LIMITATION OF BENEFICIARY LIABILITY FOR SERVICES DISALLOWED BY PEER REVIEW ORGANIZATIONS.

SEC. 4096. LIMITATION OF BENEFICIARY LIABILITY FOR SERVICES DISALLOWED BY PEER REVIEW ORGANIZATIONS. (a) Part B Services— (1) Section 1842 of the Social Security Act (42 U.S.C 1395u) is amended— (A) in subsection (b)(3)(ii), by inserting “(and to refund amounts already collected)” after “agrees not to charge”, and by striking “and (II)” and inserting “, (II) the physician or other person furnishing such service agrees not to charge (and to refund amounts already collected) for services for which payment under this title is denied under section 1154(a)(2) by reason of a determination under section 1154(a)(1)(B), and (III)”; (B) in subsection (1)(1)(A)(iii), by inserting “(I)” after “(iii)” and by inserting before the comma the following: “or (II) payment under this title for such services is denied under section 1154(a)(2) by reason of a determination under section 1154(a)(1)(B)”; and (C) in subsection (1)(1)(C), by inserting “in the case described in subparagraph (A)(iii)(I)” after “to an individual”. (2) Section 1870(f) of such Act (42 U.S.C. 1395gg(f)) is amended by striking “that the reasonable charge is the full charge for the services” each place it appears and inserting “to the terms specified in subclauses (I) and (II) of section 1842(b)(3)(B)(ii) with respect to the services”. (b) Indemnification.— Section 1879(b) of such Act (42 U.S.C. 1395pp(b)) is amended— (1) in the first sentence, by striking “, subject to the deductible and coinsurance provisions of this title,”, and (2) by adding at the end the following: “No item or service for which an individual is indemnified under this subsection shall be taken into account in applying any limitation on the amount of items and services for which payment may be made to or on behalf of the individual under this title.”. (c) Patient Liability for Hospital Charges During Appeal of Discharge Notice.— 101 STAT. 1330–140 (1) Section 1154(e)(2) of such Act (42 U.S.C. 1320c–3(e)(2)) is amended by adding at the end thereof the following: “If the hospital requests such a review, it shall also notify the patient that the review has been requested.”. (2) Sections 1154(e)(3)(A)(i) (42 U.S.C. 1320c–3(e)(3)(A)(i)) and 1154(e)(3)(B) (42 U.S.C. 1320c–3(e)(3)(B)) of such Act are each amended by inserting “or (2)” after “paragraph (1)”. (d) Effective Date.— The amendments made by this section shall apply to services furnished on or after January 1, 1988.