Page:United States Statutes at Large Volume 102 Part 1.djvu/754

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PUBLIC LAW 100-000—MMMM. DD, 1988

102 STAT. 716

PUBLIC LAW 100-360—JULY 1, 1988

(4) by redesignating paragraphs (1) and (2) as subparagraphs (A) and (B), respectively; (5) by inserting "(1)" after "(0"; and (6) by adding at the end the following new paragraph: "(2) No payment may be made under part B for any expense incurred for a covered outpatient drug if the drug is dispensed in a quantity exceeding a supply of 30 days or such longer period of time (not to exceed 90 days, except in exceptional circumstances) as the Secretary may authorize.". (e) U S E OF CARRIESS, FISCAL INTERMEDIABIES, AND OTHER ENTITIES IN ADMINISTRATION.— (1) AUTHORIZING USE OF OTHER ENTITIES IN ELECTRONIC CLAIMS

Ckintracts.

SYSTEM.—Section 1842(f) (42 U.S.C. 1395u(f)) is amended— (A) by striking "and" at the end of paragraph (1), (B) by striking the period at the end of paragraph (2) and inserting "; and', and (C) by adding at the end the following new paragraph: "(3) with respect to implementation and operation (and related functions) of the electronic system established under subsection (o)(4), a voluntary association, corporation, partnership, or other nongovernmental organization, which the Secretary determines to be qualified to conduct such activities.". (2) ADDITIONAL FUNCTIONS OF CARRIERS.—Section 1842(b)(3) (42 U.S.C. 1395u(b)(3)), as amended by section 201(c) of this Act, is amended— (A) by striking "and" at the end of subparagraph (H), and (B) by inserting after subparagraph (I) the following new subparagraphs: "(J) if it makes determinations or payments with respect to covered outpatient drugs, will— "(i) receive information transmitted under the electronic system est£d)lished under subsection (o)(4), and "(ii) respond to requests by participating pharmacies (and individuals entitled to benefits under this part) as to whether or not such an individual has met the catastrophic drug deductible established under section 1834(c)(l)(A) tor a year; and "(K) will enter into such contracts with organizations described in subsection (f)(3) as the Secretary determines may be necessary to implement and operate (and for related functions with respect to) the electronic system established under subsection (o)(4) for covered outpatient drugs under this part;". (3) SPECIAL CONTRACT PROVISIONS FOR ELECTRONIC CLAIMS SYSTEM.— (A) PAYMENT ON OTHER THAN A COST BASIS.—Section

1842(c)(l)(A) (42 U.S.C. 1395u(c)(l)(A)) is amended— (i) by inserting "(i)" after "(c)(l)(A)", (ii) in the first sentence, by inserting ", except as provided in clause (ii)," after "under this part, and", and (iii) by adding at the end the following new clause: "(ii) To the extent that a contract under this section provides for implementation and operation (and related functions) of the electronic system established under subsection (o)(4) for covered outpatient drugs, the Secretary may provide for payment for such activities \xaed on any method of payment determined by the Secretary to be appropriate.".