Page:United States Statutes at Large Volume 117.djvu/2435

 117 STAT. 2416

PUBLIC LAW 108–173—DEC. 8, 2003 prior determination process under such section. Such report shall include— (A) information concerning— (i) the number and types of procedures for which a prior determination has been sought; (ii) determinations made under the process; (iii) the percentage of beneficiaries prevailing; (iv) in those cases in which the beneficiaries do not prevail, the reasons why such beneficiaries did not prevail; and (v) changes in receipt of services resulting from the application of such process; (B) an evaluation of whether the process was useful for physicians (and other suppliers) and beneficiaries, whether it was timely, and whether the amount of information required was burdensome to physicians and beneficiaries; and (C) recommendations for improvements or continuation of such process. (5) ADVANCE BENEFICIARY NOTICE DEFINED.—In this subsection, the term ‘‘advance beneficiary notice’’ means a written notice provided under section 1879(a) of the Social Security Act (42 U.S.C. 1395pp(a)) to an individual entitled to benefits under part A or enrolled under part B of title XVIII of such Act before items or services are furnished under such part in cases where a provider of services or other person that would furnish the item or service believes that payment will not be made for some or all of such items or services under such title.

SEC. 939. APPEALS BY PROVIDERS WHEN THERE IS NO OTHER PARTY AVAILABLE.

42 USC 1395gg note.

(a) IN GENERAL.—Section 1870 (42 U.S.C. 1395gg) is amended by adding at the end the following new subsection: ‘‘(h) Notwithstanding subsection (f) or any other provision of law, the Secretary shall permit a provider of services or supplier to appeal any determination of the Secretary under this title relating to services rendered under this title to an individual who subsequently dies if there is no other party available to appeal such determination.’’. (b) EFFECTIVE DATE.—The amendment made by subsection (a) shall take effect on the date of the enactment of this Act and shall apply to items and services furnished on or after such date. SEC. 940. REVISIONS TO APPEALS TIMEFRAMES AND AMOUNTS.

(a) TIMEFRAMES.—Section 1869 (42 U.S.C. 1395ff) is amended— (1) in subsection (a)(3)(C)(ii), by striking ‘‘30-day period’’ each place it appears and inserting ‘‘60-day period’’; and (2) in subsection (c)(3)(C)(i), by striking ‘‘30-day period’’ and inserting ‘‘60-day period’’. (b) AMOUNTS.— (1) IN GENERAL.—Section 1869(b)(1)(E) (42 U.S.C. 1395ff(b)(1)(E)) is amended by adding at the end the following new clause: ‘‘(iii) ADJUSTMENT OF DOLLAR AMOUNTS.—For requests for hearings or judicial review made in a year after 2004, the dollar amounts specified in clause (i) shall be equal to such dollar amounts increased

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