ceiling for payments to physicians under champus

ceiling for payments to physicians under champus Sec. 806. (a)(1) Section 1079 of title 10, United States Code, is amended by adding at the end thereof the following new subsection: “(h) Payment of a charge for physician services for which a claim is submitted under a plan contracted for under subsection (a) may be denied because the charge is in excess of a predetermined charge level based upon customary charges made for similar services in the same locality only to the extent that such charge is in excess of the charge level that, on the basis of statistical data and methodology acceptable to the Secretary of Defense, in consultation with the Secretary of Health, Education, and Welfare, is equivalent to the 90th percentile of the customary charges made for similar services in the same locality during the last preceding calendar year elapsing before the start of the twelve-month period (beginning July 1 of each year) in which the claim for the payment is submitted.”. (2) Section 1086 of such title is amended by adding at the end thereof the following new subsection: “(f) The provisions of section 1079(h) of this title shall apply to payments for physician services under a plan contracted for under subsection (a).”. (b) The amendments made by subsection (a) shall apply with respect to claims submitted for payment for services provided on or after the first day of the first calendar year beginning after the date of enactment of this Act.