Page:United States Statutes at Large Volume 102 Part 1.djvu/756

 102 STAT. 718

PUBLIC LAW 100-360—JULY 1, 1988 (2) ADDITIONAL OPTIONAL BENEFITS.—Section 1876(g)(3)(A) (42

U.S.C. 1395mm(g)(3)(A)) is amended by striking '^ate" and inserting "rates". (g) REQUIRING SUBMISSION OF DIAGNOSTIC INFORMATION.—Section

1842 (42 U.S.C. 1395u), as amended by subsection (c)(l)(C), is amended by adding at the end the following new subsection: Health care "(p)(1) Each request for payment, or bill submitted, for an item or professionals. service fumished by a physician for which payment may be made under this part shall include the appropriate diagnosis code (or codes) as established by the Secretary for such item or service. "(2) In the case of a request for payment for an item or service furnished by a physician on an assignment-related basis which does not include the code (or codes) required under paragraph (1), payment may be denied under this part. Law "(3) In the case of a request for payment for an item or service enforcement and furnished by a physician not submitted on an assignment-related basis and which does not include the code (or codes) required under paragraph (1)— "(A) if the physician knowingly and willfully fails to provide the code (or codes) promptly upon request of the Secret^uy or a carrier, the physician may be subject to a civil money penalty in an amount nottoexceed $2,000, and "(B) if the physician knowingly, willfully, and in repeated cases faOs, after being notified by the Secretary of the obligations and requiremente of this subsection, to include the code (or codes) required under paragraph (1), the physician may be subject to the sanction described in section 18420'X2XA). The provisions of section 1128A (other than subsections (a) and (b)) shall apply to civil money penalties under subparagraph (A) in the same manner as they apply to a penalty or proceeding under section 1128A(a).". (h) CONFORMING AMENDMENTS.—

Drugs and drug abuse.

42 USC 1395m

note.

(1) The first sentence of section 1866(a)(2)(A) (42 U.S.C. 1395cc(a)(2)(A)) is amended— (A) by inserting "1834(c)," after "1833(b),", and (B) by inserting "and in the case of covered outpatient drugs, applicable coinsurance percent (specified in section 1834(c)(2)(C)) of the lesser of the actual charges for the drugs or the payment limit (established under section 1834(c)(3))" after "established by the Secretary". (2) Section 1903(i)(5) (42 U.S.C. 1396b(i)(5)) is amended by striking "section 1862(c)" and inserting "section 1862(c)(l)". (i) REPORTS ON MEDICARE BENEFICIARY D R U G EXPENSES.—

(1) HHS.—The Secretary of Health and Human Services, by not later than April 1, 1989— (A) using date from the 1987 National Medical Expenditures Survey (conducted by the National Center for He£dth Services Research and Health Care Technology Assessment), shall report to Congress on expenses incurred by medicare beneficiaries for outpatient prescription drugs, and (B) shall provide the Director of the Congressional Budget Office with such date from that Survey as the Director may request to make the estimates required under paragraph (2). (2) REESTIMATION OF COSTS.—The Director of the Congressional Budget Office shall transmit to the Congress, not later

