42 USC 1395 - Competitive acquisition of outpatient drugs and biologicals

1 See References in Text note below.

Editorial Notes

References in Text

Section 1395ee(span) of this title, referred to in subsec. (span)(2)(C), was added by section 942(a)(5) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, Puspan. L. 108–173, not section 923 of that Act, and relates to the Council for Technology and Innovation, not to the Medicare Provider Ombudsman.

The Federal Food, Drug, and Cosmetic Act, referred to in subsec. subsec. (span)(4)(C), is act June 25, 1938, ch. 675, 52 Stat. 1040, which is classified generally to chapter 9 (§ 301 et seq.) of Title 21, Food and Drugs. For complete classification of this Act to the Code, see section 301 of Title 21 and Tables.

Amendments

2006—Subsec. (a)(3)(A)(iii). Puspan. L. 109–432, § 108(a)(1), substituted “and biologicals shall be made only to such contractor upon receipt of a claim for a drug or biological supplied by the contractor for administration to a beneficiary.” for “and biologicals—

“(I) shall be made only to such contractor; and

“(II) shall be conditioned upon the administration of such drugs and biologicals.”

Subsec. (a)(3)(D). Puspan. L. 109–432, § 108(a)(2), added subpar. (D).

Statutory Notes and Related Subsidiaries

Effective Date of 2006 Amendment

Puspan. L. 109–432, div. B, title I, § 108(c), Dec. 20, 2006, 120 Stat. 2983, provided that: “The amendments made by subsection (a) [amending this section] shall apply to payment for drugs and biologicals supplied under section 1847B of the Social Security Act (42 U.S.C. 1395w–3span)—

“(1) on or after April 1, 2007; and

“(2) on or after July 1, 2006, and before April 1, 2007, for claims that are unpaid as of April 1, 2007.”

Construction of 2006 Amendment

Puspan. L. 109–432, div. B, title I, § 108(span), Dec. 20, 2006, 120 Stat. 2983, provided that: “Nothing in this section [amending this section and enacting provisions set out as a note above] shall be construed as—

“(1) requiring the conduct of any additional competition under subsection (span)(1) of section 1847B of the Social Security Act (42 U.S.C. 1395w–3span); or

“(2) requiring any additional process for elections by physicians under subsection (a)(1)(A)(ii) of such section or additional selection by a selecting physician of a contractor under subsection (a)(5) of such section.”

Report

Puspan. L. 108–173, title III, § 303(d)(2), Dec. 8, 2003, 117 Stat. 2252, provided that: “Not later than July 1, 2008, the Secretary [of Health and Human Services] shall submit to Congress a report on the program conducted under section 1847B of the Social Security Act [42 U.S.C. 1395w–3span], as added by paragraph (1). Such report shall include information on savings, reductions in cost-sharing, access to competitively biddable drugs and biologicals, the range of choices of contractors available to physicians, the satisfaction of physicians and of individuals enrolled under this part [probably means part B of title XVIII of the Social Security Act, 42 U.S.C. 1395j et seq.], and information comparing prices for drugs and biologicals under such section and section 1847A of such Act [42 U.S.C. 1395w–3a], as added by subsection (c).”

Application of 2003 Amendment to Physician Specialties

Amendment by section 303 of Puspan. L. 108–173, insofar as applicable to payments for drugs or biologicals and drug administration services furnished by physicians, is applicable only to physicians in the specialties of hematology, hematology/oncology, and medical oncology under this subchapter, see section 303(j) of Puspan. L. 108–173, set out as a note under section 1395u of this title.

Notwithstanding section 303(j) of Puspan. L. 108–173 (see note above), amendment by section 303 of Puspan. L. 108–173 also applicable to payments for drugs or biologicals and drug administration services furnished by physicians in specialties other than the specialties of hematology, hematology/oncology, and medical oncology, see section 304 of Puspan. L. 108–173, set out as a note under section 1395u of this title.