ADMINISTRATION OF CLAIMS RELATING TO PHYSICIANS’ SERVICES.

SEC. 125. ADMINISTRATION OF CLAIMS RELATING TO PHYSICIANS’ SERVICES. (a) Limitation on Carrier User Fees.— Section 1842(c) (42 U.S.C. 1395u(c)) is amended by adding at the end the following new paragraph: “(4) Neither a carrier nor the Secretary may impose a fee under this title— “(A) for the filing of claims related to physicians’ services, “(B) for an error in filing a claim relating to physicians’ services or for such a claim which is denied, “(C) for any appeal under this title with respect to physicians’ services, “(D) for applying for (or obtaining) a unique identifier under subsection (r), or “(E) for responding to inquiries respecting physicians’ services or for providing information with respect to medical review of such services.”. (b) Clarification of Permissible Substitute Billing Arrangements.— (1) In general.— Clause (D) of section 1842(b)(6) (42 U.S.C. 1395u(b)(6)) is amended to read as follows: “(D) payment may be made to a physician for physicians’ services (and services108 STAT. 4414 furnished incident to such services) furnished by a second physician to patients of the first physician if (i) the first physician is unavailable to provide the services; (ii) the services are furnished pursuant to an arrangement between the two physicians that (I) is informal and reciprocal, or (II) involves per diem or other fee-for-time compensation for such services; (iii) the services are not provided by the second physician over a continuous period of more than 60 days; and (iv) the claim form submitted to the carrier for such services includes the second physician’s unique identifier (provided under the system established under subsection (r)) and indicates that the claim meets the requirements of this subparagraph for payment to the first physician”. (2) Effective date.— The amendment made by paragraph (1) shall apply to services furnished on or after the first day of the first month beginning more than 60 days after the date of the enactment of this Act.