Page:United States Statutes at Large Volume 111 Part 1.djvu/485

 PUBLIC LAW 105-33—AUG. 5, 1997 111 STAT. 461 (B) a carrier's capacity to conduct electronic data interchange with laboratories and data matches with other carriers. (3) SINGLE DATA RESOURCE.— The Secretary shall select one of the designated carriers to serve as a central statistical resource for all claims information relating to such clinical diagnostic laboratory tests handled by all the designated carriers under such part. (4) ALLOCATION OF CLAIMS. —The allocation of claims for clinical diagnostic laboratory tests to particular designated carriers shall be based on whether a carrier serves the geographic area where the laboratory specimen was collected or other method specified by the Secretary. (5) SECRETARL\L EXCLUSION. —Paragraph (1) shall not apply with respect to clinical diagnostic laboratory tests furnished by physician office laboratories if the Secretary determines that such offices would be unduly burdened by the application of billing responsibilities with respect to more than one carrier. Cb) ADOPTION OF NATIONAL POLICIES FOR CLINICAL LABORATORY TESTS BENEFIT. — (1) IN GENERAL.—Not later than January 1, 1999, the Secretary shall first adopt, consistent with paragraph (2), national coverage and administrative policies for clinical diagnostic laboratory tests under part B of title XVIII of the Social Security Act, using a negotiated rulemaking process under subchapter III of chapter 5 of title 5, United States Code. (2) CONSIDERATIONS IN DESIGN OF NATIONAL POLICIES.— The policies under paragraph (1) shall be designed to promote program integrity and national uniformity and simplify administrative requirements with respect to clinical diagnostic laboratory tests payable under such part in connection with the following: (A) Beneficiary information required to be submitted with each claim or order for laboratory tests. (B) The medical conditions for which a laboratory test is reasonable and necessary (within the meaning of section 1862(a)(1)(A) of the Social Security Act). (C) The appropriate use of procedure codes in billing for a laboratory test, including the unbundling of laboratory services. (D) The medical documentation that is required by a medicare contractor at the time a claim is submitted for a laboratory test in accordance with section 1833(e) of the Social Security Act. (E) Recordkeeping requirements in addition to any information required to be submitted with a claim, including physicians' obligations regarding such requirements. (F) Procedures for filing claims and for providing remittances by electronic media. (G) Limitation on frequency of coverage for the same tests performed on the same individual. (3) CHANGES IN LABORATORY POLICIES PENDING ADOPTION OF NATIONAL POLICY.— During the period that begins on the date of the enactment of this Act and ends on the date the Secretary first implements national policies pursuant to regulations promulgated under this subsection, a carrier under such

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