Page:United States Statutes at Large Volume 122.djvu/2602

 12 2 STA T . 2 579PUBLIC LA W 11 0– 275 —J UL Y 15, 200 8det e rmin ed u nder s u bpa ra g rap h(D) (i v )) .I nterest am o unts paid under this subparagraph sha l lnotbe c ounted against the administrative costs o f a prescrip - tion drug plan or treated as allo w able ris k corridor costs under section 1860 D – 1 5 (e). ‘ ‘(ii) AUTHORI T YN OT TO C H A R GE INTERE S T. —T he S ecretar y may provide that a P DP sponsor is not charged interest under clause (i) in the case where there are e x igent circumstances, including natural disasters and other uni q ue and unexpected events, that prevent the timely processing of claims. ‘‘(D) PROCE D URES IN V O L VING CLAI M S.— ‘‘(i) C LAIM DEEMED TO B E CLEAN.—A claim is deemed to be a clean claim if the PDP sponsor involved does not provide notice to the claimant of any deficiency in the claim— ‘‘(I) with respect to claims submitted electroni- cally, within 10 days after the date on which the claim is received and ‘‘(II) with respect to claims submitted other- wise, within 15 days after the date on which the claim is received. ‘‘(ii) CLAIM DETERMINED TO NOT BE A CLEAN CLAIM.— ‘‘(I) IN GENERAL.—If a PDP sponsor determines that a submitted claim is not a clean claim, the PDP sponsor shall, not later than the end of the period described in clause (i), notify the claimant of such determination. Such notification shall specify all defects or improprieties in the claim and shall list all additional information or docu- ments necessary for the proper processing and pay- ment of the claim. ‘‘(II) DETERMINATION A F TER SUBMISSION OF ADDITIONAL INFORMATION.—A claim is deemed to be a clean claim under this paragraph if the PDP sponsor involved does not provide notice to the claimant of any defect or impropriety in the claim within 10 days of the date on which additional information is received under subclause (I). ‘‘(iii) O BLIGATION TO P AY.—A claim submitted to a PDP sponsor that is not paid or contested by the sponsor within the applicable number of days (as defined in subparagraph ( B )) after the date on which the claim is received shall be deemed to be a clean claim and shall be paid by the PDP sponsor in accord- ance with subparagraph (A). ‘‘(iv) DATE OF PAYMENT OF CLAIM.—Payment of a clean claim under such subparagraph is considered to have been made on the date on which— ‘‘(I) with respect to claims paid electronically, the payment is transferred; and ‘‘(II) with respect to claims paid otherwise, the payment is submitted to the U nited States Postal Service or common carrier for delivery. Notice.D e adl i n e s . Notice. Deadlines.

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