Section 1395ww(e)(6) of this title, referred to in subsec. (a)(1)(D), was repealed by Puspan. L. 105–33, title IV, § 4022(span)(1)(A)(i), Aug. 5, 1997, 111 Stat. 354.

The Assisted Suicide Funding Restriction Act of 1997, referred to in subsec. (a)(16), is Puspan. L. 105–12, Apr. 30, 1997, 111 Stat. 23, which is classified principally to chapter 138 (§ 14401 et seq.) of this title. For complete classification of this Act to the Code, see Short Title note set out under section 14401 of this title and Tables.

The Internal Revenue Code of 1986, referred to in subsec. (span), is classified generally to Title 26, Internal Revenue Code.

Section 107(c)(3) of the Drug Amendments of 1962, referred to in subsec. (c)(1)(A), is section 107(c)(3) of Puspan. L. 87–781, title I, Oct. 10, 1962, 76 Stat. 788, which is set out as an Effective Date of 1962 Amendment note under section 321 of Title 21, Food and Drugs.

Section 1314(i) of this title, which was transferred and redesignated as subsec. (j) of this section by Puspan. L. 108–173, was based on act Aug. 14, 1935, ch. 531, title XI, § 1114(i), as added Puspan. L. 106–554, § 1(a)(6) [title V, § 522(c)], Dec. 21, 2000, 114 Stat. 2763, 2763A–546.

Amendments by section 301(a) to (c) of Puspan. L. 108–173 were executed to this section as it read on the date of enactment of Puspan. L. 108–173 to reflect the probable intent of Congress, notwithstanding section 301(d) of Puspan. L. 108–173, set out as an Effective Date of 2003 Amendment note below, which provided that the amendments by section 301(a) of Puspan. L. 108–173 be effective as if included in the enactment of title III of Puspan. L. 98–369 and that the amendments by section 301(span), (c) of Puspan. L. 108–173 be effective as if included in the enactment of section 953 of Puspan. L. 96–499. The amendments by section 301(a) are incapable of being executed to this section as it read on the effective date of title III of Puspan. L. 98–369, and the amendments by section 301(span), (c) are incapable of being executed to this section as it read on the effective date of section 953 of Puspan. L. 96–499. See 2003 Amendment notes below.

2022—Subsec. (span)(1)(E)(iv). Puspan. L. 117–108 added cl. (iv).

2021—Subsec. (g). Puspan. L. 117–2 designated existing provisions as par. (1) and added par. (2).

2020—Subsec. (span)(8)(G). Puspan. L. 116–215 inserted clause (i) designation and span and added clause (ii).

2018—Subsec. (span)(7)(A)(i). Puspan. L. 115–271, § 4002, amended cl. (i) generally. Prior to amendment, cl. (i) read as follows: “secure from the plan sponsor and plan participants such information as the Secretary shall specify for the purpose of identifying situations where the group health plan is or has been a primary plan to the program under this subchapter; and”.

Subsec. (o)(3). Puspan. L. 115–271, § 2008(c), inserted “, section 1395w–112(span)(7) of this section (including as applied pursuant to section 1395w–27(f)(3)(D) of this title),” after “this subsection”.

Subsec. (o)(4). Puspan. L. 115–271, § 2008(d), added par. (4).

2016—Subsec. (l)(5)(D). Puspan. L. 114–255 added subpar. (D).

2015—Subsec. (span)(5)(E). Puspan. L. 114–10 added subpar. (E).

2014—Subsec. (span)(9)(B)(i). Puspan. L. 113–188 substituted “for 2014, the Secretary shall” for “for a year, the Secretary shall”.

2013—Subsec. (span)(2)(B)(ii). Puspan. L. 112–242, § 202(a)(1), substituted “Subject to paragraph (9), a primary plan” for “A primary plan”.

Subsec. (span)(2)(B)(iii). Puspan. L. 112–242, § 205(a), inserted at end “An action may not be brought by the United States under this clause with respect to payment owed unless the complaint is filed not later than 3 years after the date of the receipt of notice of a settlement, judgment, award, or other payment made pursuant to paragraph (8) relating to such payment owed.”

Subsec. (span)(2)(B)(vii), (viii). Puspan. L. 112–242, § 201, added cls. (vii) and (viii).

Subsec. (span)(8)(B). Puspan. L. 112–242, § 204, inserted concluding provisions.

Subsec. (span)(8)(E)(i). Puspan. L. 112–242, § 203(1), substituted “may be subject to a civil money penalty of up to $1,000” for “shall be subject to a civil money penalty of $1,000”.

Subsec. (span)(8)(I). Puspan. L. 112–242, § 203(2), added subpar. (I).

Subsec. (span)(9). Puspan. L. 112–242, § 202(a)(2), added par. (9).

2011—Subsecs. (a)(15)(A), (g). Puspan. L. 112–40 substituted “quality improvement” for “utilization and quality control peer review”.

2010—Subsec. (a)(1)(P). Puspan. L. 111–148, § 4103(d)(1), added subpar. (P).

Subsec. (a)(7). Puspan. L. 111–148, § 4103(d)(2), substituted “(K), or (P)” for “or (K)”.

Subsec. (a)(25). Puspan. L. 111–148, § 1104(d), added par. (25).

Subsec. (n). Puspan. L. 111–148, § 6402(g)(3), added subsec. (n).

Subsec. (o). Puspan. L. 111–148, § 6402(h)(1), added subsec. (o).

2008—Subsec. (a)(1)(A). Puspan. L. 110–275, § 101(a)(3), inserted “or additional preventive services (as described in section 1395x(ddd)(1) of this title)” after “succeeding subparagraph”.

Subsec. (a)(1)(K). Puspan. L. 110–275, § 101(span)(3), (4), substituted “more” for “not later” and “1 year” for “6 months”.

Subsec. (a)(1)(O). Puspan. L. 110–275, § 152(span)(1)(D), added subpar. (O).

Subsec. (a)(20). Puspan. L. 110–275, § 143(span)(7), substituted “outpatient physical therapy services, outpatient speech-language pathology services, or outpatient occupational therapy services” for “outpatient occupational therapy services or outpatient physical therapy services” and “subsection (g) or (ll)(2) of section 1395x” for “section 1395x(g)”.

Subsec. (a)(23). Puspan. L. 110–275, § 135(a)(2)(A), added par. (23).

Subsec. (a)(24). Puspan. L. 110–275, § 153(span)(2), added par. (24).

2007—Subsec. (span)(7), (8). Puspan. L. 110–173 added pars. (7) and (8).

2006—Subsec. (a)(1)(N). Puspan. L. 109–171 added subpar. (N).

2003—Subsec. (a). Puspan. L. 108–173, § 948(a)(2)(A), struck out “established under section 1314(f) of this title” after “meetings of advisory committees” in concluding provisions.

Puspan. L. 108–173, § 731(a)(1)(A), inserted “consistent with subsection (l)” after “the Secretary shall ensure” in concluding provisions.

Subsec. (a)(1)(J). Puspan. L. 108–173, § 303(i)(3)(B), added subpar. (J).

Subsec. (a)(1)(K). Puspan. L. 108–173, § 611(d)(1)(A), added subpar. (K).

Subsec. (a)(1)(L). Puspan. L. 108–173, § 612(c), added subpar. (L).

Subsec. (a)(1)(M). Puspan. L. 108–173, § 613(c), added subpar. (M).

Subsec. (a)(7). Puspan. L. 108–173, § 611(d)(1)(B), substituted “(H), or (K)” for “or (H)”.

Subsec. (span)(1)(A). Puspan. L. 108–173, § 301(c)(1), realigned margins.

Subsec. (span)(2)(A). Puspan. L. 108–173, § 301(span)(1), inserted at end of concluding provisions “An entity that engages in a business, trade, or profession shall be deemed to have a self-insured plan if it carries its own risk (whether by a failure to obtain insurance, or otherwise) in whole or in part.”

Subsec. (span)(2)(A)(ii). Puspan. L. 108–173, § 301(a)(1), struck out “promptly (as determined in accordance with regulations)” after “be expected to be made”.

Subsec. (span)(2)(B)(i). Puspan. L. 108–173, § 301(a)(2)(B), added cl. (i). Former cl. (i) redesignated (ii).

Subsec. (span)(2)(B)(ii). Puspan. L. 108–173, § 301(span)(2), substituted “A primary plan, and an entity that receives payment from a primary plan, shall reimburse the appropriate Trust Fund for any payment made by the Secretary under this subchapter with respect to an item or service if it is demonstrated that such primary plan has or had a responsibility to make payment with respect to such item or service. A primary plan’s responsibility for such payment may be demonstrated by a judgment, a payment conditioned upon the recipient’s compromise, waiver, or release (whether or not there is a determination or admission of liability) of payment for items or services included in a claim against the primary plan or the primary plan’s insured, or by other means.” for “Any payment under this subchapter with respect to any item or service to which subparagraph (A) applies shall be conditioned on reimbursement to the appropriate Trust Fund established by this subchapter when notice or other information is received that payment for such item or service has been or could be made under such subparagraph.” and “on the date notice of, or information related to, a primary plan’s responsibility for such payment or other information is received” for “on the date such notice or other information is received”.

Puspan. L. 108–173, § 301(a)(2)(A), redesignated cl. (i) as (ii). Former cl. (ii) redesignated (iii).

Subsec. (span)(2)(B)(iii). Puspan. L. 108–173, § 301(span)(3), substituted “In order to recover payment made under this subchapter for an item or service, the United States may bring an action against any or all entities that are or were required or responsible (directly, as an insurer or self-insurer, as a third-party administrator, as an employer that sponsors or contributes to a group health plan, or large group health plan, or otherwise) to make payment with respect to the same item or service (or any portion thereof) under a primary plan. The United States may, in accordance with paragraph (3)(A) collect double damages against any such entity. In addition, the United States may recover under this clause from any entity that has received payment from a primary plan or from the proceeds of a primary plan’s payment to any entity.” for “In order to recover payment under this subchapter for such an item or service, the United States may bring an action against any entity which is required or responsible (directly, as a third-party administrator, or otherwise) to make payment with respect to such item or service (or any portion thereof) under a primary plan (and may, in accordance with paragraph (3)(A) collect double damages against that entity), or against any other entity (including any physician or provider) 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.”

Puspan. L. 108–173, § 301(a)(2)(A), redesignated cl. (ii) as (iii). Former cl. (iii) redesignated (iv).

Subsec. (span)(2)(B)(iv) to (vi). Puspan. L. 108–173, § 301(a)(2)(A), redesignated cls. (iii) to (v) as (iv) to (vi), respectively.

Subsec. (span)(3)(A). Puspan. L. 108–173, § 301(c)(2), struck out “such” before “paragraphs”.

Subsec. (span)(5)(A)(ii). Puspan. L. 108–173, § 900(e)(1)(J), substituted “Centers for Medicare & Medicaid Services” for “Health Care Financing Administration”.

