Sec. 303. Use of private contracts

612 words·~3 min read·/bill/118/s/1655/is/section-303

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This section shall apply beginning on the date on which benefits are first available under section 106(a). Subject to the provisions of this section, nothing in this Act shall prohibit an institutional or individual provider from entering into a private contract with an individual enrolled for benefits under the Medicare for All Program for any item or service— for which no claim for payment is to be submitted under this Act; and for which the provider receives— no reimbursement under this Act directly or on a capitated basis; and receives no amount from an organization which receives reimbursement for such item or service under this Act directly or on a capitated basis.

Any contract to provide an item or service under subsection

(a)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; be entered into at a time when the individual is facing an emergency health care situation; and contain the items described in paragraph (2). Any contract to provide an item or service to which subsection

(a)applies shall clearly indicate to the individual that by signing such contract the individual— agrees not to submit a claim (or to request that the provider submit a claim) under this Act for such item or service even if such item or service is otherwise covered by the Medicare for All Program; agrees to be responsible, whether through insurance offered under section 107(b) or otherwise, for payment of such item or service and understands that no reimbursement will be provided under this Act for such item or service; acknowledges that no limits under this Act apply to amounts that may be charged for such item or service; if the provider is a nonparticipating provider, acknowledges that the beneficiary has the right to have such item or service provided by other providers for whom payment would be made under the Medicare for All Program; and acknowledges that the provider is providing an item or service outside the scope of the Medicare for All Program. Subsection

(a)shall not apply to any contract unless an affidavit described in paragraph

(2)is in effect during the period any item or service is to be provided pursuant to the contract. An affidavit as described in this subparagraph shall— identify the provider, and be signed by such provider; provide that the provider will not submit any claim under this title for any item or service provided to any beneficiary (and will not receive any reimbursement or amount described in subsection (a)(2) for any such item or service) during the 1-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

(2)knowingly and willfully submits a claim under this title for any item or service provided during the 1-year period described in paragraph (2)(B) (or receives any reimbursement or amount described in subsection (a)(2) for any such item or service) with respect to such affidavit— this subsection shall not apply with respect to any item or service provided by the provider pursuant to any contract on and after the date of such submission and before the end of such period; and no payment shall be made under this title for any item or service furnished by the provider during the period described in subparagraph

(A)(and no reimbursement or payment of any amount described in subsection (a)(2) shall be made for any such item or service).