Page:United States Statutes at Large Volume 94 Part 2.djvu/1347

 PUBLIC LAW 96-499—DEC. 5, 1980

94 STAT. 2625

determination made by him as provided in section 1902(a)(33)(B) that 42 USC I396a. a facility fails to meet the requirements contained in section 1902(a)(28) or section 1905(c), or if he finds grounds for termination of 42 USC 1396d. his agreement with the facility pursuant to section 18660b). In that 42 USC 1395CC. event the Secretary shall notify the State agency and the skilled nursing facility or intermediate care facility that approval of eligibility of the facility to participate in the programs established by this title and title XVIII shall be terminated at a time specified by the 42 USC 1395. Secretary. The approval of eligibility of any such facility to participate in such programs may not be reinstated unless the Secretary finds that the reason for termination has been removed and there is reasonable assurance that it will not recur. "(2) Any skilled nursing facility or intermediate care facility which Hearing and is dissatisfied with a determination by the Secretary that it no longer judicial review. qualifies as a skilled nursing facility or intermediate care facility for purposes of this title, shall be entitled to a hearing by the Secretary to the same extent as is provided in section 2050t)) and to judicial review 42 USC 405. of the Secretary's final decision after such hearing as is provided in section 205(g). Any agreement between such facility and the State agency shall remain in effect until the period for filing a request for a hearing has expired or, if a request has been filed, until a decision has been made by the Secretary; except that the agreement shall not be extended if the Secretary makes a written determination, specifying the reasons therefor, that the continuation of provider status constitutes an immediate and serious threat to the health and safety of patients, and the Secretary certifies that the facility has been notified of its deficiencies and has failed to correct them.". CRIMINAL STANDARDS FOR CERTAIN MEDICARE- AND MEDICAID-RELATED CRIMES

SEC 917. Paragraphs (1) and (2) of section 1877(b) of the Social Security Act and of section 19090b) of such Act are each amended by inserting "knowingly and willfully" after "Whoever".

42 USC 1395nn, 1396h.

REIMBURSEMENT OF CUNICAL LABORATORIES

SEC 918. (a)(1) Section 1842 of the Social Security Act is amended by 42 USC I395u. inserting at the end the following new subsection: "(h) If a physician's bill or request for payment for a physician's services includes a charge to a patient for a laboratory test for which payment may be made under this part, the amount payable with respect to the test shall be determined as follows: "(1) If the bill or request for payment indicates that the physician who submitted the bill or for whose services the request for payment was made personally performed or supervised the performance of the test or that another physician with whom the physician shares his practice personally performed or supervised the test, the payment shall be the reasonable charge for the test (less the applicable deductible and coinsurance amounts). "(2) If the bill or request for payment indicates that the test was performed by a laboratory, identifies the laboratory, and indicates the amount the laboratory charged the physician who submitted the bill or for whose services the request for payment was made, payment for the test shall be the lower of— "(A) the laboratory's reasonable charge to individuals enrolled under this part for the test, or