Subsec. (d). Puspan. L. 108–173, § 944(a)(1), added subsec. (d).

Subsec. (j). Puspan. L. 108–173, § 948(a)(1), transferred subsec. (i) of section 1314 of this title and redesignated it as subsec. (j) of this section. See Codification note above.

Subsec. (j)(1). Puspan. L. 108–173, § 948(a)(2)(B), in introductory provisions, struck out “under subsection (f)” after “appointed” and substituted “subsection (a)(1)” for “section 1395y(a)(1) of this title”.

Subsec. (k). Puspan. L. 108–173, § 950(a), added subsec. (k).

Subsec. (l). Puspan. L. 108–173, § 731(a)(1)(B), added subsec. (l).

Subsec. (m). Puspan. L. 108–173, § 731(span)(1), added subsec. (m).

2001—Subsec. (a)(22). Puspan. L. 107–105, § 3(a)(1), added par. (22).

Subsec. (h). Puspan. L. 107–105, § 3(a)(2), added subsec. (h).

2000—Subsec. (a). Puspan. L. 106–554, § 1(a)(6) [title V, § 522(span)], inserted at end “In making a national coverage determination (as defined in paragraph (1)(B) of section 1395ff(f) of this title) the Secretary shall ensure that the public is afforded notice and opportunity to comment prior to implementation by the Secretary of the determination; meetings of advisory committees established under section 1314(f) of this title with respect to the determination are made on the record; in making the determination, the Secretary has considered applicable information (including clinical experience and medical, technical, and scientific evidence) with respect to the subject matter of the determination; and in the determination, provide a clear statement of the basis for the determination (including responses to comments received from the public), the assumptions underlying that basis, and make available to the public the data (other than proprietary data) considered in making the determination.”

Subsec. (a)(1)(F). Puspan. L. 106–554, § 1(a)(6) [title I, § 102(c)], struck out “and,” after “section 1395m(c)(1)(B) of this title,” and inserted at end “and, in the case of screening for glaucoma, which is performed more frequently than is provided under section 1395x(uu) of this title,”.

Subsec. (a)(3). Puspan. L. 106–554, § 1(a)(6) [title IV, § 432(span)(1)], struck out second comma after “section 1395x(aa)(1) of this title” and inserted “in the case of services for which payment may be made under section 1395qq(e) of this title,” after “section 1395x(aa)(3) of this title,”.

Subsec. (a)(18). Puspan. L. 106–554, § 1(a)(6) [title III, § 313(a)], substituted “during a period in which the resident is provided covered post-hospital extended care services (or, for services described in section 1395x(s)(2)(D) of this title, which are furnished to such an individual without regard to such period),” for “or of a part of a facility that includes a skilled nursing facility (as determined under regulations),”.

1999—Subsec. (a)(7). Puspan. L. 106–113, § 1000(a)(6) [title III, § 321(k)(10)], substituted “subparagraph” for “subparagraphs”.

Subsec. (a)(21). Puspan. L. 106–113, § 1000(a)(6) [title III, § 305(span)], inserted “(including medical supplies described in section 1395x(m)(5) of this title, but excluding durable medical equipment to the extent provided for in such section)” after “home health services”.

1997—Subsec. (a)(1)(D). Puspan. L. 105–33, § 4022(span)(1)(B), substituted “Medicare Payment Advisory Commission” for “Prospective Payment Assessment Commission”.

Subsec. (a)(1)(F). Puspan. L. 105–33, § 4102(c), inserted “and screening pelvic exam” after “screening pap smear”.

Subsec. (a)(1)(G). Puspan. L. 105–33, § 4103(c)(1), added subpar. (G).

Subsec. (a)(1)(H). Puspan. L. 105–33, § 4104(c)(3)(A), added subpar. (H).

Subsec. (a)(1)(I). Puspan. L. 105–33, § 4614(a), added subpar. (I).

Subsec. (a)(7). Puspan. L. 105–33, § 4104(c)(3)(B), substituted “(G), or (H)” for “or (G)”.

Puspan. L. 105–33, § 4103(c)(2), substituted “subparagraphs (B), (F), or (G) of paragraph (1)” for “paragraph (1)(B) or under paragraph (1)(F)”.

Subsec. (a)(14). Puspan. L. 105–33, § 4511(a)(2)(C), substituted “section 1395x(s)(2)(K) of this title” for “section 1395x(s)(2)(K)(i) or 1395x(s)(2)(K)(iii) of this title”.

Puspan. L. 105–33, § 4201(c)(1), substituted “critical access” for “rural primary care” wherever appearing.

Subsec. (a)(16). Puspan. L. 105–12 added par. (16).

Subsec. (a)(17). Puspan. L. 105–33, § 4319(span), added par. (17).

Subsec. (a)(18). Puspan. L. 105–33, § 4432(span)(1), added par. (18).

Subsec. (a)(19). Puspan. L. 105–33, § 4507(a)(2)(B), added par. (19).

Subsec. (a)(20). Puspan. L. 105–33, § 4541(span), added par. (20).

Subsec. (a)(21). Puspan. L. 105–33, § 4603(c)(2)(C), added par. (21).

Subsec. (span)(1)(B)(i). Puspan. L. 105–33, § 4631(a)(1)(A), substituted “in clause (iii))” for “in clause (iv))”.

Subsec. (span)(1)(B)(iii), (iv). Puspan. L. 105–33, § 4631(a)(1)(B), (C), redesignated cl. (iv) as (iii) and struck out span and text of former cl. (iii). Text read as follows: “Clause (i) shall only apply to items and services furnished on or after January 1, 1987, and before October 1, 1998.”

Subsec. (span)(1)(C). Puspan. L. 105–33, § 4631(span), in concluding provisions, substituted “August 5, 1997” for “October 1, 1998” and inserted at end “Effective for items and services furnished on or after August 5, 1997, (with respect to periods beginning on or after the date that is 18 months prior to August 5, 1997), clauses (i) and (ii) shall be applied by substituting ‘30-month’ for ‘12-month’ each place it appears.”

Subsec. (span)(1)(F). Puspan. L. 105–33, § 4633(span), added subpar. (F).

Subsec. (span)(2)(B)(ii). Puspan. L. 105–33, § 4633(a), substituted “(directly, as a third-party administrator, or otherwise) to make payment” for “under this subsection to pay” and inserted at end “The United States may not recover from a third-party administrator under this clause in cases where the third-party administrator would not be able to recover the amount at issue from the employer or group health plan and is not employed by or under contract with the employer or group health plan at the time the action for recovery is initiated by the United States or for whom it provides administrative services due to the insolvency or bankruptcy of the employer or plan.”

Subsec. (span)(2)(B)(v). Puspan. L. 105–33, § 4632(a), added cl. (v).

Subsec. (span)(5)(C)(iii). Puspan. L. 105–33, § 4631(c)(1), struck out span and text of cl. (iii). Text read as follows: “Clause (ii) shall not apply to inquiries made after September 30, 1998.”

Subsec. (i). Puspan. L. 105–33, § 4022(span)(1)(B), substituted “Medicare Payment Advisory Commission” for “Prospective Payment Assessment Commission” in introductory provisions.

1996—Subsec. (span)(5)(B). Puspan. L. 104–226, § 1(span)(1)(A), substituted “under subparagraph (A) for purposes of carrying out this subsection” for “under—

“(i) subparagraph (A), and

“(ii) section 1320span–14 of this title,

for purposes of carrying out this subsection”.

Subsec. (span)(5)(C)(i). Puspan. L. 104–226, § 1(span)(1)(B), substituted “disclosed under subparagraph (B)” for “disclosed under subparagraph (B)(i)”.

Subsec. (h). Puspan. L. 104–224 struck out subsec. (h) which required Secretary to provide registry of all cardiac pacemaker devices and pacemaker leads for which payment was made under this chapter.

1994—Subsec. (a)(1)(F). Puspan. L. 103–432, § 145(c)(1), substituted “or which is not conducted by a facility described in section 1395m(c)(1)(B) of this title” for “or which does not meet the standards established under section 1395m(c)(3) of this title”.

Subsec. (a)(14). Puspan. L. 103–432, § 156(a)(2)(D)(i), inserted “or” at end.

Puspan. L. 103–432, § 147(e)(6), substituted “section 1395x(s)(2)(K)(i) or 1395x(s)(2)(K)(iii) of this title” for “section 1395x(s)(2)(K)(i) of this title”.

Subsec. (a)(15). Puspan. L. 103–432, § 156(a)(2)(D)(ii), substituted period for “; or” at end.

Subsec. (a)(16). Puspan. L. 103–432, § 156(a)(2)(D)(iii), struck out par. (16) which read as follows: “furnished in connection with a surgical procedure for which a second opinion is required under section 1320c–13(c)(2) of this title and has not been obtained.”

Subsec. (span)(1)(A)(i)(II). Puspan. L. 103–432, § 151(c)(1)(A), substituted “older (and the spouse age 65 or older of any individual) who has current employment status with an employer” for “over (and the individual’s spouse age 65 or older) who is covered under the plan by virtue of the individual’s current employment status with an employer”.

Subsec. (span)(1)(A)(ii). Puspan. L. 103–432, § 151(c)(1)(B), substituted “employer that has 20 or more employees” for “employer or employee organization that has 20 or more individuals in current employment status”.

Subsec. (span)(1)(A)(v). Puspan. L. 103–432, § 151(c)(9)(B), made technical amendment to directory language of Puspan. L. 103–66, § 13561(e)(1)(D). See 1993 Amendment note below.

Subsec. (span)(1)(C). Puspan. L. 103–432, § 151(c)(5), substituted “paying benefits secondary to this subchapter when” for “taking into account that” in closing provisions.

Puspan. L. 103–432, § 151(c)(4), substituted “this subparagraph” for “clauses (i) and (ii)” after “February 1, 1990),” in last sentence.

Subsec. (span)(2)(B)(i). Puspan. L. 103–432, § 151(span)(3)(A), (B), substituted “Repayment required” for “Primary plans” in span and inserted at end “If reimbursement is not made to the appropriate Trust Fund before the expiration of the 60-day period that begins on the date such notice or other information is received, the Secretary may charge interest (beginning with the date on which the notice or other information is received) on the amount of the reimbursement until reimbursement is made (at a rate determined by the Secretary in accordance with regulations of the Secretary of the Treasury applicable to charges for late payments).”

Subsec. (span)(2)(C). Puspan. L. 103–432, § 151(a)(1)(C), added subpar. (C).

Subsec. (span)(3)(C). Puspan. L. 103–432, § 157(span)(7), substituted “group health plan or a large group health plan” for “group health plan” in span and text, struck out “, unless such incentive is also offered to all individuals who are eligible for coverage under the plan” after “(as defined in paragraph (2)(A))”, and substituted “(other than subsections (a) and (span))” for “(other than the first sentence of subsection (a) and other than subsection (span))”.

