Secretary of Health and Human Services, in consultation with appropriate organizations, shall establish outcome measures, including glysolated hemoglobin (past 90-day average blood sugar levels), for purposes of evaluating the improvement of the health status of medicare beneficiaries with diabetes mellitus. (2) RECOMMENDATIONS FOR MODIFICATIONS TO SCREENING BENEFITS. — Taking into account information on the health status of medicare beneficiaries with diabetes mellitus as measured under the outcome measures established under paragraph (1), the Secretary shall from time to time submit recommendations to Congress regarding modifications to the coverage of services for such beneficiaries under the medicare program. (d) EFFECTIVE DATE.— 42 USC i395m (1) IN GENERAL.— Except as provided in paragraph (2), the °ote. amendments made by this section shall apply to items and services fiimished on or after July 1, 1998. (2) TESTING STRIPS. —The amendment made by subsection (b)(2) shall apply with respect to blood glucose testing strips furnished on or after January 1, 1998. SEC. 4106. STANDARDIZATION OF MEDICARE COVERAGE OF BONE MASS MEASUREMENTS. (a) IN GENERAL.—Section 1861 (42 U.S.C. 1395x), as amended by sections 4103(a), 4104(a), and 4105(a), is amended— (1) in subsection (s)— (A) in paragraph (12)(C), by striking "and" at the end, (B) by striking the period at the end of paragraph (14) and inserting "; and".
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