PUBLIC LAW 104-191—AUG. 21, 1996
110 STAT. 2015
"(i) the waiver is not offered as part of any
advertisement or solicitation;
"(ii) the person does not routinely waive coinsurance or deductible amounts; and
"(iii) the person—
"(I) waives the coinsurance and deductible
amounts after determining in good faith that the
individual is in financial need;
"(II) fails to collect coinsurance or deductible
amounts after making reasonable collection
efforts; or
"(III) provides for any permissible waiver as
specified in section 1128B(b)(3) or in regulations
issued by the Secretary;
"(B) differentials in coinsurance and deductible
amounts as part of a benefit plan design as long as the
differentials have been disclosed in writing to all
beneficiaries, third party payers, and providers, to whom
claims are presented and as long as the differentials meet
the standards as defined in regulations promulgated
by the Secretary not later than 180 days after the date
of the enactment of the Health Insurance Portability and
Accountability Act of 1996; or
"(C) incentives given to individuals to promote the
delivery of preventive care as determined by the Secretary
in regulations so promulgated.".
(i) EFFECTIVE DATE. —The amendments made by this section
shall apply to acts or omissions occurring on or after January
1, 1997.
SEC. 232. PENALTY FOR FALSE CERTIFICATION FOR HOME HEALTH
SERVICES.
(a) IN GENERAL. —Section 1128A(b) (42 U.S.C. 1320a-7a(b)) is
amended by adding at the end the following new paragraph:
"(3)(A) Any physician who executes a document described in
subpgiragraph (B) with respect to an individual knowing that all
of the requirements referred to in such subparagraph are not met
with respect to the individual shall be subject to a civil monetary
penalty of not more than the greater of—
"(i) $5,000, or
"(ii) three times the amount of the pa3mients under title
XVIII for home health services which are made pursuant to
such certification.
"(B) A document described in this subparagraph is any document that certifies, for purposes of title XVIII, that an individual
meets the requirements of section 1814(a)(2)(C) or 1835(a)(2)(A)
in the case of home health services furnished to the individual.".
(b) EFFECTIVE DATE. —The amendment made by subsection (a)
shall apply to certifications made on or Eifter the date of the enactment of this Act.
42 USC 1320a-
7a note.
42 USC 1320a-
7a note.
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