104 STAT. 1388-206 PUBLIC LAW 101-508 —NOV. 5, 1990 agencies, associations, or other private entities in ensuring that providers are provided a copy of the documents that are to be distributed under the requirements of the section. (4) DUTIES OF SECRETARY,—The Secretary shall mail information to Social Security recipients, add a page to the medicare handbook with respect to the provisions of this section. SEC. 4752. IMPROVEMENT IN QUALITY OF PHYSICIAN SERVICES. (a) USE OF UNIQUE PHYSICIAN IDENTIFIERS.— (1) ESTABLISHMENT OF SYSTEM.— (A) IN GENERAL.— Section 1902 (42 U.S.C. 1396a) as amended by sections 4601(d), 4701(a), 4711(a), 4722(a), and 4751(a) is further amended by adding at the end the following new subsection: "(x) The Secretary shall establish a system, for implementation by not later than July 1, 1991, which provides for a unique identifier for each physician who furnishes services for which payment may be made under a State plan approved under this title.". 42 USC 1396a (B) DEADLINE AND CONSIDERATIONS.—The System estab- "°*®- lished under the amendment made by subparagraph (A) may be the same as, or different from, the system established under section 9202(g) of the Consolidated Omnibus Budget Reconciliation Act of 1985. (2) REQUIRING INCLUSION WITH CLAIMS.— Section 1903(i) (42 U.S.C. 1396b(i)), as amended by this title, is amended— (A) by striking the period at the end of paragraph (11) and inserting "; or", and (B) by inserting after paragraph (11) the following new paragraph: "(12) with respect to any amount expended for physicians' services furnished on or after the first day of the first quarter beginning more than 60 days after the date of establishment of the physician identifier system under section 1902(x), unless the claim for the services includes the unique physician identifier provided under such system.". (b) MAINTENANCE OF ENCOUNTER DATA BY HEALTH MAINTENANCE ORGANIZATIONS. — (1) IN GENERAL.— Section 1903(m)(2)(A) (42 U.S.C. 1396b(m)(2)(A)), as amended by this title, is amended— (A) by striking "and" at the end of clause (ix), (B) by striking the period at the end of clause (x) and inserting "; and", and (C) by adding at the end the following new clause: "(xi) such contract provides for maintenance of sufficient patient encounter data to identify the physician who delivers services to patients.". 42 USC 1396a (2) EFFECTIVE DATE. — The amendments made by paragraph (1) "*>**• shall apply to contract years beginning after the date of the establishment of the system described in section 1902(x) of the Social Security Act. (c) MAINTENANCE OF LIST OF PHYSICIANS BY STATES.— (1) IN GENERAL.— Section 1902(a) (42 U.S.C. 1396a(a)), as amended by this title, is further amended— (A) by striking "and" at the end of paragraph (56), (B) by striking the period at the end of paragraph (57) and inserting "; and", and
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