Page:United States Statutes at Large Volume 102 Part 1.djvu/755

 PUBLIC LAW 100-360—JULY 1, 1988 (B) APPLICATION

102 STAT. 717

OF DIFFERENT PERFORMANCE STAND-

ARDS.—The Secretary of Health and Human Services, before entering into contracts under section 1842 of the Social Security Act with respect to the implementation and operation (and related functions) of the electronic system for covered outpatient drugs, shall est,ablish standards with respect to performance with respect to such activities. The provisions of section 1153(e)(2), and paragraphs (1) and (2) of section 1153(h), of such Act shall apply to such activities in the same manner as they apply to contracts with peer review organizations, instead of the requirements of the last 2 sentences of section 1842(b)(2) of such Act.

Contracts. 42 USC 1395u note.

(C) U S E OF REGIONAL CARRIERS.—Section 1842(b)(2) is

amended by adding at the end the following new sentence: "With respect to activities relating to implementation and Contracts. operation (and related functions) of the electronic system established under subsection (o)(4), the Secretary may enter into contracts with carriers under this section to perform such activities on a regional basis.". (4) ADJUSTMENT OF CARRIER OBLIGATIONS.— (A) N O TOLL-FREE TELEPHONE NUMBER REQUIRED OF UM-

ITED CARRIERS.—Section 1842(h)(2) (42 U.S.C. 1395u(h)(2)) is amended by inserting "(other than a carrier described in subsection (fK3))" after "Each carrier". (B) DELAY IN APPLICATION OF COORDINATED BENEFITS WITH

MEDiGAP.—The provisions of subparagraph (B) of section 1842(h)(3) of the Social Security Act shall not apply to covered outpatient drugs (other than drugs described in section 1861(s)(2)(J) of such Act as of the date of the enactment of this Act) dispensed before January 1, 1993.

42 USC 1395u note.

(5) BATCH PROMPT PROCESSING OF CLAIMS.—Section 1842(c) (42

U.S.C. 1395u(c)) is amended— (A) in paragraphs (2)(A) and (3)(A), by striking "Each" and inserting "Except as provided in paragraph (3), each"; (B) by adding a t the end the following new paragraph: "(4)(A) Each contract under this section which provides for the Contracts. disbursement of funds, as described in subsection (a)(l)(B), with Claims. respect to claims for payment for covered outpatient drugs shall provide for a payment cycle under which each carrier will, on a monthly basis, make a payment with respect to all claims which were received and approved for payment in the period since the most recent date on which such a payment was made with respect to the participating pharmacy or individual submitting the claim. "(B) If payment is not issued, mailed, or otherwise transmitted within 5 days of when such a payment is required to be made under subparagraph (A), interest shall be paid at the rate used for purposes of section 3902(a) of title 31, United States Code (relating to interest penalties for fgdlure to make prompt pa3mients) for the period beginning on the day after such 5-day period and ending on the date on which payment is made.", (f) MODIFICATION OF HMO/CMP (DONTRACTS.— (1) SEPARATE ACTUARIAL DETERMINATION FOR COVERED OUTPATIENT DRUG BENEFIT.—Section 1876(e)(l) (42 U.S.C.

1395mm(e)(l)) is amended by adding at the end thereof the following new sentence: "The preceding sentence shall be applied separately with respect to covered outpatient drugs..

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