Pub. L. 116-94, div. N, tit. I, subtit. A, sec. 107 (as amended)

EXTENDING PASS-THROUGH STATUS FOR CERTAIN DRUGS UNDER PART B OF THE MEDICARE PROGRAM.

Year: 2025Length: 250 wordsOfficial source
SEC. 107. EXTENDING PASS-THROUGH STATUS FOR CERTAIN DRUGS UNDER PART B OF THE MEDICARE PROGRAM. (a) In General.—Section 1833(t)(6) of the Social Security Act (42 U.S.C. 1395l(t)(6)) is amended— (1) in subparagraph (E)(i), by striking “2018” and inserting “2018 or 2020”; and (2) by adding at the end the following new subparagraph: “(J) Additional pass-through extension and special payment adjustment rule for certain diagnostic radiopharmaceuticals.—In the case of a drug or biological furnished in the context of a clinical study on diagnostic imaging tests approved under a coverage with evidence development determination whose period of pass-through status under this paragraph concluded on December 31, 2018, and for which payment under this subsection was packaged into a payment for a covered OPD service (or group of services) furnished beginning January 1, 2019, the Secretary shall— “(i) extend such pass-through status for such drug or biological for the 9-month period beginning on January 1, 2020; “(ii) remove, during such period, the packaged costs of such drug or biological (as determined by the Secretary) from the payment amount under this subsection for the covered OPD service (or group of services) with which it is packaged; and “(iii) not make any adjustments to payment amounts under this subsection for a covered OPD service (or group of services) for which no costs were removed under clause (ii).” . (b) Implementation.—Notwithstanding any other provision of law, the Secretary of Health and Human Service may implement the amendments made by subsection (a) by program instruction or otherwise.
Pub. L. 116-94, div. N, tit. I, subtit. A, sec. 107 (as amended): EXTENDING PASS-THROUGH STATUS FOR CERTAIN DRUGS UNDER PART B OF THE MEDICARE PROGRAM. | Justis AI