Page:United States Statutes at Large Volume 114 Part 5.djvu/583

 PUBLIC LAW 106-554—APPENDIX F 114 STAT. 2763A-543 include any recommendations for administrative or legislative actions that the Secretary determines appropriate.". (b) APPLICABILITY OF REQUIREMENTS AND LIMITATIONS ON LIABILITY OF QUALIFIED INDEPENDENT CONTRACTORS TO MEDICARE+CHOICE INDEPENDENT APPEALS CONTRACTORS. —Section 1852(g)(4) (42 U.S.C. 1395w-22(g)(4)) is amended by adding at the end the following: "The provisions of section 1869(c)(5) shall apply to independent outside entities under contract with the Secretary under this paragraph.". (c) CONFORMING AMENDMENT.— Section 1154(e) (42 U.S.C. 1320c-3(e)) is amended by striking paragraphs (2), (3), and (4). (d) EFFECTIVE DATE.—The amendments made by this section shall apply with respect to initial determinations made on or after October 1, 2002. SEC. 522. REVISIONS TO MEDICARE COVERAGE PROCESS. (a) REVIEW OF DETERMINATIONS.— Section 1869 (42 U.S.C. 1395ff), as amended by section 521, is further amended by adding at the end the following new subsection: " (f) REVIEW OF COVERAGE DETERMINATIONS.— "(1) NATIONAL COVERAGE DETERMINATIONS. — "(A) IN GENERAL. —Review of any national coverage determination shall be subject to the following limitations: "(i) Such a determination shall not be reviewed by any administrative law judge. "(ii) Such a determination shall not be held unlawful or set aside on the ground that a requirement of section 553 of title 5, United States Code, or section 1871(b) of this title, relating to publication in the Federal Register or opportunity for public cormnent, was not satisfied. "(iii) Upon the filing of a complaint by an aggrieved party, such a determination shall be reviewed by the Departmental Appeals Board of the Department of Health and Human Services. In conducting such a review, the Departmental Appeals Board— "(I) shall review the record and shall permit discovery and the taking of evidence to evaluate the reasonableness of the determination, if the Board determines that the record is incomplete or lacks adequate information to support the validity of the determination; "(II) may, as appropriate, consult with appropriate scientific and clinical experts; and "(III) shall defer only to the reasonable findings of fact, reasonable interpretations of law, and reasonable applications of fact to law by the Sec- ' retary. "(iv) The Secretary shall implement a decision of the Departmental Appeals Board within 30 days of receipt of such decision. "(v) A decision of the Departmental Appeals Board constitutes a final agency action and is subject to judicial review.

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