Page:United States Statutes at Large Volume 91.djvu/1209

 91 STAT. 1175

PUBLIC LAW 95-142—OCT. 25, 1977

Public Law 95-142 95th Congress An Act To strengthen the capability of the Government to detect, prosecute, and punish fraudulent activities under the medicare and medicaid programs, and for other purposes. Be it enacted by the Senate and House of Representatives United States of America in Congress assembled,

Oct. 25, 1977 [H.R. 3]

of the

MedicareMedicaid Anti-Fraud and SHORT TITLE Abuse Amendments. SECTION 1. This Act may be cited as the "Medicare-Medicaid Anti- 42 USC 1305 F r a u d and Abuse Amendments". note. rROIIIBITION AGAINST ASSIGNMENT BY PHYSICIANS AND OTHERS OF CLAIMS FOR SERVICES: CLAIMS PAYMENT PROCEDURES FOR MEDICAID PROGRAM

SEC. 2. (a)(1) Section 1842(b)(5) of the Social Security Act is Carrier contracts. amended by a d d i n g at the end thereof the following new sentence: 42 USC 1395u. "No payment which under the preceding sentence may be made directly to the physician or other person providing the service involved (pursuant to an assignment described in subparagraph (B) (ii) of paragraph (3)) shall be made to anyone else under a reassignment or power of attorney (except to an employer or facility as described in clause (A) or (B) of such sentence); but nothing in this subsection shall be construed (i) to prevent the making of such a payment in accordance with an assignment from the individual to whom the service was provided or a reassignment from the physician or other person providing such service if such assignment or reassignment is made to a governmental agency or entity or is established by or pursuant to the order of a court of competent jurisdiction, or (ii) to preclude an agent of the physician or other person providing the service from receiving any such payment if (but only if) such agent does so pursuant to an agency agreement under which the compensation to be paid to the agent for his services for or in connection with the billing or collection of payments due such physician or other person under this title is unrelated (directly or indirectly) to the amount of such payments or the billings therefor, and is not dependent upon the actual collection of any such payment.". (2) Section 1815 of such Act is amended by adding at the end 42 USC 1395g, thereof the following new subsection: " (c) No payment which may be made to a provider of services under this title for any service furnished to an individual shall be made to any other person under an assignment or power of attorney; but nothing in this subsection shall be construed (1) to prevent the making of such a payment in accordance with an assignment from the provider if such assignment is made to a governmental agency or entity or is established by or pursuant to the order of a court of competent jurisdiction, or (2) to preclude an agent of the provider of services from receiving any such payment if (but only if) such agent does so pursuant to an agency agreement under which the compensation to be paid to the agent for his services for on in connection with the billing or collection of payments due such provider under this title is unrelated (directly or indirectly) to the amount of such pay-

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