section 413(b) has a reasonable belief that there 
may be a large opacity in the upper lungs that has 
been obscured by bony structures. 
‘‘(c) CONDITIONS
FOR SUPPLEMENTAL MEDICAL 
EVIDENCE.—The Secretary shall develop supplemental 
medical evidence, in accordance with subsection (d)— 
‘‘(1) for any claim in which the Secretary rec-
ommends an award of benefits based on the results 
of the initial report under subsection (a)(1) and a 
party opposing such award submits evidence that 
could be considered contrary to the findings of the 
Secretary; and 
‘‘(2) for any compensation case under this title 
heard by an administrative law judge, in which— 
‘‘(A) the Secretary has awarded benefits to 
the claimant; 
‘‘(B) the party opposing such award has 
submitted evidence not previously reviewed that 
could be considered contrary to the award 
under subparagraph (A); and 
‘‘(C) the claimant or, if the claimant is 
represented by an attorney, the claimant’s at-
torney consents to the Secretary developing 
supplemental medical evidence. 
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‘‘(d) PROCESS FOR SUPPLEMENTAL MEDICAL EVI-
DENCE.— 
‘‘(1) IN GENERAL.—Except as provided under 
paragraph (2), to develop supplemental medical evi-
dence under conditions described in subsection (c), 
the Secretary shall request the physician who con-
ducted the initial report under subsection (a)(1) 
to— 
‘‘(A) review any medical evidence sub-
mitted after such report or the most recent sup-
plemental report, as appropriate; and 
‘‘(B) update his or her opinion in a supple-
mental report. 
‘‘(2) ALTERNATIVE PHYSICIAN.—If such physi-
cian is no longer available or is unwilling to provide 
supplemental medical evidence under paragraph (1), 
the Secretary shall select another qualified physician 
to provide such evidence. 
‘‘(e) QUALIFIED PHYSICIANS FOR COMPLETE PUL-
MONARY EVALUATION
AND PROTECTIONS
FOR SUIT-
ABILITY AND POTENTIAL CONFLICTS OF INTEREST.— 
‘‘(1) QUALIFIED PHYSICIANS LIST.—The Sec-
retary shall create and maintain a list of qualified 
physicians to be selected by a claimant to perform 
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the complete pulmonary evaluation described in sub-
section (a). 
‘‘(2) PUBLIC
AVAILABILITY.—The Secretary 
shall make the list under this subsection available to 
the public. 
‘‘(3) ANNUAL
EVALUATION.—Each year, the 
Secretary shall update such list by reviewing the 
suitability of the listed qualified physicians and as-
sessing any potential conflicts of interest. 
‘‘(4) CRITERIA
FOR
SUITABILITY.—In deter-
mining whether a physician is suitable to be on the 
list under this subsection, the Secretary shall consult 
the National Practitioner Data Bank of the Depart-
ment of Health and Human Services and assess re-
ports of adverse licensure, certifications, hospital 
privilege, and professional society actions involving 
the physician. In no case shall such list include any 
physician— 
‘‘(A) who is not licensed to practice medi-
cine in any State or any territory, common-
wealth, or possession of the United States; 
‘‘(B) whose license is revoked by a medical 
licensing board of any State, territory, common-
wealth, or possession of the United States; or 
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‘‘(C) whose license is suspended by a med-
ical licensing board of any State, territory, com-
monwealth, or possession of the United States. 
‘‘(5) CONFLICTS OF INTEREST.—The Secretary 
shall develop and implement policies and procedures 
to ensure that any actual or potential conflict of in-
terest of qualified physicians on the list under this 
subsection, including both individual and organiza-
tional conflicts of interest, are disclosed to the De-
partment, and to provide such disclosure to claim-
ants. Such policies and procedures shall provide 
that, unless the claimant knowingly and with the 
benefit of full disclosure waives the following limita-
tions, a physician shall not be used to perform a 
complete pulmonary medical evaluation under sub-
section (a) that is reimbursed pursuant to subsection 
(g), if— 
‘‘(A) such physician is employed by, under 
contract to, or otherwise providing services to a 
private party opposing the claim, a law firm or 
lawyer representing such opposing party, or an 
interested insurer or other interested third 
party; or 
‘‘(B) such physician has been retained by 
a private party opposing the claim, a law firm 
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or lawyer representing such opposing party, or 
an interested insurer or other interested third 
party in the previous 24 months. 
‘‘(f) RECORD.—Upon receipt of any initial report or 
supplemental report under this section, the Secretary shall 
enter the report in the record and provide a copy of such 
report to all parties to the proceeding. 
‘‘(g) EXPENSES.—All expenses related to obtaining 
the medical evidence under this section shall be paid for 
by the fund. If a claimant receives a final award of bene-
fits, the operator liable for payment of benefits, if any, 
shall reimburse the fund for such expenses, which shall 
include interest.’’. 
SEC. 109. ESTABLISHMENT OF PILOT PROGRAM TO PRO-
VIDE 
IMPARTIAL 
CLASSIFICATIONS 
OF 
CHEST RADIOGRAPHS. 
(a) ESTABLISHMENT.—Part C of the Black Lung 
Benefits Act (30 U.S.C. 931 et seq.), as amended by sec-
tion 108, is further amended by adding at the end the 
following: 
‘‘SEC. 436. ESTABLISHMENT OF PILOT PROGRAM TO PRO-
VIDE 
IMPARTIAL 
CLASSIFICATIONS 
OF 
CHEST RADIOGRAPHS. 
‘‘(a) DEFINITIONS.—In this section: 
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