Summary: H.R.5748 — 102nd Congress (1991-1992)All Information (Except Text)

Bill summaries are authored by CRS.

Shown Here:
Reported to House amended, Part I (10/08/1992)

Miscellaneous Medicare Amendments Act of 1992 - Title I: Provisions Relating to Part B - Subtitle A: Payment for Physicians' Services - Amends part B (Supplementary Medical Insurance) of title XVIII (Medicare) of the Social Security Act to permit separate payment for interpretation of electrocardiograms.

Repeals provisions with respect to payment for services by new physicians and health care practitioners.

Prohibits the Secretary of Health and Human Services (HHS) from changing the part B payment methodology for anesthesia services insofar as such methodology provides for the use of actual time units in determining payments for anesthesia services.

Revises the prohibition on excess physician charges for unassigned claims to require a refund of excess charges, and to extend the application of such prohibition to physician services furnished by any person. Adds provisions respecting mandatory assignment with respect to certain practitioners.

Requires the Secretary to consult with representatives of physicians in reviewing geographic adjustment factors.

Provides for the use of the most recent data available in the establishment of geographic indices. Limits the use of carrier user fees. Revises provisions for certain substitute billing arrangements.

Requires an HHS study and report to the Congress with respect to: (1) payment under part B for certain medical physicist services; and (2) adjustments to physician fee schedules under such part to take into account practice-related taxes.

Requires the Physician Payment Review Commission to study and report to the Congress on physician responses to changes in payments under the Medicare Fee Schedule compared to those in payments under the radiology services fee schedule.

Subtitle B: Payment for Other Items and Services - Modifies the prohibition against distribution of medical necessity certificates by suppliers of covered items to create an exception to such prohibition for certain patient information. Provides for the treatment of nebulizers and aspirators as miscellaneous items of durable medical equipment.

Amends the Omnibus Budget Reconciliation Act of 1990 to extend the payment limit on intraocular lenses.

Provides for the treatment under Medicare of certain indian health programs and facilities as federally-qualified health centers.

Amends the Omnibus Budget Reconciliation Act of 1987 to extend a Medicare influenza vaccination demonstration project.

Title II: Provisions Relating to Parts A and B - Subtitle A: Miscellaneous Provisions - Amends the Medicare program to revise provisions: (1) for payments for graduate medical education (GME) to promote primary care services; and (2) Medicare secondary payor denials.

Requires the Secretary to study and report to the Congress on Medicare GME payments.

Provides for adjustments in Medicare capitation payments to account for regional variations in application of Medicare secondary payor provisions.

Repeals pro precertification requirements for certain surgical procedures.

Requires the Secretary of HHS (Secretary) to establish and implement a method for obtaining information to determine whether Medicare beneficiaries qualify for Medicaid payment of Medicare out-of-pocket expenses, and for transmitting such information to the State in which such a qualified Medicare beneficiary resides.

Authorizes a demonstration project for the provision of durable medical equipment by a physician-owned oncology facility.

Subtitle B: Provisions Relating to Medicare Supplemental Insurance Policies - Amends the Omnibus Budget Reconciliation Act of 1990 and the Medicare program to revise standards and requirements relating to Medicare supplemental insurance policies, with changes prohibiting duplication of coverage and requiring the Secretary to establish a toll-free number for information on medicare supplemental policies.