‘‘(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 Advantage plan but for the 
provisions of a private contract that meets the 
requirements of paragraph (2). 
‘‘(D) MA PLAN; MSA
PLAN.—The terms 
‘MA 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’’; 
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(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. 
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‘‘(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 an MA 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 fol-
lowing: 
‘‘(E) The provisions of section 1848(g)(8) 
shall apply with respect to exemption from limi-
tations on charges and from billing require-
ments for services of health care practitioners 
described in this paragraph in the same manner 
as such provisions apply to exemption from the 
requirements 
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)) is amended by striking ‘‘enrolled with a 
Medicare Advantage organization under part C’’ and in-
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serting ‘‘enrolled with an MA organization under part C 
(other than under an MSA plan)’’. 
(d) EFFECTIVE DATE.—The amendments made by 
this section shall take effect on the date that is 6 months 
after the date of the enactment of this Act and apply to 
contracts entered into on or after that date. 
SEC. 3. ALLOWING INDIVIDUALS TO CHOOSE TO OPT OUT 
OF THE MEDICARE PART A BENEFIT. 
(a) IN GENERAL.—Any individual who is otherwise 
entitled to benefits under part A of title XVIII of the So-
cial Security Act may elect (in such form and manner as 
may be specified by the Secretary of Health and Human 
Services) to waive such entitlement. 
(b) INDIVIDUALS OPTING OUT OF MEDICARE PART 
A ELIGIBLE FOR HEALTH SAVINGS ACCOUNTS.—Section 
223 of the Internal Revenue Code of 1986 is amended— 
(1) in subsection (b), by striking paragraph (7), 
and 
(2) in subsection (d)(2)(C)(iv), by inserting 
‘‘and who has not waived the rights to benefits 
under part A of title XVIII of such Act’’ after ‘‘So-
cial Security Act’’. 
Æ 
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