Subsec. (span)(5)(C)(i). Puspan. L. 103–432, § 151(c)(6), substituted “section 6103(l)(12)(E)(iii) of such Code” for “section 6103(l)(12)(D)(iii) of such Code”.

Subsec. (span)(5)(D). Puspan. L. 103–432, § 151(a)(1)(A), added subpar. (D).

Subsec. (span)(6). Puspan. L. 103–432, § 151(a)(2)(A), added par. (6).

1993—Subsec. (span)(1)(A)(i). Puspan. L. 103–66, § 13561(e)(1)(A), amended subcls. (I) and (II) generally. Prior to amendment, subcls. (I) and (II) read as follows:

“(I) may not take into account, for any item or service furnished to an individual 65 years of age or older at the time the individual is covered under the plan by reason of the current employment of the individual (or the individual’s spouse), that the individual is entitled to benefits under this subchapter under section 426(a) of this title, and

“(II) shall provide that any employee age 65 or older, and any employee’s spouse age 65 or older, shall be entitled to the same benefits under the plan under the same conditions as any employee, and the spouse of such employee, under age 65.”

Subsec. (span)(1)(A)(ii). Puspan. L. 103–66, § 13561(e)(1)(B), substituted “unless the plan is a plan of, or contributed to by, an employer or employee organization that has 20 or more individuals in current employment status” for “unless the plan is sponsored by or contributed to by an employer that has 20 or more employees”.

Subsec. (span)(1)(A)(iii). Puspan. L. 103–66, § 13561(e)(1)(C), substituted “by virtue of current employment status with an employer that does not have 20 or more individuals in current employment status for each working day in each of 20 or more calendar weeks in the current calendar year and” for “by virtue of employment with an employer that does not have 20 or more employees for each working day in each of 20 or more calendar weeks in the current calendar year or”.

Subsec. (span)(1)(A)(iv). Puspan. L. 103–66, § 13561(c)(2), substituted “Subparagraph (C) shall apply instead of clause (i)” for “Clause (i) shall not apply” and inserted “(without regard to entitlement under section 426 of this title)” after “individual is, or”.

Subsec. (span)(1)(A)(v). Puspan. L. 103–66, § 13561(e)(1)(D), as amended by Puspan. L. 103–432, § 151(c)(9)(B), inserted before period at end “, without regard to section 5000(d) of such Code”.

Subsec. (span)(1)(B). Puspan. L. 103–66, § 13561(e)(1)(E), substituted “individuals” for “active individuals” in span.

Subsec. (span)(1)(B)(i). Puspan. L. 103–66, § 13561(e)(1)(F), substituted “clause (iv)) may not take into account that an individual (or a member of the individual’s family) who is covered under the plan by virtue of the individual’s current employment status with an employer” for “clause (iv)(II)) may not take into account that an active individual (as defined in clause (iv)(I))”.

Subsec. (span)(1)(B)(ii). Puspan. L. 103–66, § 13561(c)(2), substituted “Subparagraph (C) shall apply instead of clause (i)” for “Clause (i) shall not apply” and inserted “(without regard to entitlement under section 426 of this title)” after “individual is, or”.

Subsec. (span)(1)(B)(iii). Puspan. L. 103–66, § 13561(span), substituted “1998” for “1995”.

Subsec. (span)(1)(B)(iv). Puspan. L. 103–66, § 13561(e)(1)(G), amended span and text generally. Prior to amendment, text defined “active individual” and “large group health plan”.

Subsec. (span)(1)(C). Puspan. L. 103–66, § 13561(c)(1), (3), substituted “or eligible for benefits under this subchapter under” for “benefits under this subchapter solely by reason of” in cl. (i) and concluding provisions and substituted “before October 1, 1998” for “on or before January 1, 1996” in concluding provisions.

Subsec. (span)(1)(E). Puspan. L. 103–66, § 13561(e)(1)(H), added cls. (ii) and (iii).

Puspan. L. 103–66, § 13561(d)(1), added subpar. (E).

Subsec. (span)(5)(B). Puspan. L. 103–66, § 13581(span)(1)(A), substituted “under—” for “under subparagraph (A) for the purposes of carrying out this subsection.” and added cls. (i) and (ii) and concluding provisions.

Subsec. (span)(5)(C)(i). Puspan. L. 103–66, § 13581(span)(1)(B), substituted “subparagraph (B)(i)” for “subparagraph (B)”.

Subsec. (span)(5)(C)(iii). Puspan. L. 103–66, § 13561(a)(1), substituted “1998” for “1995”.

1990—Subsec. (a). Puspan. L. 101–508, § 4161(a)(3)(C)(iii), inserted at end “Paragraph (7) shall not apply to Federally qualified health center services described in section 1395x(aa)(3)(B) of this title.”

Subsec. (a)(1)(A). Puspan. L. 101–508, § 4163(d)(2)(A)(i), substituted “a succeeding subparagraph” for “subparagraph (B), (C), (D), or (E)”.

Subsec. (a)(1)(F). Puspan. L. 101–508, § 4163(d)(2)(A)(ii)–(iv), added subpar. (F).

Subsec. (a)(2). Puspan. L. 101–508, § 4161(a)(3)(C)(i), inserted before semicolon at end “, except in the case of Federally qualified health center services”.

Subsec. (a)(3). Puspan. L. 101–508, § 4161(a)(3)(C)(ii), inserted “, in the case of Federally qualified health center services, as defined in section 1395x(aa)(3) of this title,” after “section 1395x(aa)(1) of this title,”.

Subsec. (a)(7). Puspan. L. 101–508, § 4163(d)(2)(B), inserted “or under paragraph (1)(F)” after “paragraph (1)(B)”.

Puspan. L. 101–508, § 4153(span)(2)(B), inserted “(other than eyewear described in section 1395x(s)(8) of this title)” after first reference to “eyeglasses”.

Subsec. (a)(14). Puspan. L. 101–508, § 4157(c)(1), inserted “, services described by section 1395x(s)(2)(K)(i) of this title, certified nurse-midwife services, qualified psychologist services, and services of a certified registered nurse anesthetist,” after “this paragraph)” and struck out before semicolon at end “or are services of a certified registered nurse anesthetist”.

Subsec. (a)(15). Puspan. L. 101–508, § 4107(span), designated existing provisions as par. (A), substituted “, or” for “; or” at end, and added par. (B).

Subsec. (span)(1)(B)(iii). Puspan. L. 101–508, § 4203(span), substituted “October 1, 1995” for “January 1, 1992”.

Subsec. (span)(1)(C). Puspan. L. 101–508, § 4203(c)(1)(B), inserted at end “Effective for items and services furnished on or after February 1, 1991, and on or before January 1, 1996, (with respect to periods beginning on or after February 1, 1990), clauses (i) and (ii) shall be applied by substituting ‘18-month’ for ‘12-month’ each place it appears.”

Subsec. (span)(1)(C)(i). Puspan. L. 101–508, § 4203(c)(1)(A), substituted “during the 12-month period which begins with the first month in which the individual becomes entitled to benefits under part A under the provisions of section 426–1 of this title, or, if earlier, the first month in which the individual would have been entitled to benefits under such part under the provisions of section 426–1 of this title if the individual had filed an application for such benefits; and” for “during the 12-month period which begins with the earlier of—

“(I) the month in which a regular course of renal dialysis is initiated, or

“(II) in the case of an individual who receives a kidney transplant, the first month in which he would be eligible for benefits under part A of this subchapter (if he had filed an application for such benefits) under the provisions of section 426–1(span)(1)(B) of this title; and”.

Subsec. (span)(3)(C). Puspan. L. 101–508, § 4204(g)(1), added subpar. (C).

Subsec. (span)(5)(C)(iii). Puspan. L. 101–508, § 4203(a)(1), substituted “September 30, 1995” for “September 30, 1991”.

1989—Puspan. L. 101–239, § 6202(span)(1)(A), inserted “and medicare as secondary payer” in section catchline.

Subsec. (a)(1)(A). Puspan. L. 101–234 repealed Puspan. L. 100–360, § 204(d)(2)(A)(i), and provided that the provisions of law amended or repealed by such section are restored or revived as if such section had not been enacted, see 1988 Amendment note below.

Subsec. (a)(1)(E). Puspan. L. 101–239, § 6103(span)(3)(B), substituted “section 1320span–12” for “section 1395ll(c)”.

Subsec. (a)(1)(F). Puspan. L. 101–239, § 6115(span), inserted before semicolon at end “, and, in the case of screening pap smear, which is performed more frequently than is provided under 1395x(nn) of this title”.

Puspan. L. 101–234 repealed Puspan. L. 100–360, § 204(d)(2)(A)(ii)–(iv), and provided that the provisions of law amended or repealed by such section are restored or revived as if such section had not been enacted, see 1988 Amendment note below.

Subsec. (a)(1)(G), (6), (7). Puspan. L. 101–234 repealed Puspan. L. 100–360, §§ 204(d)(2)(B), 205(e)(1), and provided that the provisions of law amended or repealed by such sections are restored or revived as if such sections had not been enacted, see 1988 Amendment notes below.

Subsec. (a)(14). Puspan. L. 101–239, § 6003(g)(3)(D)(xi), substituted “hospital or rural primary care hospital” for “hospital” in three places.

Subsec. (span). Puspan. L. 101–239, § 6202(span)(1)(B), amended span and text generally, substituting pars. (1) to (4) relating to medicare as secondary payer for former pars. (1) to (5) relating to items or services paid under workmen’s compensation laws and end stage renal disease program.

Subsec. (span)(1)(D). Puspan. L. 101–239, § 6202(e)(1), added subpar. (D).

Subsec. (span)(5). Puspan. L. 101–239, § 6202(a)(2)(A), added par. (5).

Subsec. (c). Puspan. L. 101–234 repealed Puspan. L. 100–360, § 202(d), and provided that the provisions of law amended or repealed by such section are restored or revived as if such section had not been enacted, see 1988 Amendment note below.

Subsec. (e)(1). Puspan. L. 101–239, § 6411(d)(2), inserted “, not including items or services furnished in an emergency room of a hospital” after “(other than an emergency item or service”.

1988—Subsec. (a)(1)(A). Puspan. L. 100–360, § 204(d)(2)(A)(i), substituted “a succeeding subparagraph” for “subparagraph (B), (C), (D), or (E)”.

Subsec. (a)(1)(F). Puspan. L. 100–360, § 204(d)(2)(A)(ii)–(iv), added subpar. (F) relating to screening mammography.

Subsec. (a)(1)(G). Puspan. L. 100–360, § 205(e)(1)(A), as amended by Puspan. L. 100–485, § 608(d)(7), added subpar. (G) relating to in-home care for chronically dependent individuals.

