PUBLIC LAW 105-33—AUG. 5, 1997 111 STAT. 439 (1) HOSPITAL.— The term "hospital" means a subsection (d) hospital as defined in section 1886(d) of the Social Security Act (42 U.S.C. 1395ww(d)). (2) MEDICAL STAFF. —An individual furnishing a physician's service is considered to be on the medical staff of a hospital— (A) if (in accordance with requirements for hospitals established by the Joint Commission on Accreditation of Health Organizations)— (i) the individual is subject to bylaws, rules, and regulations established by the hospital to provide a framework for the self-governance of medical staff activities, (ii) subject to the bylaws, rules, and regulations, the individual has clinical privileges granted by the hospital's governing body, and (iii) under the clinical privileges, the individual may provide physicians' services independently within the scope of the individual's clinical privileges, or (B) if the physician provides at least one service to an individual entitled to benefits under this title in that hospital. (3) PHYSICIANS' SERVICES.—The term "physicians' services" means the services described in section 1848(j)(3) of the Social Security Act (42 U.S.C. 1395w-4(j)(3)). (4) RURAL AREA; URBAN AREA.— The terms "rural area" and "urban area" have the meaning given those terms under section 1886(d)(2)(D) of such Act (42 U.S.C. 1395ww(d)(2)(D)). (5) SECRETARY.— The term "Secretary means the Secretary of Health and Human Services. (6) TEACHING HOSPITAL.—The term "teaching hospital" means a hospital which has a teaching program approved as specified in section 1861(b)(6) of the Social Security Act (42 U.S.C. 1395x(b)(6)). SEC. 4507. USE OF PRIVATE CONTRACTS BY MEDICARE BENE- FICIARIES. (a) ITEMS OR SERVICES PROVIDED THROUGH PRIVATE CON- TRACTS. — (1) IN GENERAL.— Section 1802 (42 U.S.C. 1395a) is amended by adding at the end the following new subsection: " (b) USE OF PRIVATE CONTRACTS BY MEDICARE BENEFICIARIES.— "(1) IN GENERAL.— Subject to the provisions of this subsection, nothing in this title shall prohibit a physiciein or practitioner from entering into a private contract with a medicare beneficiary for any item or service— "(A) for which no claim for payment is to be submitted under this title, and "(B) for which the physician or practitioner receives— "(i) no reimbursement under this title directly or on a capitated basis, and "(ii) receives no amount for such item or service from an organization which receives reimbursement for such item or service under this title directly or on a capitated basis. "(2) BENEFICIARY PROTECTIONS. — "(A) IN GENERAL. — Paragraph (1) shall not apply to any contract unless—
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