‘‘(A) HEALTH CARE PRACTITIONER.—The
term ‘health care practitioner’ means a practi-
tioner described in section 1842(b)(18)(C).
‘‘(B) MEDICARE BENEFICIARY.—The term
‘medicare beneficiary’ means an individual who
is enrolled under part B.
‘‘(C) MEDICARE COVERED PROFESSIONAL
SERVICES.—The term ‘medicare covered profes-
sional services’ means—
‘‘(i) physicians’ services (as defined in
section 1861(q), and including services de-
scribed in section 1861(s)(2)(A)), and
‘‘(ii) professional services of health
care practitioners, including services de-
scribed in section 1842(b)(18)(D),
for which payment may be made under part A
or B, under a contract under section 1876, or
under a Medicare+Choice plan but for the pro-
visions of a private contract that meets the re-
quirements of paragraph (2).
‘‘(D) 
MEDICARE+CHOICE
PLAN; 
MSA
PLAN.—The terms ‘Medicare+Choice plan’ and
‘MSA plan’ have the meanings given such terms
in section 1859.
‘‘(E) PHYSICIAN.—The term ‘physician’
has the meaning given such term in section
1861(r).’’.
(b) CONFORMING AMENDMENTS CLARIFYING EX-
EMPTION FROM LIMITING CHARGE AND FROM REQUIRE-
MENT FOR SUBMISSION OF CLAIMS.—Section 1848(g) of
the Social Security Act (42 U.S.C. 1395w–4(g)) is amend-
ed—
(1) in paragraph (1)(A), by striking ‘‘In’’ and
inserting ‘‘Subject to paragraph (8), in’’;
(2) in paragraph (3)(A), by striking ‘‘Payment’’
and inserting ‘‘Subject to paragraph (8), payment’’;
(3) in paragraph (4)(A), by striking ‘‘For’’ and
inserting ‘‘Subject to paragraph (8), for’’; and
(4) by adding at the end the following new
paragraph:
‘‘(8) EXEMPTION
FROM
REQUIREMENTS
FOR
SERVICES
FURNISHED
UNDER
PRIVATE
CON-
TRACTS.—
‘‘(A) IN
GENERAL.—Pursuant to section
1802(b)(1), paragraphs (1), (3), and (4) do not
apply with respect to physicians’ services (and
services described in section 1861(s)(2)(A)) fur-
nished to an individual by (or under the super-
vision of) a physician if the conditions described
in section 1802(b)(1) are met with respect to
the services.
‘‘(B) NO RESTRICTIONS FOR ENROLLEES
IN MSA PLANS.—Such paragraphs do not apply
with respect to services furnished to individuals
enrolled with MSA plans under part C, without
regard to whether the conditions described in
subparagraphs (A) through (C) of section
1802(b)(1) are met.
‘‘(C) APPLICATION
TO
ENROLLEES
IN
OTHER PLANS.—Subject to subparagraph (B)
and section 1852(k)(2), the provisions of sub-
paragraph (A) shall apply in the case of an in-
dividual enrolled under a contract under section
1876 or under a Medicare+Choice plan (other
than an MSA plan) under part C, in the same
manner as they apply to individuals not enrolled
under such a contract or plan.’’.
(c) CONFORMING AMENDMENTS.—
(1) Section 1842(b)(18) of the Social Security
Act (42 U.S.C. 1395u(b)(18)) is amended by adding
at the end the following:
‘‘(E) The provisions of section 1848(g)(8) shall apply
with respect to exemption from limitations on charges and
from billing requirements for services of health care prac-
titioners described in this paragraph in the same manner
as such provisions apply to exemption from the require-
ments referred to in section 1848(g)(8)(A) for physicians’
services.’’.
(2) Section 1866(a)(1)(O) of such Act (42
U.S.C. 1395cc(a)(1)(O)), as amended by section
4002(e) of the Balanced Budget Act of 1997, is
amended by inserting ‘‘(other than under an MSA
plan)’’ after ‘‘Medicare+Choice organization under
part C’’.
(3) Section 4507(b) of the Balanced Budget
Act of 1997 (Public Law 105–33; 111 Stat. 441) is
amended—
(A) in the matter before paragraph (1), by
striking ‘‘on the program under this title of pri-
vate contracts entered into under the amend-
ment made by subsection (a)’’ and inserting
‘‘on title XVIII of the Social Security Act of
private 
contracts 
permitted 
under 
section
1802(b) of such Act’’; and
(B) in paragraph (2), by striking ‘‘section
1802(b) of such Act (as added by subsection
(a))’’ and inserting ‘‘such section’’.
(d) EFFECTIVE DATE.—The amendments made by
this section shall be effective as if included in the enact-
ment of section 4507 of the Balanced Budget Act of 1997.
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