Subsec. (a)(6). Puspan. L. 100–360, § 205(e)(1)(B), inserted “and except, in the case of in-home care, as is otherwise permitted under paragraph (1)(G)” after “paragraph (1)(C)”.

Subsec. (a)(7). Puspan. L. 100–360, § 204(d)(2)(B), inserted “or under paragraph (1)(F)” after “(1)(B)”.

Subsec. (a)(15). Puspan. L. 100–360, § 411(f)(4)(D)(i), inserted “(including subsequent insertion of an intraocular lens)” after “operation”.

Subsec. (c). Puspan. L. 100–360, § 202(d), designated existing provisions as par. (1), redesignated former par. (1) as subpar. (A), redesignated former subpars. (A) to (D) as cls. (i) to (iv), redesignated former par. (2) as subpar. (B), redesignated former subpar. (A) as cl. (i) and substituted “subparagraph (A)” for “paragraph (1)”, redesignated former subpar. (B) as cl. (ii), and added par. (2) prohibiting payment for expenses incurred for a covered outpatient drug if the drug is dispensed in a quantity exceeding a supply of 30 days with an exception.

Subsec. (e)(1). Puspan. L. 100–360, § 411(i)(4)(D)(i), as amended by Puspan. L. 100–485, § 608(d)(24)(C)(i), designated existing provisions of subsec. (e) as par. (1), redesignated former par. (1) as subpar. (A), substituted “, 1320a–7a, 1320c–5 or 1395u(j)(2)” for “or section 1320a–7a”, and redesignated former par. (2) as subpar. (B).

Subsec. (e)(2). Puspan. L. 100–360, § 411(i)(4)(D)(ii), as amended by Puspan. L. 100–485, § 608(d)(24)(C)(ii), amended former section 1395aaa of this title by striking out the catchline “Limitation of liability of beneficiaries with respect to services furnished by excluded individuals and entities”, substituting “(2)” for the section designation, inserting “1395u(j)(2),” in text, and transferring the text to par. (2) of subsec. (e) of this section.

1987—Subsec. (a)(1)(A). Puspan. L. 100–203, § 4085(i)(15), substituted “(D), or (E)” for “or (D)”.

Subsec. (a)(8). Puspan. L. 100–203, § 4072(c), inserted “, other than shoes furnished pursuant to section 1395x(s)(12) of this title” before semicolon.

Subsec. (a)(14). Puspan. L. 100–203, § 4085(i)(16), substituted “a patient” for “an patient”.

Puspan. L. 100–203, § 4009(j)(6)(C), made technical amendment to Puspan. L. 99–509, § 9320(h)(1). See 1986 Amendment note below.

Subsec. (span)(2)(A)(ii). Puspan. L. 100–203, § 4036(a)(1), substituted “can reasonably be expected to be made under such a plan” for “the Secretary determines will be made under such a plan as promptly as would otherwise be the case if payment were made by the Secretary under this subchapter”.

Subsec. (span)(4)(B)(i). Puspan. L. 100–203, § 4034(a), substituted “subsection (span) of section 5000 of the Internal Revenue Code of 1986 without regard to subsection (d) of such section” for “section 5000(span) of the Internal Revenue Code of 1986”.

Subsec. (d). Puspan. L. 100–93, § 8(c)(1)(A), struck out subsec. (d), which provided that no payment be made under this subchapter for any item or services to an individual by a person where Secretary determines such person knowingly and willfully made any false statement or representation of a material fact, submitted excessive bills or requests, or furnished excessive services or supplies, and provided a dissatisfied person with a hearing on determination of the Secretary.

Subsec. (e) [formerly § 1395aaa]. Puspan. L. 100–93, § 10, added par. (2). See 1988 Amendment note above.

Puspan. L. 100–93, § 8(c)(1)(B), amended subsec. (e) generally. Prior to amendment, subsec. (e) read as follows: “No payment may be made under this subchapter with respect to any item or service furnished by a physician or other individual during the period when he is barred pursuant to section 1320a–7 of this title from participation in the program under this subchapter.”

Subsec. (h)(1)(B). Puspan. L. 100–203, § 4039(c)(1)(A), substituted “law (and any amount paid to a provider under any such warranty),” for “law,”.

Subsec. (h)(1)(D). Puspan. L. 100–203, § 4039(c)(1)(B), inserted “in determining the amount subject to repayment under paragraph (2)(C),” after “(3),”.

Subsec. (h)(2)(C). Puspan. L. 100–203, § 4039(c)(1)(C), added subpar. (C).

Subsec. (h)(4). Puspan. L. 100–93, § 8(c)(3), substituted “subsections (c), (f), and (g) of section 1320a–7 of this title” for “paragraphs (2) and (3) of subsection (d) of this section”.

Subsec. (h)(4)(B). Puspan. L. 100–203, § 4039(c)(1)(D), substituted “, has improperly” for “or has improperly” and inserted “or has failed to make repayment to the Secretary as required under paragraph (2)(C),” after “(2)(B),”.

1986—Subsec. (a)(1)(E). Puspan. L. 99–509, § 9316(span), added subpar. (E).

Subsec. (a)(14). Puspan. L. 99–509, § 9343(c)(1), substituted “patient” for “inpatient”.

Puspan. L. 99–509, § 9320(h)(1), as amended by Puspan. L. 100–203, § 4009(j)(6)(C), inserted “or are services of a certified registered nurse anesthetist” after “hospital” at end.

Subsec. (a)(15). Puspan. L. 99–272, § 9307(a), added par. (15).

Subsec. (a)(16). Puspan. L. 99–272, § 9401(c)(1), added par. (16).

Subsec. (span)(2)(A). Puspan. L. 99–514 substituted “Internal Revenue Code of 1986” for “Internal Revenue Code of 1954”.

Subsec. (span)(3)(A)(i). Puspan. L. 99–272, § 9201(a)(1), substituted “(or to the spouse of such individual)” for “who is under 70 years of age during any part of such month (or to the spouse of such individual, if the spouse is under 70 years of age during any part of such month)”.

Subsec. (span)(3)(A)(iii). Puspan. L. 99–272, § 9201(a)(2), struck out “and ending with the month before the month in which such individual attains the age of 70” after “section 426(a) of this title”.

Subsec. (span)(3)(A)(iv). Puspan. L. 99–514 substituted “Internal Revenue Code of 1986” for “Internal Revenue Code of 1954”.

Subsec. (span)(4). Puspan. L. 99–509, § 9319(a), added par. (4).

Subsec. (span)(5). Puspan. L. 99–509, § 9319(span), added par. (5).

1984—Subsec. (a)(12). Puspan. L. 98–369, § 2354(span)(30), struck out second comma after “dental procedure”.

Subsec. (span)(1). Puspan. L. 98–369, § 2344(a), substituted “to be made promptly” for “to be made” and “has been or could be made under such a law” for “has been made under such a law”, and inserted “In order to recover payment made under this subchapter for an item or service, the United States may bring an action against any entity which would be responsible for payment with respect to such item or service (or any portion thereof) under such a law, policy, plan, or insurance, or against any entity (including any physician or provider) which has been paid with respect to such item or service under such law, policy, plan, or insurance, and may join or intervene in any action related to the events that gave rise to the need for such item or service. The United States shall be subrogated (to the extent of payment made under this subchapter for an item or service) to any right of an individual or any other entity to payment with respect to such item or service under such a law, policy, plan, or insurance.”

Subsec. (span)(2)(B). Puspan. L. 98–369, § 2344(span), substituted “has been or could be made under a plan” for “has been made under a plan”, and inserted “In order to recover payment made under this subchapter for an item or service, the United States may bring an action against any entity which would be responsible for payment with respect to such item or service (or any portion thereof) under such a plan, or against any entity (including any physician or provider) which has been paid with respect to such item or service under such plan, and may join or intervene in any action related to the events that gave rise to the need for such item or service. The United States shall be subrogated (to the extent of payment made under this subchapter for an item or service) to any right of an individual or any other entity to payment with respect to such item or service under such a plan.”

Subsec. (span)(3)(A)(i). Puspan. L. 98–369, § 2301(a), struck out “over 64 but” before “under 70 years” in two places.

Subsec. (span)(3)(A)(ii). Puspan. L. 98–369, § 2344(c), substituted “has been or could be made under a group health plan” for “has been made under a group health plan”, and inserted “In order to recover payment made under this subchapter for an item or service, the United States may bring an action against any entity which would be responsible for payment with respect to such item or service (or any portion thereof) under such a plan, or against any entity (including any physician or provider) which has been paid with respect to such item or service under such plan, and may join or intervene in any action related to the events that gave rise to the need for such item or service. The United States shall be subrogated (to the extent of payment made under this subchapter for an item or service) to any right of an individual or any other entity to payment with respect to such item or service under such a plan.”

Subsec. (span)(3)(A)(iii). Puspan. L. 98–369, § 2354(span)(31), inserted “before the month” after “ending with the month”.

Subsec. (h). Puspan. L. 98–369, § 2304(c), added subsec. (h).

Subsec. (i). Puspan. L. 98–369, § 2313(c), added subsec. (i).

1983—Subsec. (a)(1)(A). Puspan. L. 98–21, § 601(f)(1), inserted reference to subpar. (D).

Subsec. (a)(1)(D). Puspan. L. 98–21, § 601(f)(2)–(4), added subpar. (D).

Subsec. (a)(14). Puspan. L. 98–21, § 602(e), added par. (14).

Subsec. (span)(3)(A)(i). Puspan. L. 97–448 inserted “in any month” after “service furnished”, and “during any part of such month” after “70 years of age” wherever appearing.

1982—Subsec. (a)(1). Puspan. L. 97–248, § 122(f)(1), designated existing provisions as subpars. (A) and (B), in subpar. (A) as so designated inserted exception to provisions for items and services described in subpar. (B) or (C), substituted “and” for “or” as the connector between provisions, and added subpar. (C).

Subsec. (a)(6). Puspan. L. 97–248, § 122(f)(2), inserted “(except, in the case of hospice care, as is otherwise permitted under paragraph (1)(C))”.

Subsec. (a)(7). Puspan. L. 97–248, § 122(f)(3), substituted “paragraph (1)(B)” for “paragraph (1)”.

Subsec. (a)(9). Puspan. L. 97–248, § 122(f)(4), inserted “(except, in the case of hospice care, as is otherwise permitted under paragraph (1)(C))”.

Subsec. (span)(1). Puspan. L. 97–248, § 128(a)(2), struck out “or plan” after “service has been made under such a law”.

Subsec. (span)(2)(A). Puspan. L. 97–248, § 128(a)(3), substituted “section 162(i)(2)” for “section 162(h)(2)”.

Subsec. (span)(2)(B). Puspan. L. 97–248, § 128(a)(4), inserted “furnished” before “to an individual”.

Subsec. (span)(3). Puspan. L. 97–248, § 116(span), added par. (3).

