Sec. 17004. NO PAYMENT FOR ITEMS AND SERVICES FURNISHED BY NEWLY ENROLLED PROVIDERS OR SUPPLIERS WITHIN A TEMPORARY MORATORIUM AREA
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## SEC. 17004 NO PAYMENT FOR ITEMS AND SERVICES FURNISHED BY NEWLY ENROLLED PROVIDERS OR SUPPLIERS WITHIN A TEMPORARY MORATORIUM AREA ###
(a)Medicare Section 1866(j)(7) of the Social Security Act (42 U.S.C. 1395cc(j)(7)) is amended— ####
(1)in the paragraph heading, by inserting “; nonpayment” before the period; and ####
(2)by adding at the end the following new subparagraph: > > ##### “(C) Nonpayment > > > ###### “(i) In general > > No payment may be made under this title or under a program described in subparagraph
(A)with respect to an item or service described in clause
(ii)furnished on or after October 1, 2017. > > > ###### “(ii) Item or service described > > An item or service described in this clause is an item or service furnished— > > > ###### “(I) > > within a geographic area with respect to which a temporary moratorium imposed under subparagraph
(A)is in effect; and > > > ###### “(II) > > by a provider of services or supplier that meets the requirements of clause (iii). > > > ###### “(iii) Requirements > > For purposes of clause (ii), the requirements of this clause are that a provider of services or supplier— > > > ###### “(I) > > enrolls under this title on or after the effective date of such temporary moratorium; and > > > ###### “(II) > > is within a category of providers of services and suppliers (as described in subparagraph (A)) subject to such temporary moratorium. > > > ###### “(iv) Prohibition on charges for specified items or services > > In no case shall a provider of services or supplier described in clause (ii)(II) charge an individual or other person for an item or service described in clause
(ii)furnished on or after October 1, 2017, to an individual entitled to benefits under part A or enrolled under part B or an individual under a program specified in subparagraph (A).” > . ###
(b)Conforming Amendments ####
(1)Medicaid #####
(A)In general Section 1903(i)(2) of the Social Security Act (42 U.S.C. 1396b(i)(2)), as amended by section 5005(a)(4), is further amended— ######
(i)in subparagraph (C), by striking “or” at the end; and ######
(ii)by adding at the end the following new subparagraph: > > ##### “(E) > > with respect to any amount expended for such an item or service furnished during calendar quarters beginning on or after October 1, 2017, subject to section 1902(kk)(4)(A)(ii)(II), within a geographic area that is subject to a moratorium imposed under section 1866(j)(7) by a provider or supplier that meets the requirements specified in subparagraph (C)(iii) of such section, during the period of such moratorium; or” > . #####
(B)Exception with respect to access Section 1902(kk)(4)(A)(ii) of the Social Security Act (42 U.S.C. 1396a(kk)(4)(A)(ii)) is amended to read as follows: > > ###### “(ii) Exceptions > > > ###### “(I) Compliance with moratorium > > A State shall not be required to comply with a temporary moratorium described in clause
(i)if the State determines that the imposition of such temporary moratorium would adversely impact beneficiaries’ access to medical assistance. > > > ###### “(II) FFP available > > Notwithstanding section 1903(i)(2)(E), payment may be made to a State under this title with respect to amounts expended for items and services described in such section if the Secretary, in consultation with the State agency administering the State plan under this title (or a waiver of the plan), determines that denying payment to the State pursuant to such section would adversely impact beneficiaries’ access to medical assistance. ”** > . #####
(C)State plan requirement with respect to limitation on charges to beneficiaries Section 1902(kk)(4)(A) of the Social Security Act (42 U.S.C. 1396a(kk)(4)(A)) is amended by adding at the end the following new clause: > > ###### “(iii) Limitation on charges to beneficiaries > > With respect to any amount expended for items or services furnished during calendar quarters beginning on or after October 1, 2017, the State prohibits, during the period of a temporary moratorium described in clause (i), a provider meeting the requirements specified in subparagraph (C)(iii) of section 1866(j)(7) from charging an individual or other person eligible to receive medical assistance under the State plan under this title (or a waiver of the plan) for an item or service described in section 1903(i)(2)(E) furnished to such an individual.” > . ####
(2)Correcting amendments to related provisions #####
(A)Section 1866(j) Section 1866(j) of the Social Security Act (42 U.S.C. 1395cc(j)) is amended— ######
(i)in paragraph (1)(A)— ######
(I)by striking “paragraph (4)” and inserting “paragraph (5)”; ######
(II)by striking “moratoria in accordance with paragraph (5)” and inserting “moratoria in accordance with paragraph (7)”; and ######
(III)by striking “paragraph (6)” and inserting “paragraph (9)”; and ######
(ii)by redesignating the second paragraph
(8)(redesignated by section 1304(1) of Public Law 111-152) as paragraph (9). #####
(B)Section 1902(kk) Section 1902(kk) of such Act (42 U.S.C. 1396a(kk)) is amended— ######
(i)in paragraph (1), by striking “section 1886(j)(2)” and inserting “section 1866(j)(2)”; ######
(ii)in paragraph (2), by striking “section 1886(j)(3)” and inserting “section 1866(j)(3)”; ######
(iii)in paragraph (3), by striking “section 1886(j)(4)” and inserting “section 1866(j)(5)”; and ######
(iv)in paragraph (4)(A), by striking “section 1886(j)(6)” and inserting “section 1866(j)(7)”.
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- Pub. L. 111-152
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Sec. 17004
NO PAYMENT FOR ITEMS AND SERVICES FURNISHED BY NEWLY ENROLLED PROVIDERS OR SUPPLIERS WITHIN A TEMPORARY MORATORIUM AREA
Pub. L.Pub. L. 111-152
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