Sec. 108. Development of medical evidence by the Secretary
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Part C of the Black Lung Benefits Act ( 30 U.S.C. 931 et seq.) is amended by adding at the end the following: Upon request by a claimant for benefits under this title, the Secretary shall provide the claimant an opportunity to substantiate the claim through a complete pulmonary evaluation of the miner that shall include— an initial report, conducted by a qualified physician on the list provided under subsection (d), and in accordance with subsection (d)(5) and sections 402(f)(1)(D) and 413(b); and if the conditions under subsection
(b)are met, any supplemental medical evidence described in subsection (c). The Secretary shall develop supplemental medical evidence, in accordance with subsection (c)— for any claim in which the Secretary recommends an award of benefits based on the results of the initial report under subsection (a)(1) and a party opposing such award submits evidence that could be considered contrary to the findings of the Secretary; and for any compensation case under this title heard by an administrative law judge, in which— the Secretary has awarded benefits to the claimant; the party opposing such award has submitted evidence not previously reviewed that could be considered contrary to the award under subparagraph (A); and the claimant or, if the claimant is represented by an attorney, the claimant’s attorney consents to the Secretary developing supplemental medical evidence. Except as provided under paragraph (2), to develop supplemental medical evidence under conditions described in subsection (b), the Secretary shall request the physician who conducted the initial report under subsection (a)(1) to— review any medical evidence submitted after such report or the most recent supplemental report, as appropriate; and update his or her opinion in a supplemental report. If such physician is no longer available or is unwilling to provide supplemental medical evidence under paragraph (1), the Secretary shall select another qualified physician to provide such evidence. In diagnosing whether there is complicated pneumoconiosis as a part of a medical examination conducted under paragraph
(1)or (2), the Secretary shall authorize a high-quality, low-dose or standard CT scan where one or more of the following is found: Any certified B reader of a chest radiograph associated with the examination under section 413(b) finds advanced pneumoconiosis (ILO category 2/1 or greater). Any certified B reader of a chest radiograph associated with the examination under section 413(b) finds a coalescence of small opacities. Any certified B reader of a chest radiograph associated with the examination under section 413(b) has a reasonable belief that there may be a large opacity in the upper lungs that has been obscured by bony structures. The Secretary shall create and maintain a list of qualified physicians to be selected by a claimant to perform the complete pulmonary evaluation described in subsection (a). The Secretary shall make the list under this subsection available to the public. Each year, the Secretary shall update such list by reviewing the suitability of the listed qualified physicians and assessing any potential conflicts of interest. In determining whether a physician is suitable to be on the list under this subsection, the Secretary shall consult the National Practitioner Data Bank of the Department of Health and Human Services and assess reports of adverse licensure, certifications, hospital privilege, and professional society actions involving the physician. In no case shall such list include any physician— who is not licensed to practice medicine in any State or any territory, commonwealth, or possession of the United States; whose license is revoked by a medical licensing board of any State, territory, commonwealth, or possession of the United States; or whose license is suspended by a medical licensing board of any State, territory, commonwealth, or possession of the United States. The Secretary shall develop and implement policies and procedures to ensure that any actual or potential conflict of interest of qualified physicians on the list under this subsection, including both individual and organizational conflicts of interest, are disclosed to the Department, and to provide such disclosure to claimants. Such policies and procedures shall provide that, unless the claimant knowingly and with the benefit of full disclosure waives the following limitations, a physician shall not be used to perform a complete pulmonary medical evaluation under subsection
(a)that is reimbursed pursuant to subsection (f), if— such physician is employed by, under contract to, or otherwise providing services to a private party opposing the claim, a law firm or lawyer representing such opposing party, or an interested insurer or other interested third party; or such physician has been retained by a private party opposing the claim, a law firm or lawyer representing such opposing party, or an interested insurer or other interested third party in the previous 24 months. Upon receipt of any initial report or supplemental report under this section, the Secretary shall enter the report in the record and provide a copy of such report to all parties to the proceeding. All expenses related to obtaining the medical evidence under this section shall be paid for by the fund. If a claimant receives a final award of benefits, the operator liable for payment of benefits, if any, shall reimburse the fund for such expenses, which shall include interest. .
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Sec. 108
Development of medical evidence by the Secretary
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