Subsec. (d)(1)(C). Puspan. L. 97–248, § 148(a), substituted “on the basis of information acquired by the Secretary in the administration of this subchapter” for “, on the basis of reports transmitted to him in accordance with section 1320c–6 of this title (or, in the absence of any such report, on the basis of such data as he acquires in the administration of the program under this subchapter),”.

Subsec. (f). Puspan. L. 97–248, § 122(g)(1), substituted “paragraph (1)(A)” for “paragraph (1)”.

Subsec. (g). Puspan. L. 97–248, § 142, added subsec. (g).

1981—Subsec. (span). Puspan. L. 97–35, § 2146(a), designated existing provisions as par. (1) and added par. (2).

Subsec. (c). Puspan. L. 97–35, § 2103(a)(1), added subsec. (c).

Subsec. (f). Puspan. L. 97–35, § 2152(a), added subsec. (f).

1980—Subsec. (a)(1). Puspan. L. 96–611, § 1(a)(3)(A), inserted “, or, in the case of items and services described in section 1395x(s)(10) of this title, which are not reasonable and necessary for the prevention of illness” after “of a malformed body member”.

Subsec. (a)(7). Puspan. L. 96–611, § 1(a)(3)(B), inserted “(except as otherwise allowed under section 1395x(s)(10) of this title and paragraph (1))” after “immunizations”.

Subsec. (a)(12). Puspan. L. 96–499, § 936(c), inserted “or because of the severity of the dental procedure,” after “and clinical status”.

Subsec. (a)(13)(C). Puspan. L. 96–499, § 939(a), struck out “, warts,” after “corns”.

Subsec. (span). Puspan. L. 96–499, § 953, inserted “or under an automobile or liability insurance policy or plan (including a self-insured plan) or under no fault insurance” and “, policy, plan, or insurance” after “or a State” and “, policy, plan, or insurance” after “law or plan” and inserted provision authorizing the Secretary to waive the provisions of this subsection in the case of an individual claim if he determined that the probability of recovery or amount involved did not warrant the pursuit of the claim.

Subsec. (d)(4). Puspan. L. 96–272 added par. (4).

Subsec. (e). Puspan. L. 96–499, § 913(span), substituted provisions barring payment under this subchapter with respect to items or services furnished by a physician or other individual during a period when such physician or other individual was barred pursuant to section 1320a–7 of this title from participation under this subchapter for provisions authorizing the Secretary to suspend a physician or individual practitioner from participation under this subchapter upon determining that such physician or practitioner had been convicted of a criminal offense related to such physician’s or practitioner’s involvement in the programs under this subchapter or the program under subchapter XIX of this chapter.

1977—Subsec. (a)(3). Puspan. L. 95–210 substituted “except in the case of rural health clinic services, as defined in section 1395x(aa)(1) of this title, and in such other cases as the Secretary may specify” for “except in such cases as the Secretary may specify”.

Subsec. (d)(1)(B). Puspan. L. 95–142, § 13(span)(1), struck out requirement for concurrence of appropriate program review team for finding of Secretary under this paragraph.

Subsec. (d)(1)(C). Puspan. L. 95–142, § 13(span)(2), substituted provisions relating to determinations by the Secretary on the basis of reports transmitted to him in accordance with section 1320c–6 of this title or other data acquired in the administration of this subchapter, for provisions relating to determinations by the Secretary with the concurrence of appropriate review team members.

Subsec. (d)(4). Puspan. L. 95–142, § 13(a), struck out par. (4) which set forth provisions relating to appointment and functions of program review teams.

Subsec. (e). Puspan. L. 95–142, § 7(a), added subsec. (e).

1975—Subsec. (c). Puspan. L. 94–182 struck out subsec. (c) prohibiting payments to Federal employees under this subchapter unless a determination and certification by the Secretary of a modification of any health benefits plan under chapter 89 of Title 5 was made which would allow a Federal employee benefits under part A or B of this subchapter.

1974—Subsec. (c). Puspan. L. 93–480 substituted “January 1, 1976” for “January 1, 1975”.

1973—Subsec. (a)(12). Puspan. L. 93–233 substituted “the provision of such dental services if the individual, because of his underlying medical condition and clinical status, requires hospitalization in connection with the provision of such services” for “a dental procedure where the individual suffers from impairments of such severity as to require hospitalization”.

1972—Subsec. (a)(4). Puspan. L. 92–603, § 211(c)(1), inserted reference to physicians’ services and ambulance services furnished an individual in conjunction with emergency inpatient hospital services.

Subsec. (a)(12). Puspan. L. 92–603, § 256(c), authorized payment under part A in the case of inpatient hospital services in connection with a dental procedure where the individual suffers from impairments of such severity as to require hospitalization.

Subsec. (c). Puspan. L. 92–603, § 210, added subsec. (c).

Subsec. (d). Puspan. L. 92–603, § 229(a), added subsec. (d).

1968—Subsec. (a)(7). Puspan. L. 90–248, § 128, prohibited payment for procedures performed (during the course of any eye examination) to determine the refractive state of the eyes.

Subsec. (a)(13). Puspan. L. 90–248, § 127(span), added par. (13).

Amendment by section 2008(c), (d) of Puspan. L. 115–271 applicable with respect to plan years beginning on or after Jan. 1, 2020, see section 2008(e) of Puspan. L. 115–271, set out as a note under section 1395w–27 of this title.

Puspan. L. 114–255, div. A, title IV, § 4009(span), Dec. 13, 2016, 130 Stat. 1185, provided that: “The amendment made by subsection (a) [amending this section] shall apply with respect to local coverage determinations that are proposed or revised on or after the date that is 180 days after the date of enactment of this Act [Dec. 13, 2016].”

Puspan. L. 114–10, title V, § 516(span), Apr. 16, 2015, 129 Stat. 175, provided that: “The amendment made by subsection (a) [amending this section] shall take effect on the date of the enactment of this Act [Apr. 16, 2015] and shall apply to information required to be provided on or after January 1, 2016.”

Puspan. L. 112–242, title II, § 202(span), Jan. 10, 2013, 126 Stat. 2380, provided that: “The amendments made by subsection (a) [amending this section] shall apply to years beginning with 2014.”

Puspan. L. 112–242, title II, § 205(span), Jan. 10, 2013, 126 Stat. 2381, provided that: “The amendment made by subsection (a) [amending this section] shall apply with respect to actions brought and penalties sought on or after 6 months after the date of the enactment of this Act [Jan. 10, 2013].”

Amendment by Puspan. L. 112–40 applicable to contracts entered into or renewed on or after Jan. 1, 2012, see section 261(e) of Puspan. L. 112–40, set out as a note under section 1320c of this title.

Amendment by section 4103(d) of Puspan. L. 111–148 applicable to services furnished on or after Jan. 1, 2011, see section 4103(e) of Puspan. L. 111–148, set out as a note under section 1395l of this title.

Amendment by section 101(a)(3), (span)(3), (4) of Puspan. L. 110–275 applicable to services furnished on or after Jan. 1, 2009, see section 101(c) of Puspan. L. 110–275, set out as a note under section 1395l of this title.

Puspan. L. 110–275, title I, § 135(a)(2)(B), July 15, 2008, 122 Stat. 2535, provided that: “The amendments made by this paragraph [amending this section] shall apply to advanced diagnostic imaging services furnished on or after January 1, 2012.”

Amendment by section 143(span)(7) of Puspan. L. 110–275 applicable to services furnished on or after July 1, 2009, see section 143(c) of Puspan. L. 110–275, set out as a note under section 1395k of this title.

Amendment by section 152(span)(1)(D) of Puspan. L. 110–275 applicable to services furnished on or after Jan. 1, 2010, see section 152(span)(2) of Puspan. L. 110–275, set out as a note under section 1395w–4 of this title.

Amendment by Puspan. L. 109–171 applicable to services furnished on or after Jan. 1, 2007, see section 5112(f) of Puspan. L. 109–171, set out as a note under section 1395l of this title.

Puspan. L. 108–173, title III, § 301(d), Dec. 8, 2003, 117 Stat. 2222, provided that: “The amendments made by this section [amending this section] shall be effective—

Amendment by section 611(d)(1) of Puspan. L. 108–173 applicable to services furnished on or after Jan. 1, 2005, but only for individuals whose coverage period under this part begins on or after such date, see section 611(e) of Puspan. L. 108–173, set out as a note under section 1395w–4 of this title.

Amendment by section 612(c) of Puspan. L. 108–173 applicable to tests furnished on or after Jan. 1, 2005, see section 612(d) of Puspan. L. 108–173, set out as a note under section 1395x of this title.

Amendment by section 613(c) of Puspan. L. 108–173 applicable to tests furnished on or after Jan. 1, 2005, see section 613(d) of Puspan. L. 108–173, set out as a note under section 1395x of this title.

Puspan. L. 108–173, title VII, § 731(a)(2), Dec. 8, 2003, 117 Stat. 2351, provided that: “The amendments made by paragraph (1) [amending this section] shall apply to national coverage determinations as of January 1, 2004, and section 1862(l)(5) of the Social Security Act [42 U.S.C. 1395y(l)(5)], as added by such paragraph, shall apply to local coverage determinations made on or after July 1, 2004.”

Puspan. L. 108–173, title VII, § 731(span)(2), Dec. 8, 2003, 117 Stat. 2351, provided that: “The amendment made by paragraph (1) [amending this section] shall apply to routine costs incurred on and after January 1, 2005, and, as of such date, section 411.15(o) of title 42, Code of Federal Regulations, is superseded to the extent inconsistent with section 1862(m) of the Social Security Act [42 U.S.C. 1395y(m)], as added by such paragraph.”

Puspan. L. 108–173, title IX, § 944(a)(2), Dec. 8, 2003, 117 Stat. 2423, provided that: “The amendment made by paragraph (1) [amending this section] shall apply to items and services furnished on or after January 1, 2004.”

Amendment by section 948(a) of Puspan. L. 108–173 effective, except as otherwise provided, as if included in the enactment of BIPA [the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000, H.R. 5661, as enacted by section 1(a)(6) of Public Law 106–554], see section 948(e) of Puspan. L. 108–173, set out as a note under section 1314 of this title.

Puspan. L. 108–173, title IX, § 950(span), Dec. 8, 2003, 117 Stat. 2427, provided that: “The amendment made by subsection (a) [amending this section] shall take effect on the date that is 60 days after the date of the enactment of this Act [Dec. 8, 2003].”

Puspan. L. 107–105, § 3(span), Dec. 27, 2001, 115 Stat. 1007, provided that: “The amendments made by subsection (a) [amending this section] shall apply to claims submitted on or after October 16, 2003.”

Amendment by section 1(a)(6) [title I, § 102(c)] of Puspan. L. 106–554 applicable to services furnished on or after Jan. 1, 2002, see section 1(a)(6) [title I, § 102(d)] of Puspan. L. 106–554, set out as a note under section 1395x of this title.

