Sec. 105. Providers and reimbursement rates

221 words·~1 min read·/bill/115/hr/7339/ih/section-105

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The Secretary shall establish a rate schedule for reimbursing types of health care providers furnishing items and services under the public health insurance plan option at rates based on rates applied for such items and services under title XVIII of the Social Security Act, as of the date of the enactment of this Act, that are necessary to maintain network adequacy. The Secretary shall establish a rate schedule for items and services not currently covered under title XVIII of the Social Security Act at a level to ensure adequate access to providers.

A health care provider that is a participating provider of services or supplier under the Medicare program under title XVIII of the Social Security Act or under the Medicaid program under title XIX of such Act on the date of enactment of this title shall be a participating provider for public health insurance plan option. The Secretary shall establish a process to allow health care providers not described in paragraph

(1)to become participating providers for the public health insurance plan option. The Secretary shall apply the provisions of section 1860D–11(i) of the Social Security Act ( 42 U.S.C. 1395w–111(i) ) to prescription drugs under the public health plan option in the same manner as such provisions apply with respect to applicable covered part D drugs under such section.

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42 USC 1395w–111(i)

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Sec. 105

Providers and reimbursement rates

Cite42 USC 1395w–111(i)

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