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(b) 
TERMINOLOGY
CORRECTIONS.—(1) 
Section
1869(c)(3)(I)(ii) (42 U.S.C. 1395ff(c)(3)(I)(ii)), as
amended by section 521 of BIPA, is amended—
(A) in subclause (III), by striking ‘‘policy’’ and
inserting ‘‘determination’’; and
(B) in subclause (IV), by striking ‘‘medical re-
view policies’’ and inserting ‘‘coverage determina-
tions’’.
(2) Section 1852(a)(2)(C) (42 U.S.C. 1395w–
22(a)(2)(C)) is amended by striking ‘‘policy’’ and ‘‘POL-
ICY’’ and inserting ‘‘determination’’ each place it appears
and ‘‘DETERMINATION’’, respectively.
(c) REFERENCE CORRECTIONS.—Section 1869(f)(4)
(42 U.S.C. 1395ff(f)(4)), as added by section 522 of
BIPA, is amended—
(1) in subparagraph (A)(iv), by striking ‘‘sub-
clause (I), (II), or (III)’’ and inserting ‘‘clause (i),
(ii), or (iii)’’;
(2) in subparagraph (B), by striking ‘‘clause
(i)(IV)’’ and ‘‘clause (i)(III)’’ and inserting ‘‘sub-
paragraph (A)(iv)’’ and ‘‘subparagraph (A)(iii)’’, re-
spectively; and
(3) in subparagraph (C), by striking ‘‘clause
(i)’’, ‘‘subclause (IV)’’ and ‘‘subparagraph (A)’’ and
inserting ‘‘subparagraph (A)’’, ‘‘clause (iv)’’ and
141
‘‘paragraph (1)(A)’’, respectively each place it ap-
pears.
(d) OTHER CORRECTIONS.—Effective as if included
in the enactment of section 521(c) of BIPA, section
1154(e) (42 U.S.C. 1320c–3(e)) is amended by striking
paragraph (5).
(e) EFFECTIVE DATE.—Except as otherwise pro-
vided, the amendments made by this section shall be effec-
tive as if included in the enactment of BIPA.
SEC. 510. CONFORMING AUTHORITY TO WAIVE A PROGRAM
EXCLUSION.
The first sentence of section 1128(c)(3)(B) (42
U.S.C. 1320a–7(c)(3)(B)) is amended to read as follows:
‘‘Subject to subparagraph (G), in the case of an exclusion
under subsection (a), the minimum period of exclusion
shall be not less than five years, except that, upon the
request of the administrator of a Federal health care pro-
gram (as defined in section 1128B(f)) who determines
that the exclusion would impose a hardship on individuals
entitled to benefits under part A of title XVIII or enrolled
under part B of such title, or both, the Secretary may
waive the exclusion under subsection (a)(1), (a)(3), or
(a)(4) with respect to that program in the case of an indi-
vidual or entity that is the sole community physician or
142
sole source of essential specialized services in a commu-
nity.’’.
SEC. 511. TREATMENT OF CERTAIN DENTAL CLAIMS.
(a) IN GENERAL.—Section 1862 (42 U.S.C. 1395y)
is amended by inserting after subsection (c) the following
new subsection:
‘‘(d)(1) Subject to paragraph (2), a group health plan
(as defined in subsection (a)(1)(A)(v)) providing supple-
mental or secondary coverage to individuals also entitled
to services under this title shall not require a medicare
claims determination under this title for dental benefits
specifically excluded under subsection (a)(12) as a condi-
tion of making a claims determination for such benefits
under the group health plan.
‘‘(2) A group health plan may require a claims deter-
mination under this title in cases involving or appearing
to involve inpatient dental hospital services or dental serv-
ices expressly covered under this title pursuant to actions
taken by the Secretary.’’.
(b) EFFECTIVE DATE.—The amendment made by
subsection (a) shall take effect on the date that is 60 days
after the date of the enactment of this Act.
143
SEC. 512. MISCELLANEOUS REPORTS, STUDIES, AND PUBLI-
CATION REQUIREMENTS.
(a) GAO REPORTS ON THE PHYSICIAN COMPENSA-
TION.—
(1) SUSTAINABLE
GROWTH
RATE
AND
UP-
DATES.—Not later than 6 months after the date of
the enactment of this Act, the Comptroller General
of the United States shall submit to Congress a re-
port on the appropriateness of the updates in the
conversion factor under subsection (d)(3) of section
1848 of the Social Security Act (42 U.S.C. 1395w–
4), including the appropriateness of the sustainable
growth rate formula under subsection (f) of such
section for 2002 and succeeding years. Such report
shall examine the stability and predictability of such
updates and rate and alternatives for the use of such
rate in the updates.
(2) PHYSICIAN COMPENSATION GENERALLY.—
Not later than 12 months after the date of the en-
actment of this Act, the Comptroller General shall
submit to Congress a report on all aspects of physi-
cian compensation for services furnished under title
XVIII of the Social Security Act, and how those as-
pects interact and the effect on appropriate com-
pensation for physician services. Such report shall
review alternatives for the physician fee schedule
144
under section 1848 of such title (42 U.S.C. 1395w–
4).
(b) PROMPT SUBMISSION OF OVERDUE REPORTS ON
PAYMENT AND UTILIZATION OF OUTPATIENT THERAPY
SERVICES.—The Secretary shall submit to Congress as ex-
peditiously as practicable the reports required under sec-
tion 4541(d)(2) of the Balanced Budget Act of 1997 (re-
lating to alternatives to a single annual dollar cap on out-
patient therapy) and under section 221(d) of the Medi-
care, Medicaid, and SCHIP Balanced Budget Refinement
Act of 1999 (relating to utilization patterns for outpatient
therapy).
(c) ANNUAL PUBLICATION OF LIST OF NATIONAL
COVERAGE DETERMINATIONS.—The Secretary shall pro-
vide, in an appropriate annual publication available to the
public, a list of national coverage determinations made
under title XVIII of the Social Security Act in the pre-
vious year and information on how to get more informa-
tion with respect to such determinations.
Æ