Page:United States Statutes at Large Volume 104 Part 2.djvu/472

This page needs to be proofread.

104 STAT. 1388-64 PUBLIC LAW 101-508 —NOV. 5, 1990 42 USC 1395u note. 42 USC 1395u note. able to provide the visit services, (ii) the individual has arranged or seeks to receive the visit services from the first physician, (iii) the claim form submitted to the carrier includes the second physician's unique identifier (provided under the system established under subsection (r)) and indicates that the claim is for such a 'covered visit service (and related services)', and (iv) the visit services are not provided by the second physician over a continuous period of longer than 60 days", (b) EFFECTIVE DATE.—The amendment made by subsection (a) shall apply to services furnished on or after the first day of the first month beginning more than 60 days after the date of the enactment of this Act. SEC. 4111. STUDY OF PREPAYMENT MEDICAL REVIEW SCREENS. (a) IN GENERAL.— The Secretary of Health and Human Services shall conduct a study of the effect of the release of medicare prepayment medical review screen parameters on physician billings for the services to which the parameters apply. (b) LIMITATIONS. —The study shall be based upon the release of the screen parameters at a minimum of six carriers. (c) REPORT.— The Secretary shall report the results of the study to the Committees on Ways and Means and Energy and Commerce of the House of Representatives and the Committee on Finance of the Senate not later than October 1, 1992. SEC. 4112. PRACTICING PHYSICIANS ADVISORY COUNCIL. Title XVIII of the Social Security Act is amended by inserting after section 1867 the following new section: "PRACTICING PHYSICIANS ADVISORY COUNCIL 42 USC 1395ee. "SEC. 1868. (a) The Secretary shall appoint, based upon nominations submitted by medical organizations representing physicians, a ^ Practicing Physicians Advisory Council (in this section referred to as the 'Council') to be composed of 15 physicians, each of whom has submitted at least 250 claims for physicians' services under this title in the previous year. At least 11 of the members of the Council shall be physicians described in section 1861(r)(l) and the members of the Council shall include both participating and nonparticipating physicians and physicians practicing in rural areas and underserved urban areas. "(b) The Council shall meet once during each calendar quarter to discuss certain proposed changes in regulations and carrier manual instructions related to physician services identified by the Secretary. To the extent feasible and consistent with statutory deadlines, such consultation shall occur before the publication of such proposed changes. "(c) Members of the Council shall be entitled to receive reimbursement of expenses and per diem in lieu of subsistence in the same manner as other members of advisory councils appointed by the Secretary are provided such reimbursement and per diem under this title.". 42 USC 1395ff SEC. 4113. STUDY OF AGGREGATION RULE FOR CLAIMS FOR SIMILAR note. PHYSICIANS' SERVICES. The Secretary of Health and Human Services shall carry out a study of the effects of permitting the aggregation of claims that involve common issues of law and fact furnished in the same carrier