Amendment by section 1(a)(6) [title III, § 313(a)] of Puspan. L. 106–554 applicable to services furnished on or after Jan. 1, 2001, see section 1(a)(6) [title III, § 313(c)] of Puspan. L. 106–554, set out as a note under section 1395u of this title.

Amendment by section 1(a)(6) [title IV, § 432(span)(1)] of Puspan. L. 106–554 applicable to services furnished on or after July 1, 2001 see section 1(a)(6) [title IV, § 432(c)] of Puspan. L. 106–554, set out as a note under section 1395u of this title.

Amendment by section 1(a)(6) [title V, § 522(span)] of Puspan. L. 106–554 applicable with respect to a review of any national or local coverage determination filed, a request to make such a determination made, and a national coverage determination made, on or after Oct. 1, 2001, see section 1(a)(6) [title V, § 522(d)] of Puspan. L. 106–554, set out as a note under section 1314 of this title.

Amendment by section 1000(a)(6) [title III, § 305(span)] of Puspan. L. 106–113 applicable to payments for services provided on or after Nov. 29, 1999, see § 1000(a)(6) [title III, § 305(c)] of Puspan. L. 106–113, set out as a note under section 1395u of this title.

Amendment by section 1000(a)(6) [title III, § 321(k)(10)] of Puspan. L. 106–113 effective as if included in the enactment of the Balanced Budget Act of 1997, Puspan. L. 105–33, except as otherwise provided, see section 1000(a)(6) [title III, § 321(m)] of Puspan. L. 106–113, set out as a note under section 1395d of this title.

Amendment by Puspan. L. 105–12 effective Apr. 30, 1997, and applicable to Federal payments made pursuant to obligations incurred after Apr. 30, 1997, for items and services provided on or after such date, subject to also being applicable with respect to contracts entered into, renewed, or extended after Apr. 30, 1997, as well as contracts entered into before Apr. 30, 1997, to the extent permitted under such contracts, see section 11 of Puspan. L. 105–12, set out as an Effective Date note under section 14401 of this title.

Amendment by section 4022(span)(1)(B) of Puspan. L. 105–33 effective Nov. 1, 1997, the date of termination of the Prospective Payment Assessment Commission and the Physician Payment Review Commission, see section 4022(c)(2) of Puspan. L. 105–33, set out as an Effective Date; Transition; Transfer of Functions note under section 1395span–6 of this title.

Amendment by section 4102(c) of Puspan. L. 105–33 applicable to items and services furnished on or after Jan. 1, 1998, see section 4102(e) of Puspan. L. 105–33, set out as a note under section 1395l of this title.

Amendment by section 4103(c) of Puspan. L. 105–33 applicable to items and services furnished on or after Jan. 1, 2000, see section 4103(e) of Puspan. L. 105–33, set out as a note under section 1395l of this title.

Amendment by section 4104(c)(3) of Puspan. L. 105–33 applicable to items and services furnished on or after Jan. 1, 1998, see section 4104(e) of Puspan. L. 105–33, set out as a note under section 1395l of this title.

Amendment by section 4201(c)(1) of Puspan. L. 105–33 applicable to services furnished on or after Oct. 1, 1997, see section 4201(d) of Puspan. L. 105–33, set out as a note under section 1395f of this title.

Amendment by section 4432(span)(1) of Puspan. L. 105–33 applicable to items and services furnished on or after July 1, 1998, see section 4432(d) of Puspan. L. 105–33, set out as a note under section 1395i–3 of this title.

Amendment by section 4507(a)(2)(B) of Puspan. L. 105–33 applicable with respect to contracts entered into on and after Jan. 1, 1998, see section 4507(c) of Puspan. L. 105–33, set out as a note under section 1395a of this title.

Amendment by section 4511(a)(2)(C) of Puspan. L. 105–33 applicable with respect to services furnished and supplies provided on and after Jan. 1, 1998, see section 4511(e) of Puspan. L. 105–33, set out as a note under section 1395k of this title.

Amendment by section 4541(span) of Puspan. L. 105–33 applicable to services furnished on or after Jan. 1, 1998, including portions of cost reporting periods occurring on or after such date, see section 4541(e) of Puspan. L. 105–33, set out as a note under section 1395l of this title.

Amendment by section 4603(c)(2)(C) of Puspan. L. 105–33 applicable to cost reporting periods beginning on or after Oct. 1, 1999, except as otherwise provided, see section 4603(d) of Puspan. L. 105–33, set out as an Effective Date note under section 1395fff of this title.

Puspan. L. 105–33, title IV, § 4614(c), Aug. 5, 1997, 111 Stat. 475, provided that: “The amendments made by this section [amending this section] apply to services furnished on or after October 1, 1997.”

Puspan. L. 105–33, title IV, § 4632(span), Aug. 5, 1997, 111 Stat. 486, provided that: “The amendments made by this section [amending this section] apply to items and services furnished on or after the date of the enactment of this Act [Aug. 5, 1997].”

Puspan. L. 105–33, title IV, § 4633(c), Aug. 5, 1997, 111 Stat. 487, provided that: “The amendments made by this section [amending this section] apply to items and services furnished on or after the date of the enactment of this Act [Aug. 5, 1997].”

Amendment by section 145(c)(1) of Puspan. L. 103–432 applicable to mammography furnished by a facility on and after the first date that the certificate requirements of section 263span(span) of this title apply to such mammography conducted by such facility, see section 145(d) of Puspan. L. 103–432, set out as a note under section 1395m of this title.

Amendment by section 147(e)(6) of Puspan. L. 103–432 effective as if included in the enactment of Puspan. L. 101–508, see section 147(g) of Puspan. L. 103–432, set out as a note under section 1320a–3a of this title.

Puspan. L. 103–432, title I, § 151(a)(2)(B), Oct. 31, 1994, 108 Stat. 4433, provided that: “The amendment made by subparagraph (A) [amending this section] shall apply with respect to items and services furnished on or after the expiration of the 120-day period beginning on the date of the enactment of this Act [Oct. 31, 1994].”

Puspan. L. 103–432, title I, § 151(span)(3)(C), Oct. 31, 1994, 108 Stat. 4434, provided that: “The amendments made by this paragraph [amending this section] shall apply to payments for items and services furnished on or after the date of the enactment of this Act [Oct. 31, 1994].”

Puspan. L. 103–432, title I, § 151(c)(1), (9), Oct. 31, 1994, 108 Stat. 4435, 4436, provided that the amendment made by that section is effective as if included in the enactment of Puspan. L. 103–66.

Puspan. L. 103–432, title I, § 151(c)(4), Oct. 31, 1994, 108 Stat. 4435, provided that the amendment made by that section is effective as if included in the enactment of Puspan. L. 101–508.

Puspan. L. 103–432, title I, § 151(c)(5), (6), Oct. 31, 1994, 108 Stat. 4436, provided that the amendment made by that section is effective as if included in the enactment of Puspan. L. 101–239.

Amendment by section 156(a)(2)(D) of Puspan. L. 103–432 applicable to services provided on or after Oct. 31, 1994, see section 156(a)(3) of Puspan. L. 103–432, set out as a note under section 1320c–3 of this title.

Puspan. L. 103–432, title I, § 157(span)(8), Oct. 31, 1994, 108 Stat. 4442, provided that: “The amendments made by this subsection [amending this section, section 1395mm of this title, and provisions set out as notes under section 1395mm of this title] shall take effect as if included in the enactment of OBRA–1990 [Puspan. L. 101–508].”

Puspan. L. 103–432, title I, § 151(c)(10), Oct. 31, 1994, 108 Stat. 4436, provided that: “The amendment made by section 13561(e)(1)(G) of OBRA–1993 [Puspan. L. 103–66, amending this section], to the extent it relates to the definition of large group health plan, shall be effective as if included in the enactment of OBRA–1989 [Puspan. L. 101–239].”

Amendment by section 13561(d)(1) of Puspan. L. 103–66 effective 90 days after Aug. 10, 1993, see section 13561(d)(3) of Puspan. L. 103–66, set out as a note under section 5000 of Title 26, Internal Revenue Code.

Puspan. L. 103–66, title XIII, § 13561(e)(1)(D), Aug. 10, 1993, 107 Stat. 595, as amended by Puspan. L. 103–432, title I, § 151(c)(9)(A), Oct. 31, 1994, 108 Stat. 4436, provided that the amendment made by that section is effective as if included in the enactment of Puspan. L. 101–239.

Puspan. L. 103–66, title XIII, § 13581(d), Aug. 10, 1993, 107 Stat. 611, provided that: “The amendments made by this section [enacting section 1320span–14 of this title and amending this section, section 1396a of this title, and section 552a of Title 5, Government Organization and Employees] shall take effect on January 1, 1994.”

Amendment by section 4153(span)(2)(B) of Puspan. L. 101–508 applicable to items furnished on or after Jan. 1, 1991, see section 4153(span)(2)(C) of Puspan. L. 101–508, set out as a note under section 1395x of this title.

Amendment by section 4157(c)(1) of Puspan. L. 101–508 applicable to services furnished on or after Jan. 1, 1991, see section 4157(d) of Puspan. L. 101–508, set out as a note under section 1395k of this title.

Amendment by section 4161(a)(3)(C) of Puspan. L. 101–508 applicable to services furnished on or after Oct. 1, 1991, see section 4161(a)(8) of Puspan. L. 101–508, set out as a note under section 1395k of this title.

Amendment by section 4163(d)(2)(A)(i)–(iii), (B) of Puspan. L. 101–508 applicable to screening mammography performed on or after Jan. 1, 1991, see section 4163(e) of Puspan. L. 101–508, as amended, set out as a note under section 1395l of this title.

Puspan. L. 101–508, title IV, § 4163(d)(3), as added by Puspan. L. 103–432, title I, § 147(f)(5)(A), Oct. 31, 1994, 108 Stat. 4431, provided that: “The amendment made by paragraph (2)(A)(iv) [amending this section] shall apply to screening pap smears performed on or after July 1, 1990.”

Puspan. L. 101–508, title IV, § 4204(g)(2), Nov. 5, 1990, 104 Stat. 1388–112, provided that: “The amendment made by paragraph (1) [amending this section] shall apply to incentives offered on or after the date of the enactment of this Act [Nov. 5, 1990].”

Amendment by section 6115(span) of Puspan. L. 101–239 applicable to screening pap smears performed on or after July 1, 1990, see section 6115(d) of Puspan. L. 101–239, set out as a note under section 1395x of this title.

Amendment by section 6202(span)(1) of Puspan. L. 101–239 applicable to items and services furnished after Dec. 19, 1989, see section 6202(span)(5) of Puspan. L. 101–239, set out as a note under section 162 of Title 26, Internal Revenue Code.

