Page:United States Statutes at Large Volume 108 Part 5.djvu/930

 108 STAT. 4420 PUBLIC LAW 103-432—OCT. 31, 1994 15-month period preceding the date on which the supplier makes such contact. " (B) PROHIBITING PAYMENT FOR ITEMS FURNISHED SUB- SEQUENT TO UNSOLICITED CONTACTS. — If a suppHer knowingly contacts an individual in violation of subparagraph (A), no payment may be made under this part for any item subsequently furnished to the individual by the supplier. "(C) EXCLUSION FROM PROGRAM FOR SUPPLIERS ENGAG- ING IN PATTERN OF UNSOLICITED CONTACTS.— If a supplier knowingly contacts individuals in violation of subparagraph (A) to such an extent that the supplier's conduct establishes a pattern of contacts in violation of such subparagraph, the Secretary shall exclude the supplier from participation in the programs under this Act, in accordance with the procedures set forth in subsections (c), (f), and (g) of section 1128. ". (2) REQUIRING REFUND OF AMOUNTS COLLECTED FOR DIS- ALLOWED ITEMS.—Section 1834(a) (42 U.S.C. 1395m(a)), as amended by paragraph (1), is amended by adding at the end the following new paragraph: "(18) REFUND OF AMOUNTS COLLECTED FOR CERTAIN DIS- ALLOWED ITEMS.— "(A) IN GENERAL. — If a nonparticipating supplier furnishes to an individual enrolled under this part a covered item for which no payment may be made under this part by reason of paragraph (17)(B), the supplier shall refund on a timely basis to the patient (and shall be liable to the patient for) any amounts collected from the patient for the item, unless— "(i) the supplier establishes that the supplier did not know and could not reasonably have been expected to know that payment may not be made for the item by reason of paragraph (17)(B), or "(ii) before the item was furnished, the patient was informed that payment under this part may not be made for that item and the patient has agreed to pay for that item. "(B) SANCTIONS.— I f a supplier knowingly and willfully fails to make refunds in violation of subparagraph (A), the Secretary may apply sanctions against the supplier in accordance with section 1842(j)(2). "(C) NOTICE.—Each carrier with a contract in effect under this part with respect to suppliers of covered items shall send any notice of denial of payment for covered items by reason of paragraph (17)(B) and for which pay- ment is not requested on an assignment-related basis to the supplier and the patient involved. "(D) TIMELY BASIS DEFINED.- — A refund under subparagraph (A) is considered to be on a timely basis only if^ "(i) in the case of a supplier who does not request reconsideration or seek appeal on a timely basis, the refund is made within 30 days after the date the supplier receives a denial notice under subparagraph (C),or "(ii) in the case in which such a reconsideration or appeal is taken, the refund is made within 15 days

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