Sec. 303. Use of private contracts
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This section shall apply beginning 2 years after the date of the enactment of this Act. An institutional or individual provider with an agreement in effect under section 301 may not bill or enter into any private contract with any individual eligible for benefits under the Act for any item or service that is a benefit under this Act. An institutional or individual provider with an agreement in effect under section 301 may bill or enter into a private contract with an individual eligible for benefits under the Act for any item or service that is not a benefit under this Act only if— the contract and provider meet the requirements specified in paragraphs
(3)and (4), respectively; such item or service is not payable or available under this Act; and the provider receives— no reimbursement under this Act directly or indirectly for such item or service, and receives no amount for such item or service from an organization which receives reimbursement for such items or service under this Act directly or indirectly. Any contract to provide items and services described in paragraph
(2)shall— be in writing and signed by the individual (or authorized representative of the individual) receiving the item or service before the item or service is furnished pursuant to the contract; not be entered into at a time when the individual is facing an emergency health care situation; and clearly indicate to the individual receiving such items and services that by signing such a contract the individual— agrees not to submit a claim (or to request that the provider submit a claim) under this Act for such items or services; agrees to be responsible for payment of such items or services and understands that no reimbursement will be provided under this Act for such items or services; acknowledges that no limits under this Act apply to amounts that may be charged for such items or services; and acknowledges that the provider is providing services outside the scope of the program under this Act. A participating provider who enters into a contract described in paragraph
(2)shall have in effect during the period any item or service is to be provided pursuant to the contract an affidavit that shall— identify the provider who is to furnish such noncovered item or service, and be signed by such provider; state that the provider will not submit any claim under this Act for any noncovered item or service provided to any individual enrolled under this Act; and be filed with the Secretary no later than 10 days after the first contract to which such affidavit applies is entered into. If a provider signing an affidavit described in paragraph
(4)knowingly and willfully submits a claim under this title for any item or service provided or receives any reimbursement or amount for any such item or service provided pursuant to a private contract described in paragraph
(2)with respect to such affidavit— any contract described in paragraph
(2)shall be null and void; no payment shall be made under this title for any item or service furnished by the provider during the 1-year period beginning on the date the affidavit was signed; and any payment received under this title for any item or service furnished during such period shall be remitted. An institutional or individual provider with an agreement in effect under section 301 may bill or enter into a private contract with any individual ineligible for benefits under the Act for any item or service. An institutional or individual provider with no agreement in effect under section 301 may bill or enter into any private contract with any individual eligible for benefits under the Act for any item or service that is a benefit under this Act described in title II only if the contract and provider meet the requirements specified in paragraphs
(2)and (3), respectively. Any contract to provide items and services described in paragraph
(1)shall— be in writing and signed by the individual (or authorized representative of the individual) receiving the item or service before the item or service is furnished pursuant to the contract; not be entered into at a time when the individual is facing an emergency health care situation; and clearly indicate to the individual receiving such items and services that by signing such a contract the individual— acknowledges that the individual has the right to have such items or services provided by other providers for whom payment would be made under this Act; agrees not to submit a claim (or to request that the provider submit a claim) under this Act for such items or services even if such items or services are otherwise covered by this Act; agrees to be responsible for payment of such items or services and understands that no reimbursement will be provided under this Act for such items or services; acknowledges that no limits under this Act apply to amounts that may be charged for such items or services; and acknowledges that the provider is providing services outside the scope of the program under this Act. A provider who enters into a contract described in paragraph
(1)shall have in effect during the period any item or service is to be provided pursuant to the contract an affidavit that shall— identify the provider who is to furnish such covered item or service, and be signed by such provider; state that the provider will not submit any claim under this Act for any covered item or service provided to any individual enrolled under this Act during the 2-year period beginning on the date the affidavit is signed; and be filed with the Secretary no later than 10 days after the first contract to which such affidavit applies is entered into. If a provider signing an affidavit described in paragraph
(3)knowingly and willfully submits a claim under this title for any item or service provided or receives any reimbursement or amount for any such item or service provided pursuant to a private contract described in paragraph
(1)with respect to such affidavit— any contract described in paragraph
(1)shall be null and void; and no payment shall be made under this title for any item or service furnished by the provider during the 2-year period beginning on the date the affidavit was signed. An institutional or individual provider with no agreement in effect under section 301 may bill or enter into a private contract with any individual for a item or service that is not a benefit under this Act.