Puspan. L. 101–239, title VI, § 6202(e)(2), Dec. 19, 1989, 103 Stat. 2235, provided that: “The amendment made by paragraph (1) [amending this section] shall apply to items and services furnished on or after October 1, 1989.”

Amendment by Puspan. L. 101–234 effective Jan. 1, 1990, see section 201(c) of Puspan. L. 101–234, set out as a note under section 1320a–7a of this title.

Amendment by Puspan. L. 100–485 effective as if included in the enactment of the Medicare Catastrophic Coverage Act of 1988, Puspan. L. 100–360, see section 608(g)(1) of Puspan. L. 100–485, set out as a note under section 704 of this title.

Amendment by section 202(d) of Puspan. L. 100–360 applicable to items dispensed on or after Jan. 1, 1990, see section 202(m)(1) of Puspan. L. 100–360, set out as a note under section 1395u of this title.

Amendment by section 204(d)(2) of Puspan. L. 100–360 applicable to screening mammography performed on or after Jan. 1, 1990, see section 204(e) of Puspan. L. 100–360, set out as a note under section 1395m of this title.

Amendment by section 205(e)(1) of Puspan. L. 100–360 applicable to items and services furnished on or after Jan. 1, 1990, see section 205(f) of Puspan. L. 100–360, set out as a note under section 1395k of this title.

Except as specifically provided in section 411 of Puspan. L. 100–360, amendment by section 411(i)(4)(D) of Puspan. L. 100–360, as it relates to a provision in the Omnibus Budget Reconciliation Act of 1987, Puspan. L. 100–203, effective as if included in the enactment of that provision in Puspan. L. 100–203, see section 411(a) of Puspan. L. 100–360, set out as a Reference to OBRA; Effective Date note under section 106 of Title 1, General Provisions.

Puspan. L. 100–360, title IV, § 411(f)(4)(D)(ii), July 1, 1988, 102 Stat. 778, provided that: “The amendment made by clause (i) [amending this section] shall apply to operations performed on or after 60 days after the date of the enactment of this Act [July 1, 1988].”

Puspan. L. 100–203, title IV, § 4009(j)(6), Dec. 22, 1987, 101 Stat. 1330–59, provided that the amendment made by that section is effective as if included in the enactment of Puspan. L. 99–509.

Puspan. L. 100–203, title IV, § 4034(span), Dec. 22, 1987, 101 Stat. 1330–77, provided that: “The amendment made by subsection (a) [amending this section] shall be effective as if included in the enactment of section 9319(a) of the Omnibus Budget Reconciliation Act of 1986 [Puspan. L. 99–509].”

Puspan. L. 100–203, title IV, § 4036(a)(2), Dec. 22, 1987, 101 Stat. 1330–79, provided that: “The amendment made by paragraph (1) [amending this section] shall apply with respect to items and services furnished on or after 30 days after the date of the enactment of this Act [Dec. 22, 1987].”

Puspan. L. 100–203, title IV, § 4039(c)(2), Dec. 22, 1987, 101 Stat. 1330–82, provided that: “The amendments made by paragraph (1) [amending this section] shall become effective on January 1, 1988.”

For effective date of amendment by section 4072(c) of Puspan. L. 100–203, see section 4072(e) of Puspan. L. 100–203, set out as a note under section 1395x of this title.

Amendment by Puspan. L. 100–93 effective at end of fourteen-day period beginning Aug. 18, 1987, and inapplicable to administrative proceedings commenced before end of such period, see section 15(a) of Puspan. L. 100–93, set out as a note under section 1320a–7 of this title.

Puspan. L. 99–509, title IX, § 9319(f), Oct. 21, 1986, 100 Stat. 2013, provided that:

Amendment by section 9320(h)(1) of Puspan. L. 99–509 applicable to services furnished on or after Jan. 1, 1989, with exceptions for hospitals located in rural areas which meet certain requirements related to certified registered nurse anesthetists, see section 9320(i), (k) of Puspan. L. 99–509, as amended, set out as notes under section 1395k of this title.

Amendment by section 9343(c)(1) of Puspan. L. 99–509 applicable to services furnished after June 30, 1987, see section 9343(h)(2) of Puspan. L. 99–509, as amended, set out as a note under section 1395l of this title.

Puspan. L. 99–272, title IX, § 9201(d)(1), Apr. 7, 1986, 100 Stat. 171, provided that: “The amendments made by subsection (a) [amending this section] shall apply with respect to items and services furnished on or after May 1, 1986.”

Amendment by section 9307(a) of Puspan. L. 99–272 applicable to services performed on or after Apr. 1, 1986, see section 9307(e) of Puspan. L. 99–272, set out as a note under section 1320c–3 of this title.

Puspan. L. 98–369, div. B, title III, § 2301(c)(1), July 18, 1984, 98 Stat. 1063, provided that: “The amendment made by subsection (a) [amending this section] shall be effective with respect to items and services furnished on or after January 1, 1985.”

Amendment by section 2304(c) of Puspan. L. 98–369 applicable to pacemaker devices and leads implanted or removed on or after the effective date of final regulations promulgated to carry out such amendment, see section 2304(d) of Puspan. L. 98–369, set out as a note below.

Puspan. L. 98–369, div. B, title III, § 2313(e), July 18, 1984, 98 Stat. 1079, provided that: “The amendments made by this section [amending this section and section 1395ww of this title] shall become effective on the date of the enactment of this Act [July 18, 1984].”

Puspan. L. 98–369, div. B, title III, § 2344(d), July 18, 1984, 98 Stat. 1096, provided that: “The amendments made by this section [amending this section] shall apply to items and services furnished on or after the date of the enactment of this Act [July 18, 1984].”

Amendment by section 2354(span)(30), (31) of Puspan. L. 98–369 effective July 18, 1984, but not to be construed as changing or affecting any right, liability, status, or interpretation which existed (under the provisions of law involved) before that date, see section 2354(e)(1) of Puspan. L. 98–369, set out as a note under section 1320a–1 of this title.

Amendment by section 601(f) of Puspan. L. 98–21 applicable to items and services furnished by or under arrangement with a hospital beginning with its first cost reporting period that begins on or after Oct. 1, 1983, any change in a hospital’s cost reporting period made after November 1982 to be recognized for such purposes only if the Secretary finds good cause therefor, and amendment by section 602(e)(3) of Puspan. L. 98–21 effective Oct. 1, 1983, see section 604(a)(1), (2) of Puspan. L. 98–21, set out as a note under section 1395ww of this title.

Amendment by Puspan. L. 97–448 effective as if originally included as a part of this section as this section was amended by the Tax Equity and Fiscal Responsibility Act of 1982, Puspan. L. 97–248, see section 309(c)(2) of Puspan. L. 97–448, set out as a note under section 426–1 of this title.

Amendment by section 116(span) of Puspan. L. 97–248 applicable with respect to items and services furnished on or after Jan. 1, 1983, see section 116(c) of Puspan. L. 97–248, set out as a note under section 623 of Title 29, Labor.

Amendment by section 122(f), (g)(1) of Puspan. L. 97–248 applicable to hospice care provided on or after Nov. 1, 1983, see section 122(h)(1) of Puspan. L. 97–248, as amended, set out as a note under section 1395c of this title.

Amendment by section 128(a)(2)–(4) of Puspan. L. 97–248 effective as if originally included as part of this section as this section was amended by the Omnibus Budget Reconciliation Act of 1981, Puspan. L. 97–35, see section 128(e)(2) of Puspan. L. 97–248, set out as a note under section 1395x of this title.

Amendment by sections 142 and 148(a) of Puspan. L. 97–248 effective with respect to contracts entered into or renewed on or after Sept. 3, 1982, see section 149 of Puspan. L. 97–248, set out as an Effective Date note under section 1320c of this title.

Puspan. L. 97–35, title XXI, § 2103(a)(2), Aug. 13, 1981, 95 Stat. 787, provided that: “The amendment made by paragraph (1) [amending this section] shall apply with respect to expenses incurred on or after October 1, 1981.”

Puspan. L. 97–35, title XXI, § 2146(c)(1), Aug. 13, 1981, 95 Stat. 801, provided that: “The amendments made by subsection (a) [amending this section] shall become effective on October 1, 1981.”

Amendment by Puspan. L. 96–611 effective July 1, 1981, and applicable to services furnished on or after that date, see section 2 of Puspan. L. 96–611, set out as a note under section 1395l of this title.

Amendment by section 936(c) of Puspan. L. 96–499 applicable with respect to services provided on or after July 1, 1981, see section 936(d) of Puspan. L. 96–499, set out as a note under section 1395f of this title.

Puspan. L. 96–499, title IX, § 939(span), Dec. 5, 1980, 94 Stat. 2640, provided that: “The amendment made by subsection (a) [amending this section] shall apply with respect to services furnished on or after July 1, 1981.”

Amendment by Puspan. L. 95–210 applicable to services rendered on or after first day of third calendar month which begins after Dec. 31, 1977, see section 1(j) of Puspan. L. 95–210, set out as a note under section 1395k of this title.

Puspan. L. 95–142, § 13(c), Oct. 25, 1977, 91 Stat. 1198, provided that: “The amendments made by this section [amending this section and sections 1320c–6 and 1395cc of this title] shall take effect on the date of the enactment of this Act [Oct. 25, 1977].”

Amendment by Puspan. L. 93–233 effective with respect to admissions subject to the provisions of section 1395(a)(2) of this title which occur after Dec. 31, 1973, see section 18(z–3)(2) of Puspan. L. 93–233, set out as a note under section 1395f of this title.

Amendment by section 211(c)(1) of Puspan. L. 92–603 applicable to services furnished with respect to admissions occurring after Dec. 31, 1972, see section 211(d) of Puspan. L. 92–603, set out as a note under section 1395f of this title.

Amendment by section 256(c) of Puspan. L. 92–603 applicable with respect to admissions occurring after the second month following the month of enactment of Puspan. L. 92–603 which was approved on Oct. 30, 1972, see section 256(d) of Puspan. L. 92–603, set out as a note under section 1395f of this title.

Amendment by section 127(span) of Puspan. L. 90–248 applicable with respect to services furnished after Dec. 31, 1967, see section 127(c) of Puspan. L. 90–248, set out as a note under section 1395x of this title.

For construction of amendment by section 153(span)(2) of Puspan. L. 110–275, see section 153(span)(4) of Puspan. L. 110–275, set out as a note under section 1395rr of this title.

Puspan. L. 110–173, title I, § 111(span), Dec. 29, 2007, 121 Stat. 2499, provided that: “Nothing in the amendments made by this section [amending this section] shall be construed to limit the authority of the Secretary of Health and Human Services to collect information to carry out Medicare secondary payer provisions under title XVIII of the Social Security Act [42 U.S.C. 1395 et seq.], including under parts C and D of such title.”

