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107 STAT. 604 PUBLIC LAW 103-66—AUG. 10, 1993 physician members may provide a variety of different specialty services and provide professional services both within and outside the group, as well as perform other tasks such as research, subparagraph (A) shall be applied only with respect to the services provided withm the faculty practice plan. "(5) REFERRAL; REFERRING PHYSICIAN.— "(A) PHYSICIANS' SERVICES.—Except as provided in subparagraph (C), in the case of an item or service for which payment may be made under part B, the request by a physician for the item or service, including the request by a pnysician for a consultation with another physician (and any test or procedure ordered by, or to be performed by (or under the supervision of) that other physicitui), constitutes a Referral' by a 'referring physician'. "(B) OTHER ITEMS.—^Except as provided in subpara- graph (C), the request or establishment of a plan of care by a physician wnich includes the provision of the des- ignated nealUi service constitutes a 'referral' by a 'referring physician'. "(C) CLARIFICATION RESPECTING CERTAIN SERVICES INTEGRAL TO A CONSULTATION BY CERTAIN SPECIALISTS.— A request by a pathologist for clinical diagnostic laboratory tests and pathological examination services, a request by a radiologist for diagnostic radiologn^ services, and a request by a raouation oncologist for radiation therapy, if such services are furnished b^ (or under the supervision of) such pathologist, radiologist, or radiation oncologist pursu- ant to a consultation requested by another physician does not constitute a *referral'by a 'referring physician'. "(6) DESIGNATED HEALTH SERVICES.—The term 'designated health services' means any of the following items or services: "(A) Clinical laboratory services. "(B) Physical therapy services. "(C) Occupational therapy services. "(D) Radiology or other diagnostic services. "(E) Radiation therapy services. "(F) Durable medical equipment. "(G) Parenteral and enteral nutrients, equipment, and supplies. "(H) Prosthetics, orthotics, and prosthetic devices. "(I) Home healUi services. "(J) Outpatient prescription drugs. "(K) Inpatient and outpatient hospital services."; (3) in subsection (f), by striking "clinical laboratory serv- ices" and inserting "designated health services"; and (4) in para^aph (1) of subsection (g), by striking "clinical laboratory service and inserting "designated health service". 42 use 1395nn (b) EFFECTIVE DATES.— "°*® (1) I N GENERAL.—Except as provided in paragraph (2), the amendments made by this section shall apply to referrals— (A) made on or after January 1, 1992, in the case of clinical laboratory services, and (B) made after December 31, 1994, in the case of other designated health services. (2) ElaccEPTlONS.—^With respect to referrals made for clinical laboratory services on or before December 31,1994—