Sec. 201. No payment for items and services furnished by newly enrolled providers or suppliers within a temporary moratorium area
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/bill/114/hr/5713/ih/section-201·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
Section 1866(j)(7) of the Social Security Act ( 42 U.S.C. 1395cc(j)(7) ) is amended— in the paragraph heading, by inserting before the period; and ; Nonpayment by adding at the end the following new subparagraph: No payment may be made under this title or under a program described in subparagraph
(A)with respect to an item or service described in clause (ii). An item or service described in this clause is an item or service furnished— within a geographic area with respect to which a temporary moratorium imposed under subparagraph
(A)is in effect; and by a provider of services or supplier that meets the requirements of clause (iii). For purposes of clause (ii), the requirements of this clause are that a provider of services or supplier— enrolls under this title on or after the effective date of such temporary moratorium; and is within a category of providers of services and suppliers (as described in subparagraph (A)) subject to such temporary moratorium. In no case shall a provider of services or supplier described in clause (ii)(II) charge an individual or other person for an item or service described in clause
(ii)furnished to an individual entitled to benefits under part A or enrolled under part B or an individual under a program specified in subparagraph (A). . Section 1903(i)(2) of the Social Security Act ( 42 U.S.C. 1396b(i)(2) ) is amended— in subparagraph (A), by striking the comma at the end and inserting a semicolon; in subparagraph (B), by striking or at the end; and by adding at the end the following new subparagraph: subject to section 1902(kk)(4)(A)(ii)(II), within a geographic area that is subject to a moratorium imposed under section 1866(j)(7) by a provider or supplier that meets the requirements specified in subparagraph (C)(iii) of such section, during the period of such moratorium; or . Section 1902(kk)(4)(A)(ii) of the Social Security Act ( 42 U.S.C. 1396a(kk)(4)(A)(ii) ) is amended to read as follows: A State shall not be required to comply with a temporary moratorium described in clause
(i)if the State determines that the imposition of such temporary moratorium would adversely impact beneficiaries’ access to medical assistance. Notwithstanding section 1903(i)(2)(D), payment may be made to a State under this title with respect to amounts expended for items and services described in such section if the Secretary, in consultation with the State agency administering the State plan under this title (or a waiver of the plan), determines that denying payment to the State pursuant to such section would adversely impact beneficiaries’ access to medical assistance. . Section 1902(kk)(4)(A) of the Social Security Act ( 42 U.S.C. 1396a(kk)(4)(A) ) is amended by adding at the end the following new clause: The State prohibits, during the period of such a moratorium, a provider meeting the requirements specified in subparagraph (C)(iii) of section 1866(j)(7) from charging an individual or other person eligible to receive medical assistance under the State plan under this title (or a waiver of the plan) for an item or service described in section 1903(i)(2)(D) furnished to such an individual. . 1866(j) Section 1866(j) of the Social Security Act ( 42 U.S.C. 1395cc(j) ) is amended— in paragraph (1)(A)— by striking paragraph
(4)and inserting paragraph
(5); by striking moratoria in accordance with paragraph
(5)and inserting moratoria in accordance with paragraph
(7); and by striking paragraph
(6)and inserting paragraph
(9); and by redesignating the second paragraph
(8)(added by section 1304(1) of Public Law 111–152 ) as paragraph (9). 1902(kk) Section 1902(kk) of such Act ( 42 U.S.C. 1396a(kk) ) is amended— in paragraph (1), by striking section 1886(j)(2) and inserting section 1866(j)(2) ; in paragraph (2), by striking section 1886(j)(3) and inserting section 1866(j)(3) ; in paragraph (3), by striking section 1866(j)(4) and inserting section 1866(j)(5) ; and in paragraph (4)(A), by striking section 1886(j)(6) and inserting section 1866(j)(7) . The amendments made by this section (other than subsection (b)(2)) shall apply with respect to items and services furnished on or after the date that is one year after the date of enactment of this section.
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- Pub. L. 111-152
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Sec. 201
No payment for items and services furnished by newly enrolled providers or suppliers within a temporary moratorium area
Pub. L.Pub. L. 111-152
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