Page:United States Statutes at Large Volume 96 Part 1.djvu/396

 96 STAT. 354

"Waiver."

42 USC 426. 42 USC 426-1. "Group health plan." 26 USC 162.

Ante, p. 331.

Effective date. 29 USC 623 note.

PUBLIC LAW 97-248—SEPT. 3, 1982 tioned on reimbursement to the appropriate Trust Fund established by this title when notice or other information is received that payment for such item or service has been made under a group health plan. The Secretary may waive the provisions of this clause in the case of an individual claim if he determines that the probability of recovery or amount involved in such claim does not warrant the pursuing of the claim. "(iii) The provisions of clauses (i) and (ii) shall apply to an individual only for the period beginning with the month in which such individual becomes entitled to benefits under this title under section 226(a) and ending with the month in which such individual attains the age of 70 and shall not include any month for which the individual would, upon application, be entitled to benefits under section 226A. "(iv) For purposes of this paragraph, the term 'group health plan' has the meaning given to such term in section 162(i)(2) of the Internal Revenue Code of 1954. "(B) Where payment for an item or service under a group health plan is less than the amount of the charge for such item or service, payment may be made under this title (without regard to deductibles and coinsurance under this title) for the remainder of such charge, but— "(i) such payment under this title may not exceed an amount which would be payable under this title for such item or service in the absence of such group health plan; and "(ii) such payment under this title, when combined with the amount payable under such plan, may not exceed— "(I) in the case of an item or service payment for which is determined under this title on the basis of reasonable cost (or other cost-related basis) or under section 1886, the amount which would be payable under this title on such basis; and "(II) in the case of an item or service for which payment is authorized under this title on another basis, the greater of— "(a) the amount which would be payable under the group health plan (without regard to deductibles and coinsurance under such plan), or "(b) the reasonable charge or other amount which would be payable under this title (without regard to deductibles and coinsurance under this title).". (c) The amendment made by subsection (a) shall become effective on January 1, 1983, and the amendment made by subsection (b) shall apply with respect to items and services furnished on or after such date. INTEREST CHARGES ON OVERPAYMENTS A N D UNDERPAYMENTS

42 USC I395g.

SEC. 117. (a)(1) Section 1815 of the Social Security Act is amended by adding at the end the following new subsection: "(d) Whenever a final determination is made that the amount of payment made under this part to a provider of services was in excess of or less than the amount of payment that is due, and payment of such excess or deficit is not made (or effected by offset) within 30 days of the date of the determination, interest shall accrue on the balance of such excess or deficit not paid or offset (to the extent that the balance is owed by or owing to the provider) at a rate deter-

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