Page:United States Statutes at Large Volume 108 Part 5.djvu/923

 '•^ ^ PUBLIC LAW 103-432—OCT. 31, 1994 108 STAT. 4413 (2) PRACTITIONERS.—The amendments made by subsection (b) shall apply to services furnished on or after January 1, 1995. (3) EOMBs. —The amendments made by subsection (c)(1) shall apply to explanations of benefits provided on or after July 1, 1995. (4) CARRIER DETERMINATIONS. —The amendments made by subsection (c)(2) shall apply to contracts as of January 1, 1995. (5) REPORT. —The amendment made by subsection (d) shall apply to reports for years beginning with 1995. SEC. 124. RELATIVE VALUES FOR PEDIATRIC SERVICES. (a) IN GENERAL.— The Secretary of Health and Human Services shall fully develop, by not later than July 1, 1995, relative values for the full range of pediatric physicians' services which are consistent with the relative values developed for other physicians' services under section 1848(c) of the Social Security Act. In developing such values, the Secretary shall conduct such refinements as may be necessary to produce appropriate estimates for such relative values. (b) STUDY.— (1) IN GENERAL. —The Secretary shall conduct a study of the relative values for pediatric and other services to determine whether there are significant variations in the resources used in providing similar services to different populations. In conducting such study, the Secretary shall consult with appropriate organizations representing pediatricians and other physicians and physical and occupational therapists. (2) REPORT. — Not later than July 1, 1995, the Secretary shall submit to Congress a report on the study conducted under paragraph (1). Such report shall include any appropriate recommendations regarding needed changes in coding or other payment policies to ensure that payments for pediatric services appropriately reflect the resources required to provide these services. SEC. 125. ADMINISTRATION OF CLAIMS RELATING TO PHYSICIANS' SERVICES. (a) LIMITATION ON CARRIER USER FEES.— Section 1842(c) (42 U.S.C. 1395u(c)) is amended by adding at the end the following new paragraph: "(4) Neither a carrier nor the Secretary may impose a fee under this title— "(A) for the filing of claims related to physicians' services, "(B) for an error in filing a claim relating to physicians' services or for such a claim which is denied, "(C) for any appeal under this title with respect to physicians' services, "(D) for applying for (or obtaining) a unique identifier under subsection (r), or "(E) for responding to inquiries respecting physicians' services or for providing information with respect to medical review of such services.". (b) CLARIFICATION OF PERMISSIBLE SUBSTITUTE BILLING ARRANGEMENTS. — (1) IN GENERAL.—Clause (D) of section 1842(b)(6) (42 U.S.C. 1395u(b)(6)) is amended to read as follows: "(D) payment may be made to a physician for physicians' services (and services 42 USC 1395/ note. 42 USC 1395u note. 42 USC 1395u note. 42 USC 1395W-4 note. 42 USC 1395W-4 note.

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