Page:United States Statutes at Large Volume 111 Part 1.djvu/465

 PUBLIC LAW 105-33 —AUG. 5, 1997 111 STAT. 441 "(C) ENFORCEMENT.—I f a physician or practitioner signing an affidavit under subparagraph (B) knowingly and willfully submits a claim under this title for any item or service provided during the 2-year period described in subparagraph (B)(ii) (or receives any reimbursement or amount described in paragraph (1)(B) for any such item or service) with respect to such affidavit— "(i) this subsection shall not apply with respect to any items and services provided by the physician or practitioner pursuant to any contract on and after the date of such submission and before the end of such period; and "(ii) no pa5anent shall be made under this title for any item or service furnished by the physician or practitioner during the period described in clause (i) (and no reimbursement or payment of any amount described in paragraph (1)(B) shall be made for any such item or service). "(4) LIMITATION ON ACTUAL CHARGE AND CLAIM SUBMISSION REQUIREMENT NOT APPLICABLE.— Section 1848(g) shall not apply with respect to any item or service provided to a medicare beneficiary under a contract described in paragraph (1). "(5) DEFINITIONS.— In this subsection: "(A) MEDICARE BENEFICIARY.—The term 'medicare beneficiary' means an individual who is entitled to benefits under part A or enrolled under part B. "(B) PHYSICIAN.—The term 'physician' has the meaning given such term by section 1861(r)(l). "(C) PRACTITIONER.—The term 'practitioner' has the meaning given such term by section 1842(b)(18)(C)." (2) CONFORMING AMENDMENTS.— (A) Section 1802 (42 U.S.C. 1395a) is amended by striking "Any" and inserting "(a) BASIC FREEDOM OF CHOICE.— Any". (B) Section 1862(a) (42 U.S.C. 1395y(a)), as amended by sections 4319(b) and 4432, is amended by striking "or" at the end of paragraph (17), by striking the period at the end of paragraph (18) and inserting "; or", and by adding after paragraph (18) the following new paragraph: "(19) which are for items or services which are furnished pursuant to a private contract described in section 1802(b).". (b) REPORT.— Not later than October 1, 2001, the Secretary 42 USC i395a of Health and Human Services shall submit a report to Congress note. on the effect on the program under this title of private contracts entered into under the amendment made by subsection (a). Such report shall include— (1) analyses regarding— (A) the fiscal impact of such contracts on total Federal expenditures under title XVIII of the Social Security Act and on out-of-pocket expenditures by medicare beneficiaries for health services under such title; and (B) the quality of the health services provided under such contracts; and (2) recommendations as to whether medicare beneficiaries should continue to be able to enter private contracts under section 1802(b) of such Act (as added by subsection (a)) and

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