Puspan. L. 108–173, title VII, § 731(span)(3), Dec. 8, 2003, 117 Stat. 2351, provided that: “Nothing in the amendment made by paragraph (1) [amending this section] shall be construed as applying to, or affecting, coverage or payment for a nonexperimental/investigational (category B) device.”

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.

Puspan. L. 108–173, title IX, § 943, Dec. 8, 2003, 117 Stat. 2422, provided that:

Puspan. L. 108–173, title IX, § 953(span), Dec. 8, 2003, 117 Stat. 2428, provided that: “The Secretary [of Health and Human Services] shall provide, in an appropriate annual publication available to the public, a list of national coverage determinations made under title XVIII of the Social Security Act [42 U.S.C. 1395 et seq.] in the previous year and information on how to get more information with respect to such determinations.”

Puspan. L. 105–33, title IV, § 4614(span), Aug. 5, 1997, 111 Stat. 474, provided that: “The Secretary of Health and Human Services may establish a process for notifying a physician in cases in which the number of home health visits, furnished under title XVIII of the Social Security Act [42 U.S.C. 1395 et seq.] pursuant to a prescription or certification of the physician, significantly exceeds such threshold (or thresholds) as the Secretary specifies. The Secretary may adjust such threshold to reflect demonstrated differences in the need for home health services among different beneficiaries.”

Puspan. L. 103–432, title I, § 151(a)(1)(B), Oct. 31, 1994, 108 Stat. 4433, provided that: “The Secretary of Health and Human Services shall enter into an agreement with an entity not later than 60 days after the date of the enactment of the Social Security Act Amendments of 1994 [Oct. 31, 1994], to distribute the questionnaire described in section 1862(span)(5)(D) of the Social Security Act [42 U.S.C. 1395y(span)(5)(D)] (as added by subparagraph (A)).”

Puspan. L. 103–66, title XIII, § 13561(f), Aug. 10, 1993, 107 Stat. 595, provided that: “Section 1862(span)(1)(D) of the Social Security Act [42 U.S.C. 1395y(span)(1)(D)] applies, with respect to items and services furnished before October 1, 1989, to any claims that the Secretary of Health and Human Services had not identified as of that date as subject to the provisions of section 1862(span) of such Act.”

Puspan. L. 101–508, title IV, § 4203(c)(2), Nov. 5, 1990, 104 Stat. 1388–108, as amended by Puspan. L. 103–432, title I, § 151(c)(7), Oct. 31, 1994, 108 Stat. 4436, directed Comptroller General to conduct study of impact of second sentence of subsec. (span)(1)(C) of this section and to submit preliminary report to Congress not later than Jan. 1, 1993, and final report not later than Jan. 1, 1995.

Puspan. L. 101–239, title VI, § 6202(a)(2)(B), Dec. 19, 1989, 103 Stat. 2229, provided that:

Puspan. L. 100–203, title IV, § 4009(span), Dec. 22, 1987, 101 Stat. 1330–57, provided that: “For purposes of determining whether a pediatric hospital that performs pediatric heart transplants meets the criteria established by the Secretary of Health and Human Services for facilities in which the heart transplants performed will be considered to meet the requirement of section 1862(a)(1)(A) of the Social Security Act [42 U.S.C. 1395y(a)(1)(A)], the Secretary shall treat such a hospital as meeting such criteria if—

Puspan. L. 99–514, title XVIII, § 1895(span)(16)(C), Oct. 22, 1986, 100 Stat. 2934, provided that: “For purposes of section 1862(a)(15) of the Social Security Act (42 U.S.C. 1395y(a)(15)), added by section 9307(a)(3) of COBRA, and for surgical procedures performed during the period beginning on April 1, 1986, and ending on December 15, 1986, a carrier is deemed to have approved the use of an assistant in a surgical procedure, before the surgery is performed, based on the existence of a complicating medical condition if the carrier determines after the surgery is performed that the use of the assistant in the procedure was appropriate based on the existence of a complicating medical condition before or during the surgery.”

Puspan. L. 99–509, title IX, § 9305(f), Oct. 21, 1986, 100 Stat. 1991, as amended by Puspan. L. 100–360, title IV, § 426(a), July 1, 1988, 102 Stat. 814; Puspan. L. 101–508, title IV, § 4008(a)(2), Nov. 5, 1990, 104 Stat. 1388–44, provided that:

[Puspan. L. 101–508, title IV, § 4008(a)(3), Nov. 5, 1990, 104 Stat. 1388–44, provided that: “The amendments made by paragraphs (1) and (2) [amending section 9305(f) of Puspan. L. 99–509, set out above, and section 9126(c) of Puspan. L. 99–272, set out below] shall take effect on the date of the enactment of this Act [Nov. 5, 1990].”]

Puspan. L. 99–509, title IX, § 9319(e), Oct. 21, 1986, 100 Stat. 2012, directed Comptroller General to study and report to Congress, not later than Mar. 1, 1990, the impact of the amendments made by this section (enacting section 5000 of Title 26, Internal Revenue Code, and amending this section and sections 1395p and 1395r of this title) on access of disabled individuals and members of their family to employment and health insurance, such report to include information relating to number of disabled medicare beneficiaries for whom medicare has become secondary, either through their employment or the employment of a family member, amount of savings to the medicare program achieved annually through this provision, and effect on employment, and employment-based health coverage, of disabled individuals and family members.

Puspan. L. 99–272, title IX, § 9126(c), Apr. 7, 1986, 100 Stat. 170, as amended by Puspan. L. 100–360, title IV, § 426(span), July 1, 1988, 102 Stat. 814; Puspan. L. 101–508, title IV, § 4008(a)(1), Nov. 5, 1990, 104 Stat. 1388–44, provided that: “The Secretary of Health and Human Services shall, for purposes of determining whether payments to a skilled nursing facility should be denied pursuant to section 1862(a)(1)(A) of the Social Security Act [42 U.S.C. 1395y(a)(1)(A)], apply the same presumption of compliance (5 percent) as in effect under regulations as of July 1, 1985. Such presumption shall apply for the period beginning with the first month beginning after the date of the enactment of this Act [Apr. 7, 1986] and ending on December 31, 1995.”

Puspan. L. 99–272, title IX, § 9205, Apr. 7, 1986, 100 Stat. 178, as amended by Puspan. L. 100–360, title IV, § 426(d), July 1, 1988, 102 Stat. 814; Puspan. L. 103–432, title I, § 158(span)(1), Oct. 31, 1994, 108 Stat. 4442, provided that: “The Secretary of Health and Human Services shall, for purposes of determining whether payments to a home health agency should be denied pursuant to section 1862(a)(1)(A) of the Social Security Act [42 U.S.C. 1395y(a)(1)(A)], apply a presumption of compliance (2.5 percent) in the same manner as under the regulations in effect as of July 1, 1985. Such presumption shall apply until December 31, 1995.”

[Puspan. L. 103–432, title I, § 158(span)(2), Oct. 31, 1994, 108 Stat. 4443, provided that: “The amendment made by paragraph (1) [amending section 9205 of Puspan. L. 99–272, set out above] shall take effect as if included in the enactment of OBRA–1990 [Puspan. L. 101–508].”]

Puspan. L. 99–272, title IX, § 9307(d), Apr. 7, 1986, 100 Stat. 194, provided that the Secretary of Health and Human Services, after consultation with the Physician Payment Review Commission, develop recommendations and guidelines respecting other surgical procedures for which an assistant at surgery was generally not medically necessary and circumstances under which use of an assistant at surgery was generally appropriate but should be subject to prior approval of an appropriate entity and that the Secretary report to Congress, not later than January 1, 1987, on these recommendations and guidelines.

Puspan. L. 98–369, div. B, title III, § 2304(d), July 18, 1984, 98 Stat. 1069, provided that: “The Secretary of Health and Human Services shall promulgate final regulations to carry out this section and the amendment made by this section [amending this section and enacting provisions set out as a note under section 1395l of this title] prior to January 1, 1985, and the amendment made by subsection (c) [amending this section] shall apply to pacemaker devices and leads implanted or removed on or after the effective date of such regulations.”

Puspan. L. 98–369, div. B, title III, § 2325, July 18, 1984, 98 Stat. 1087, provided that: “The Secretary shall provide, pursuant to section 1862(a) of the Social Security Act [42 U.S.C. 1395y(a)], that payment will not be made under part B of title XVIII of such Act [42 U.S.C. 1395j et seq.] for a physician’s debridement of mycotic toenails to the extent such debridement is performed for a patient more frequently than once every 60 days, unless the medical necessity for more frequent treatment is documented by the billing physician.”

Puspan. L. 98–21, title VI, § 602(k), Apr. 20, 1983, 97 Stat. 165, as amended by Puspan. L. 99–272, title IX, § 9112(a), Apr. 7, 1986, 100 Stat. 163, provided that:

[Puspan. L. 99–272, title IX, § 9112(span), Apr. 7, 1986, 100 Stat. 163, provided that:

[“(1) Section 602(k)(2) of the Social Security Amendments of 1983 (as added by subsection (a)) [set out above] shall apply to cost reporting periods beginning on or after January 1, 1986.

[“(2) Section 602(k)(3) of the Social Security Amendments of 1983 (as added by subsection (a)) [set out above] shall apply to items and services furnished after the end of the 10-day period beginning on the date of the enactment of this Act [Apr. 7, 1986].”]

Puspan. L. 97–248, title I, § 115(span), Sept. 3, 1982, 96 Stat. 353, provided that: “No provision of law limiting the use of funds for purposes of enforcing or implementing section 1862(c) [42 U.S.C. 1395y(c)] or section 1903(i)(5) [42 U.S.C. 1396span(i)(5)] of the Social Security Act, section 2103 of the Omnibus Budget Reconciliation Act of 1981 [section 2103 of Puspan. L. 97–35, amending sections 1395y and 1396span of this title and enacting provisions set out as notes under sections 1395y and 1396span of this title], or any rule or regulation issued pursuant to any such section (including any provision contained in, or incorporated by reference into, any appropriation Act or resolution making continuing appropriations) shall apply to any period after September 30, 1982, unless such provision of law is enacted after the date of the enactment of this Act [Sept. 3, 1982] and specifically states that such provision is to supersede this section.”

Puspan. L. 97–35, title XXI, § 2152(span), Aug. 13, 1981, 95 Stat. 802, directed the Secretary of Health and Human Services to establish, and provide for the implementation of, the guidelines described in subsec. (f) of this section not later than Oct. 1, 1981.

Puspan. L. 93–480, § 4(span), Oct. 26, 1974, 88 Stat. 1454, provided that the Civil Service Commission and the Secretary of Health, Education, and Welfare submit a report on or before Mar. 1, 1975, on the steps which have been taken, and the steps which are planned, to enable the Secretary to make the determination and certification referred to in former subsec. (c) of this section and that if such report is not submitted by Mar. 1, 1975, the date specified in former subsec. (c) shall be deemed to be July 1, 1975, rather than Jan. 1, 1976.