Page:United States Statutes at Large Volume 98 Part 1.djvu/1135

 PUBLIC LAW 98-369—JULY 18, 1984

98 STAT. 1087

supervision, and items related to the administration of such factors, subject to utilization controls deemed necessary by the Secretary for the efficient use of such factors;". (b) The amendments made by subsection (a) shall be effective with respect to items and services purchased on or after the date of the enactment of this Act.

Effective date. 42 USC 1395x note.

PAYMENT FOR DEBRIDEMENT OF MYCOTIC TOENAILS

SEC. 2325. The Secretary shall provide, pursuant to section 1862(a) of the Social Security Act, that payment will not be made under part B of title XVIII of such Act for a physician's debridement of mycotic toenails to the extent such debridement is performed for a patient more frequently than once every 60 days, unless the medical necessity for more frequent treatment is documented by the billing physician.

42 USC 1395y note. 42 USC 1395y. 42 USC 1395J.

CONTRACTS FOR MEDICARE CLAIMS PROCESSING

SEC. 2326. (a) During each of the fiscal years 1985 and 1986, the Secretary of Health and Human Services may enter into not more than two agreements under section 1816 of the Social Security Act, and not more than two contracts under section 1842 of such Act, on the basis of competitive bidding, without regard to the nominating process under section 1816(a) of such Act during the term of the agreement. Such procedure may be used only for the purpose of replacing an agency or organization or carrier which over a period of time has been in the lowest 20th percentile of agencies and organizations or carriers having agreements or contracts under the respective section, as measured by the Secretary's cost and performance criteria. Any agency or organization or carrier selected on the basis of competitive bidding must perform all of the duties listed in section 1816(a)(l) of such Act, or the duties listed in paragraphs (1) through (4) of section 1842(a) of such Act, as the case may be, and must be a health insuring organization (as determined by the Secretary). (b) Section 1816(e)(4) of the Social Security Act is amended by adding at the end thereof the following new sentence: "By not later than July 1, 1987, the Secretary shall limit the number of such regional agencies or organizations to not more than ten.". (c)(1) Section 1816(f) of such Act is amended by striking out ", by regulation," in clause (2), and by adding at the end thereof the following: "Such standards and criteria shall be published in the Federal Register, and opportunity shall be provided for public comment prior to implementation.". (2) Section 1842(b)(2) of such Act is amended by adding at the end thereof the following new sentence: "The Secretary shall publish in the Federal Register standards and criteria for the efficient and effective performance of contract obligations under this section, and opportunity shall be provided for public comment prior to implementation.". (d)(1) Section 1816(c) of such Act is amended by adding at the end the following new sentence: "The Secretary shall provide that in determining the necessary and proper cost of administration, the Secretary shall, with respect to each agreement, take into account the amount that is reasonable and adequate to meet the costs which

42 USC 1395h note. 42 USC 1395h,. 42 USC 1395u,

42 USC 1395h.

Federal Register, publication. 42 USC 1395u. Federal Register, publication.

42 USC 1395h.

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