103 STAT. 2242 PUBLIC LAW 101-239—DEC. 19, 1989 42 USC 1395nn note. 42 USC 1395nn note. 42 USC 1395nn note. Reports. meaning of section 1877) shall include the name and provider number for the referring physician and indicate whether or not the referring physician is an interested investor (within the meaning of section 1877(h)(5)). "(2)(A) In the case of a request for payment for an item or service furnished by an entity under this part on an assignment-related basis and for which information is required to be provided under paragraph (1) but not included, payment may be denied under this part, "(B) In the case of a request for payment for an item or service furnished by an entity under this part not submitted on an assign- ment-related basis and for which information is required to be provided under paragraph (1) but not included— "(i) if the entity knowingly and willfully fails to provide such information promptly upon request of the Secretary or a car- rier, the entity may be subject to a civil money penalty in an amount not to exceed $2,000, and "(ii) if the entity knowingly, willfully, and in repeated cases fails, after being notified by the Secretary of the obligations and requirements of this subsection to provide the information re- quired under paragraph (1), the entity may be subject to exclu- sion from participation in the programs under this Act for a period not to exceed 5 years, in accordance with the procedures of subsections (c), (f), and (g) of section 1128. The provisions of section 1128A (other than subsections (a) and (b)) shall apply to civil money penalties under clause (i) in the same manner as they apply to a penalty or proceeding under section 1128A(a).". (c) EFFECTIVE DATES.— (1) Except as provided in paragraph (2), the amendments made by this section shall become effective with respect to referrals made on or after January 1, 1992. (2) The reporting requirement of section 1877(f) of the Social Security Act shall take effect on October 1, 1990. (d) DEADLINE FOR CERTAIN REGULATIONS.—The Secretary of Health and Human Services shall publish final regulations to carry out section 1877 of the Social Security Act by not later than October 1, 1990. (e) GAO STUDY OF OWNERSHIP BY REFERRING PHYSICIANS.—The Comptroller General shall conduct a study of the ownership of hospitals and other providers of medicare services by referring physicians. Such study shall investigate— (1) the types of such ownership arrangements and types of services offered under such arrangements, (2) the returns generally earned by physician investors in such arrangements, (3) the effect of such arrangements on (A) the utilization of items and services by medicare beneficiaries, (B) medicare expenditures, and (C) other entities providing items and services in the communities served, (4) the effect of such arrangements on independent providers of similar services, and (5) the effect on the provision of in-office clinical laboratory services of the limitation on payment for certain referrals contained in section 1877 of the Social Security Act. By not later than February 1, 1991, the Comptroller General shall report to Congress on the results of such study.
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