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Bill - HR3200

This Document was obtained from The Library of Congress Thomas System as of July 14th, 2009

SEC. 1633. REQUIRED INCLUSION OF PAYMENT MODIFIER FOR CERTAIN EVALUATION AND MANAGEMENT SERVICES.

Section- 1848 of the Social Security Act [42 U.S.C. 1395w-4], as amended by section 4101 of the HITECH Act [Public Law 111-5], is amended by adding at the end the following new subsection:

'[p] Payment Modifier for Certain Evaluation and Management Services- The Secretary shall establish a payment modifier under the fee schedule under this section for evaluation and management services [as specified in section 1842[b][16][B][ii]] that result in the ordering of additional services [such as lab tests], the prescription of drugs, the furnishing or ordering of durable medical equipment in order to enable better monitoring of claims for payment for such additional services under this title, or the ordering, furnishing, or prescribing of other items and services determined by the Secretary to pose a high risk of waste, fraud, and abuse. The Secretary may require providers of services or suppliers to report such modifier in claims submitted for payment.'.

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