Page:United States Statutes at Large Volume 100 Part 3.djvu/215

 PUBLIC LAW 99-509—OCT. 21, 1986

100 STAT. 2023

percent of the total payments to carriers for claims processing in any fiscal year, to carriers under section 1842 of such Act, to reward such carriers for their success in increasing the proportion of physicians in the carrier's service area who are participating physicians. (4) EFFECTIVE DATES.— (A) CARRIER RESPONSIBILITY.—The

amendment made by paragraph (1) shall be effective for contracts under section 1842 of the Social Security Act as of October 1, 1987.

42 USC 1395u note. Contracts. ''

(B) PERFORMANCE MEASURES.—The Secretary of Health biif^i

3 .,•

and Human Services shall provide for the establishment of the standards and criteria required under paragraph (2) by not later than October 1, 1987, which shall apply to contracts as of October 1, 1987. (C) CARRIER BONUSES.—From the amounts appropriated for each fiscal year (beginning with fiscal year 1988), the Secretary of Health and Human Services shall first provide for pa3mients of bonuses to carriers under paragraph (3) not later than April 1, 1988, to reflect performance of carriers during the enrollment period at the end of 1987.

(b) DIRECTORIES OF PARTICIPATING PHYSICIANS.— (1) REQUIRING DISTRIBUTION TO MEDICARE BENEFICIARIES, UPON

REQUEST.—Section 1842(h) of the Social Security Act (42 U.S.C. 1395u(h)) is amended— (A) in paragraph (2), by striking period and inserting the following: "and may request a copy of an appropriate directory published under paragraph (4). Each such carrier shall, without charge, mail a copy of such directory upon such a request."; EBW (B) in paragraph (5)— (i) by striking "publication of the directories" and inserting "the participation program under this subsection and the publication and availability of the directories", and (ii) by adding at the end the following: "The Secretary shall include such notice in the mailing of appropriate benefit checks provided under title II."; and (C) in the second sentence of paragraph (6)— (i) by inserting before the period the following: "and that an appropriate number of copies of each such directory is sent to hospitals located in the area", and I.;. (ii) by adding at the end the following: "Such copies shall be sent free of charge.". (2) ORGANIZATION OF DIRECTORIES.—Section 1842(h)(4) of such Act is amended by adding at the end the following: "Each g participating physician directory for an area shall provide an J alphabetical listing of all participating physicians practicing in the area and an alphabetical listing by locality and specialty of such physicians.". f. (3) EFFECTIVE DATES.—The amendments made by this paragraph shall first apply to directories for 1987. (c) PROHIBITING UNASSIGNED BILLING OF SERVICES DETERMINED TO BE MEDICALLY UNNECESSARY BY A CARRIER.—

(1) IN GENERAL.—Section 1842 of the Social Security Act is further amended by adding at the end the following new », subsection: 8, "(IXIXA) Subject to subparagraph (C), if—

Health care facilities.

il D81J Sl^

42 USC 1395u note.

