Page:United States Statutes at Large Volume 108 Part 5.djvu/922

 108 STAT. 4412 PUBLIC LAW 103-432—OCT. 31, 1994 (iii) in subsection (r), by striking paragraph (3) and redesignating paragraph (4) as paragraph (3). (B) Section 1842(b)(12) (42 U.S.C. 1395u(b)(12)) is amended by striking subparagraph (C). (c) INFORMATION ON EXTRA-BILLING LIMITS.— (1) PART OF EXPLANATION OF MEDICARE BENEFITS. —Section 1842(h)(7) (42 U.S.C. 1395u(h)(7)) is amended— (A) by striking "and" at the end of subparagraph (B), (B) in subparagraph (C), by striking "shall include", (C) in subparagraph (C), by striking the period at the end and inserting ", and", and (D) by adding at the end the following new subparagraph: "(D) in the case of services for which the billed amount exceeds the limiting charge imposed under section 1848(g), information regarding such applicable limiting charge (including information concerning the right to a refund under section 1848(g)(l)(A)(iv)).". (2) DETERMINATIONS BY CARRIERS. —Subparagraph (G) of section 1842(b)(3) (42 U.S.C. 1395u(b)(3)) is amended to read as follows: "(G) will, for a service that is furnished with respect to an individual enrolled under this part, that is not paid on an assignment-related basis, and that is subject to a limiting charge under section 1848(g)— "(i) determine, prior to making payment, whether the amount billed for such service exceeds the limiting charge applicable under section 1848(g)(2); "(ii) notify the physician, supplier, or other person periodically (but not less often than once every 30 days) of determinations that amounts billed exceeded such applicable limiting charges; and "(iii) provide for prompt response to inquiries of physicians, suppliers, and other persons concerning the accuracy of such limiting charges for their services;". (d) REPORT ON CHARGES IN EXCESS OF LIMITING CHARGE.— Section 1848(g)(6)(B) (42 U.S.C. 1395w-4(g)(6)(B)) is amended by inserting "information on the extent to which actual charges exceed limiting charges, the number and types of services involved, and the average amount of excess charges and information" after "report to the Congress". (e) MISCELLANEOUS AND TECHNICAL AMENDMENTS. —Section 1833(h)(5)(D) (42 U.S.C. 13951(h)(5)(D)) is amended— (1) by striking "paragraphs (2) and (3)" and by inserting "paragraph (2)"; and (2) by adding at the end the following: "Paragraph (4) of such section shall apply in this subparagraph in the same manner as such paragraph applies to such section.". (f) EFFECTIVE DATES.— 42 USC 1395/ (1) ENFORCEMENT; MISCELLANEOUS AND TECHNICAL AMEND- note- MENTS.— The amendments made by subsections (a) and (e) shall apply to services furnished on or after the date of the enactment of this Act; except that the amendments made by subsection (a) shall not apply to services of a nonparticipating supplier or other person furnished before January 1, 1995.

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