Page:United States Statutes at Large Volume 104 Part 2.djvu/498

 104 STAT. 1388-90 PUBLIC LAW 101-508—NOV. 5, 1990 (3) TREATMENT OF PAYMENTS TO HEALTH MAINTENANCE ORGANIZATIONS.— Subsection (a) shall not apply to payments under risk-sharing contracts under section 1876 of the Social Security Act or under similar contracts under section 402 of the Social Security Amendments of 1967 or section 222 of the Social Security Amendments of 1972. 42 USC 1395WW SEC. 4159. PAYMENTS FOR MEDICAL EDUCATION COSTS. (a) HOSPITAL GRADUATE MEDICAL EDUCATION RECOUPMENT. — (1) IN GENERAL.—The Secretary of Health and Human Services may not, before October 1, 1991, recoup payments from a hospital because of alleged overpayments to such hospital under part B of title XVIII of the Social Security Act due to a determination that the amount of payments.made for graduate medical education programs exceeds the amount allowable under section 1886(h). (2) CAP ON ANNUAL AMOUNT OF RECOUPMENT. —With respect to overpayments to a hospital described in paragraph (1), the Secretary may not recoup more than 25 percent of the amount of such overpayments from the hospital during a fiscal year. (3) EFFECTIVE DATE.—Paragraphs (1) and (2) shall take effect October 1, 1990. (b) UNIVERSITY HOSPITAL NURSING EDUCATION. — (1) IN GENERAL.—The reasonable costs incurred by a hospital (or by an educational institution related to the hospital by common ownership or control) during a cost reporting period for clinical training (as defined by the Secretary) conducted on the premises of the hospital under approved nursing and allied health education programs that are not operated by the hospital shall be allowable as reasonable costs under part B of title XVIII of the Social Security Act and reimbursed under such part on a pass-through basis. (2) CONDITIONS FOR REIMBURSEMENT. —The reasonable costs incurred by a hospital during a cost reporting period shall be reimbursable pursuant to paragraph (1) only if— (A) the hospital claimed and was reimbursed for such costs during the most recent cost reporting period that ended on or before October 1, 1989; (B) the proportion of the hospital's total allowable costs that is attributable to the clinical training costs of the approved program, and allowable under (b)(1) during the cost reporting period does not exceed the proportion of total allowable costs that were attributable to clinical training costs during the cost reporting period described in subparagraph (A); (C) the hospital receives a benefit for the support it furnishes to such program through the provision of clinical services by nursing or allied health students participating in such program; and (D) the costs incurred by the hospital for such program do not exceed the costs that would be incurred by the hospital if it operated the program itself. (3) PROHIBITION AGAINST RECOUPMENT OF COSTS BY SEC- RETARY.— (A) IN GENERAL.—The Secretary of Health and Human Services may not recoup payments from (or otherwise reduce or adjust payments under part B of title XVIII of the

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