Page:United States Statutes at Large Volume 117.djvu/2423

 117 STAT. 2404

PUBLIC LAW 108–173—DEC. 8, 2003 (B) by adding at the end the following new subparagraph: ‘‘(K) INDEPENDENCE REQUIREMENTS.— ‘‘(i) IN GENERAL.—Subject to clause (ii), a qualified independent contractor shall not conduct any activities in a case unless the entity— ‘‘(I) is not a related party (as defined in subsection (g)(5)); ‘‘(II) does not have a material familial, financial, or professional relationship with such a party in relation to such case; and ‘‘(III) does not otherwise have a conflict of interest with such a party. ‘‘(ii) EXCEPTION FOR REASONABLE COMPENSATION.— Nothing in clause (i) shall be construed to prohibit receipt by a qualified independent contractor of compensation from the Secretary for the conduct of activities under this section if the compensation is provided consistent with clause (iii). ‘‘(iii) LIMITATIONS ON ENTITY COMPENSATION.— Compensation provided by the Secretary to a qualified independent contractor in connection with reviews under this section shall not be contingent on any decision rendered by the contractor or by any reviewing professional.’’. (2) ELIGIBILITY REQUIREMENTS FOR REVIEWERS.—Section 1869 (42 U.S.C. 1395ff) is amended— (A) by amending subsection (c)(3)(D) to read as follows: ‘‘(D) QUALIFICATIONS FOR REVIEWERS.—The requirements of subsection (g) shall be met (relating to qualifications of reviewing professionals).’’; and (B) by adding at the end the following new subsection: ‘‘(g) QUALIFICATIONS OF REVIEWERS.— ‘‘(1) IN GENERAL.—In reviewing determinations under this section, a qualified independent contractor shall assure that— ‘‘(A) each individual conducting a review shall meet the qualifications of paragraph (2); ‘‘(B) compensation provided by the contractor to each such reviewer is consistent with paragraph (3); and ‘‘(C) in the case of a review by a panel described in subsection (c)(3)(B) composed of physicians or other health care professionals (each in this subsection referred to as a ‘reviewing professional’), a reviewing professional meets the qualifications described in paragraph (4) and, where a claim is regarding the furnishing of treatment by a physician (allopathic or osteopathic) or the provision of items or services by a physician (allopathic or osteopathic), a reviewing professional shall be a physician (allopathic or osteopathic). ‘‘(2) INDEPENDENCE.— ‘‘(A) IN GENERAL.—Subject to subparagraph (B), each individual conducting a review in a case shall— ‘‘(i) not be a related party (as defined in paragraph (5)); ‘‘(ii) not have a material familial, financial, or professional relationship with such a party in the case under review; and

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