Page:United States Statutes at Large Volume 101 Part 2.djvu/871

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101 STAT. 1330-77
PUBLIC LAW 100-000—MMMM. DD, 1987
101 STAT. 1330-77

PUBLIC LAW 100-203—DEC. 22, 1987

101 STAT. 1330-77

(b) PERFORMANCE STANDARDS FOR FISCAL INTERMEDIARIES AND

CARRIERS.—Section 1816(f) of such Act (42 U.S.C. 1395h(f)) is amended by adding at the end the following: "Such standards and criteria shall include with respect to claims for services furnished under this part by any provider of services other than a hospital whether such agency or organization is able to process 75 percent of reconsiderations within 60 days (except in the case of the fiscal year 1989, 66 percent of reconsiderations) and 90 percent of reconsiderations within 90 days and the extent to which its determinations are reversed on appeal.". 42 USC 1395h note.

(c) EFFECTIVE DATE.—

t

(I)(A) The amendment made by subsection (a) shall apply with respect to claims received on or after January 1, 1988. (B) The amendment made by subsection (b) shall apply with respect to claims filed on or after October 1, 1988. (2) The Secretary of Health and Human Services shall provide Contracts. for such timely amendments to agreements under section 1816 Regulations. and contracts under section 1842 of the Social Security Act, and regulations, to such extent as may be necessary to implement the amendments made by subsections (a) and (b) on a timely basis.

SEC. 4033. PERMITTING DISABLED INDIVIDUALS TO RENEW ENTITLEMENT TO MEDICARE AFTER GAINFUL EMPLOYMENT WITH. •'••3^--OUT A 2.YEAR WAITING PERIOD. (a) IN GENERAL.—

(1) Section 226(0 of the Social Security Act (42 U.S.C. 426(f)) is amended by inserting before the period at the end the following: ", unless the physical or mental impairment which is the basis for disability is the same as (or directly related to) the physical or mental impairment which served as the bsisis for disability in such previous period". (2)(A) The amendment made by subsection (a) shall apply to 42 USC 426 note. months beginning after the end of the 60-day period beginning on the date of enactment of this Act. (B) The amendment made by subsection (a) shall not apply so as to include (for the purposes described in section 226(f) of the Social Security Act) monthly benefits paid for any month in a previous period (described in that section) that terminated before the end of the 60-day period described in paragraph (1). SEC. 4034. APPLICATION OF SECONDARY GOVERNMENTAL ENTITIES.

PAYER

PROVISIONS

TO

(a) IN GENERAL.—Section 1862(b)(4)(B)(i) of the Social Security Act (42 U.S.C. 1395y(b)(4)(B)(i)), as added by the amendment made by ,,... section 9319(a) of the Omnibus Budget Reconciliation Act of 1986, is amended by striking "section 5000(b) of the Internal Revenue (Dode of 1986" and inserting "subsection (b) of section 5000 of the Internal Revenue Code of 1986 without regard to subsection (d) of such section". Oa) EFFECTIVE DATE.—The amendment made by subsection (a) 42 USC I395y shall be effective as if included in the enactment of section 9319(a) of note. the Omnibus Budget Reconciliation Act of 1986. SEC. 4035. PUBLICATION AND NOTIFICATION OF POLICIES. (a) REQUIRING PUBLICATION OF INTERMEDIARY AND CARRIER BUDGET METHODOLOGY.—

Federal Register, publication.