Page:United States Statutes at Large Volume 100 Part 3.djvu/202

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PUBLIC LAW 99-000—MMMM. DD, 1986

100 STAT. 2010 usgi IE) SI •»• >;i

PUBLIC LAW 99-509—OCT. 21, 1986

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the previous two years as meeting the standards to be a qualifjgd organ procurement organization (as so described); "(B) meets the requirements that are applicable under such title for organ procurement agencies; "(C) meets performance-related standards prescribed by the «6T Secretary; <:iri "(D) is a member of, and abides by the rules and requirements of, the Network; "(E) allocates organs, within its service area and nationally, ?r mo s^ ' i. •- in accordance with medical criteria and the policies of the Network; and "(F) is designated by the Secretary as an organ procurement

. organization payments to which may be treated as organ

procurement costs for purposes of reimbursement under such title. "(2) The Secretary may not designate more than one organ procurement organization for each service area (described in section 371(b)(1)(E) of the Public Health Service Act) under paragraph 42 USC 273. (IXF).". 42 USC 1320b-8 (b) EFFECTIVE DATES.—(1) Section 1138(a) of the Social Security note. Act shall apply to hospitals participating in the programs under 42 USC 1395, titles XVIII and XIX of such Act as of October 1, 1987. 1396. (2) Section 1138(b) of such Act shall apply to costs of organs procured on or after October 1, 1987. SEC. 9319. MEDICARE AS SECONDARY PAYER; COVERAGE REQUIREMENTS FOR CERTAIN OTHER PAYERS. (a) MEDICARE SECONDARY FOR DISABLED EMPLOYEES OF CERTAIN LARGE EMPLOYERS.—Section 1862(b) of the Social Security Act (42

U.S.C. 1395y(b)) is amended by adding at the end the following new paragraph: "(4)(A)(i) A large group health plan may not take into account that an active individual is eligible for or receives benefits under this title under section 226(b), other than an individual who is, or would 42 USC 426. 42 USC 426upon application be, entitled to benefits under section 226A. "(ii) Payment may not be made under this title, except as provided in clause (iii), with respect to any item or service to the extent that payment has been made, or can reasonably be expected to be made, with respect to the item or service as required under clause (i). "(iii) Any payment under this title with respect to any item or Claims. service to which clause (i) applies shall be conditioned on reimbursement to the appropriate Trust Fund established by this title. In order to recover payment made under this title for the item or service, the United States may bring an action against any entity jfT: O ' ^ l; •?!which is required under this subsection (a) to pay with respect to the item or service (and may, in accordance with paragraph (5), collect double damages against that entity), or against any other entity that has received payment from that entity with respect to the item or service, and may join or intervene in any action related to the events that gave rise to the need for the item or service. The United States shall be subrogated (to the extent of payment made under this title for an item or service) to any right under clause (i) of an individual or any other entity to payment with respect to the item or service. The Secretary may waive (in whole or in part) the .CT5'. Qb i Si- provisions of this clause in the case of an individual claim if the Secretary determines that the waiver is in the best interests of the program established under this title.