Page:United States Statutes at Large Volume 100 Part 3.djvu/194

 PUBLIC LAW 99-509—OCT. 21, 1986

100 STAT. 2002 '

42 USC 1395mm.

42 USC 1395mm note.

(1) the adjusted average per capita cost ("AAPCC", as defined in section 1876(a)(4) of the Social Security Act) can be refined to more accurately reflect the average cost of providing care to different classes of patients, and (2) the adjusted community rate ("ACR", as defined in section 1876(e)(3) of such Act) can be refined. The Secretary shall submit to Congress, by not later than January 1, 1988, specific legislative recommendations concerning methods by which the calculation of the AAPCC and the ACR can be refined, (h) ALLOWING MEDICARE BENEFICIARIES TO DISENROLL AT A LOCAL SOCIAL SECURITY OFFICE.—The Secretary of Health and Human

Services shall provide that individuals enrolled with an eligible organization under section 1876 of the Social Security Act may disenroll, on and after June 1, 1987, at any local office of the Social Security Administration. 42 USC 1395mm note.

99 Stat. 1037.

(i) USE OF RESERVE FUNDS.—Notwithstanding any provision of

section 1876(g)(5) of the Social Security Act (42 U.S.C. 1395mm(g)(5)) to the contrary, funds reserved by an eligible organization under such section before the date of the enactment of this Act may be applied, at the organization's option, to offset the amount of any reduction in payment amounts to the organization effected under Public Law 99-177 during fiscal year 1986. SEC. 9313. PROVISIONS RELATING TO IMPROVEMENT OF QUALITY OF CARE. (a) PERMITTING PROVIDER REPRESENTATION OF BENEFICIARIES.—

42 USC 406, 1302, 1395hh.

42 USC 1395pp.

(1) IN GENERAL.—Section 1869(b)(1) of the Social Security Act (42 U.S.C. 1395ff(b)(l)) is amended by adding at the end the following new sentence: "Sections 206(a), 1102, and 1871 shall '[•' not be construed as authorizing the Secretary to prohibit an individual from being represented under this subsection by a person that furnishes or supplies the individual, directly or indirectly, with services or items solely on the basis that the person furnishes or supplies the individual with such a service " or item. Any person that furnishes services or items to an ' ' • individual may not represent an individual under this subsection with respect to the issue described in section 1879(a)(2) unless the person has waived any rights for payment from the beneficiary with respect to the services or items involved in the appeal. If a person furnishes services or items to an individual WiSf and represents the individual under this subsection, the person may not impose any financial liability on such individual in f, connection with such representation.". (2) TREATMENT OF COSTS OF UNSUCCESSFUL APPEAL.—Section

42 USC 1395x note.

1861(v)(l) of such Act (42 U.S.C. 1395x(v)(l)) is amended by adding at the end the following new subparagraph: "(R) In determining such reasonable cost, costs incurred by a provider of services representing a beneficiary in an unsuccessful appeal of a determination described in section 1869(b) shall not be allowable as reasonable costs.". (3) EFFECTIVE DATE.—The amendments made by this paragraph take effect on the date of the enactment of this Act. (b) PERMITTING REVIEW OF TECHNICAL DENIALS.—

(1) IN GENERAL.—Section 1869 of such Act is amended—

further

