PUBLIC LAW 109–432—DEC. 20, 2006
120 STAT. 2979
(5) APPLICATION.— (A) PHYSICIAN REPORTING SYSTEM RULES.—Paragraphs (5), (6), and (8) of section 1848(k) of the Social Security Act, as added by subsection (b), shall apply for purposes of this subsection in the same manner as they apply for purposes of such section. (B) COORDINATION WITH OTHER BONUS PAYMENTS.— The provisions of this subsection shall not be taken into account in applying subsections (m) and (u) of section 1833 of the Social Security Act (42 U.S.C. 1395l) and any payment under such subsections shall not be taken into account in computing allowable charges under this subsection. (C) IMPLEMENTATION.—Notwithstanding any other provision of law, the Secretary may implement by program instruction or otherwise this subsection. (D) VALIDATION.— (i) IN GENERAL.—Subject to the succeeding provisions of this subparagraph, for purposes of determining whether a measure is applicable to the covered professional services of an eligible professional under paragraph (2), the Secretary shall presume that if an eligible professional submits data for a measure, such measure is applicable to such professional. (ii) METHOD.—The Secretary shall validate (by sampling or other means as the Secretary determines to be appropriate) whether measures applicable to covered professional services of an eligible professional have been reported. (iii) DENIAL OF PAYMENT AUTHORITY.—If the Secretary determines that an eligible professional has not reported measures applicable to covered professional services of such professional, the Secretary shall not pay the bonus incentive payment. (E) LIMITATIONS ON REVIEW.— (i) IN GENERAL.—There shall be no administrative or judicial review under section 1869 or 1878 of the Social Security Act or otherwise of— (I) the determination of measures applicable to services furnished by eligible professionals under this subsection; (II) the determination of satisfactory reporting under paragraph (2); (III) the determination of the payment limitation under paragraph (3); and (IV) the determination of the bonus incentive payment under this subsection. (ii) TREATMENT OF DETERMINATIONS.—A determination under this subsection shall not be treated as a determination for purposes of section 1869 of the Social Security Act. (6) DEFINITIONS.—For purposes of this subsection: (A) ELIGIBLE PROFESSIONAL; COVERED PROFESSIONAL SERVICES.—The terms ‘‘eligible professional’’ and ‘‘covered professional services’’ have the meanings given such terms in section 1848(k)(3) of the Social Security Act, as added by subsection (b).
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