Page:United States Statutes at Large Volume 101 Part 2.djvu/933

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101 STAT. 1330-139
101 STAT. 1330-139
PUBLIC LAW 100-000—MMMM. DD, 1987

PUBLIC LAW 100-203—DEC. 22, 1987

101 STAT. 1330-139

section 1156(b) of such Act until the provider or practitioner has been provided an administrative hearing thereon under paragraph (4) of such section, notwithstanding any failure by the provider or practitioner to request the hearing on a timely basis. (e) REPORT ON IMPROVEMENTS IN PROCEDURES FOR IMPOSING SANC-

TIONS.—Not later than one year after the date of enactment of this Act, the Secretary of Health and Human Services shall report to Congress on the improved procedures for imposing sanctions against a practitioner or person under section 1156 of the Social Security Act established through agreement by the Health Care Financing Administration, the American Association of Retired Persons, the American Medical Association, and the Office of the Inspector General in the Department of Health and Human Services. The report shall set forth such improved procedures, describe the response of physicians and providers to the procedures, assess whether the procedures effect an appropriate balance between procedural fairness and the need for ensuring quality medical care, comment on the alternative provider-patient notification procedure contained in the agreement, and recommend whether such procedures should apply to institutional providers of health care services. SEC. 4096. LIMITATION OF BENEFICIARY LIABILITY FOR SERVICES DISALLOWED BY PEER REVIEW ORGANIZATIONS. (a\ p^jii' B SERVICES.

(1) Section 1842 of the Social Security Act (42 U.S.C 1395u) is— amended— (A) in subsection (b)(3)(ii), by inserting "(and to refund amounts already collected)" after "agrees not to charge", and by striking 'and (II)" and inserting ", (II) the physician or other person furnishing such service agrees not to charge (and to refund amounts already collected) for services for which payment under this title is denied under section 1154(a)(2) by reason of a determination under section 1154(a)(l)(B), and (III)"; (B) in subsection (IXlXAXiii), by inserting "(I)" after "(iii)" and by inserting before the comma the following: "or (II) payment under this title for such services is denied under i-A^-><'<'} section 1154(a)(2) by reason of a determination under section 1154(a)(l)(B)"; and (C) in subsection (IXIXC), by inserting "in the case described in subparagraph (A)(iiiXD" after to an individual". (2) Section 1870(f) of such Act (42 U.S.C. 1395gg(f)) is amended by striking "that the reasonable charge is the full charge for the services" each place it appears and inserting "to the terms specified in subclauses (I) and (II) of section 1842(b)(3)(B)(ii) with respect to the services". (b) INDEMNIFICATION.—Section 1879(b) of such Act (42 U.S.C. 1395pp(b)) is amended— (1) in the first sentence, by striking ", subject to the deductible and coinsurance provisions of this title,", and (2) by adding at the end the following: "No item or service for which an individual is indemnified under this subsection shall be taken into account in applying any limitation on the amount of items and services for which payment may be made to or on behalf of the individual under this title.". (c) PATIENT LIABILITY FOR HOSPITAL CHARGES DURING APPEAL OF DISCHARGE NOTICE.—