100 STAT. 200
PUBLIC LAW 99-272—APR. 7, 1986
42 USC 1320C-3 note. Contracts.
(d) EFFECTIVE DATES.—The amendments made by subsection (a) shall apply to items and services furnished on or after January 1, 1987. The Secretary of Health and Human Services shall provide for such modification of contracts under part B of title XI of the Social 42 USC 1320c. Security Act that are in effect on that date as may be necessary to effect these amendments on a timely basis. 42 USC 1320C-13 (e) STUDY.—The Secretary of Health and Human Services shall note. conduct a study of the results of the amendments made by this section, and shall report the results of the study to the Congress within 36 months after the date of the enactment of this Act. SEC. 9402. PEER REVIEW ORGANIZATION REIMBURSEMENT.
42 USC 1395CC note. 42 USC 1320C-2 note.
(a) REIMBURSEMENT AMOUNTS.—Section 1866(a)(1)(F) of the Social Security Act (42 U.S.C. 1395cc(a)(l)(F)) is amended— (1) by striking out clause (iii), (2) by inserting "and" at the end of clause (ii), (3) by redesignating clause (iv) as clause (iii), and (4) by striking out "1982" in clause (iii) as so redesignated and inserting in lieu thereof "1986". (b) MONTHLY PAYMENTS.—Section 1153(c)(8) of such Act (42 U.S.C. 1320c-2(c)(8)) is amended to read as follows: "(8) reimbursement shall be made to the organization on a monthly basis, with payments for any month being made not later than 15 days after the close of such month.". (c) EFFECTIVE DATES.—(1) The amendments made by subsection (a) shall become effective on the date of the enactment of this Act. (2) The amendment made by subsection (b) shall apply to contracts entered into or renewed on or after the date of the enactment of this Act. SEC. 9403. DENIAL OF PAYMENT FOR SUBSTANDARD CARE.
42 USC 1320C-3 note.
(a) DENIAL AUTHORITY FOR PRO.—Section 1154(a)(2) of the Social Security Act (42 U.S.C. 1320c-3(a)(2)) is amended— (1) by striking out "subparagraphs (A) and (C)" and inserting in lieu thereof "subparagraphs (A), (B), and (C)"; and (2) by adding at the end thereof (after and below subparagraph (D)) the following: "Determinations that payment should not be made by reason of subparagraph (B) of paragraph (1) shall be made only on the basis of criteria which are consistent with guidelines established by the Secretary.". (b) WAIVER OF LIABILITY.—Section 1866(a)(1) of such Act (42 U.S.C. 1395cc(a)(l)) is amended by striking out "and" at the end of subparagraph (G), by striking out the period at the end of subparagraph (H) and inserting in lieu thereof ", and", and by inserting after subparagraph (H) the following new subparagraph: "(I) not to charge any individual or any other person for items or services for which payment under this title is denied under section 1154(a)(2) by reason of a determination under section 1154(a)(1)(B).". (c) EFFECTIVE DATE.—The amendments made by this section shall become effective on the date of the enactment of this Act. SEC. 9404. HEALTH MAINTENANCE ORGANIZATION MEMBERSHIP ON PEER REVIEW ORGANIZATION BOARDS.
(a) REMOVAL OF ONE-MEMBER LIMITATION.—Section 1153(b)(2)(A) of the Social Security Act (42 U.S.C. 1320c-2(b)(2)(A)) is amended by
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