Sec. 211. Public disclosure of direct and indirect remuneration review and audit results
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Section 1860D–42 of the Social Security Act ( 42 U.S.C. 1395w–152 ) is amended by adding at the end the following new subsection: Except as provided in subparagraph (B), in 2023 and each subsequent year, the Secretary shall make available to the public on the Internet website of the Centers for Medicare & Medicaid Services information on discrepancies related to summary and detailed DIR reports submitted by PDP sponsors pursuant to section 1860D–15 across all prescription drug plans based on the most recent data available.
Information made available under this subparagraph shall include the following: The number of potential errors identified by the Secretary for PDP sponsors to review. The extent to which PDP sponsors resubmitted DIR reports to make changes for previous contract years. The extent to which resubmitted DIR reports resulted in an increase or decrease in DIR in a previous contract year. The Secretary shall exclude any information in DIR reports submitted with respect to PACE programs under section 1894 (pursuant to section 1860D–21(f)) and qualified retiree prescription drug plans (as defined in section 1860D–22(a)(2)) from the information that is made available to the public under subparagraph (A).
In 2023 and each subsequent year, the Secretary shall make available to the public on the Internet website of the Centers for Medicare & Medicaid Services the results of DIR audits required under section 1860D–12(b)(3)(C). Information made available under this paragraph shall include the following: With respect to the year, the number of PDP sponsors that received each of the following: A notice of observations or findings that required the sponsor to make DIR report corrections.
An unqualified audit opinion that renders the audit closed. A qualified audit opinion that requires the sponsor to submit a corrective action plan to the Secretary. An adverse opinion, with a description of the types of actions that the Secretary takes when issuing an adverse opinion. With respect to a preceding year: The number of PDP sponsors that reopened a previously closed reconciliation as a result of an audit, including as a result of DIR changes. The extent to which the Secretary recouped an overpayment or made an underpayment as a result of a reopening of a previously closed reconciliation.
For purposes of this subsection, the term DIR means direct and indirect remuneration as defined in section 423.308 of title 42, Code of Federal Regulations, or any successor regulation. .
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- 42 USC 1395w–152
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Sec. 211
Public disclosure of direct and indirect remuneration review and audit results
Cite42 USC 1395w–152
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