(I) by striking ‘‘hospital’’ and in-
serting ‘‘provider’’; and
(II) by striking ‘‘inpatient hos-
pital care’’ and inserting ‘‘items or
services furnished’’;
(v) in paragraph (2)(B) by striking
‘‘hospital’s’’ and inserting ‘‘provider’s’’;
(vi) in the matter following subpara-
graph (B) of paragraph (2)—
(I) by striking ‘‘hospital’’ each
place it appears and inserting ‘‘pro-
vider’’; and
(II) by striking ‘‘hospital’s’’ and
inserting ‘‘provider’s’’;
(vii) in paragraph (3)(A), in the mat-
ter 
following 
clause 
(ii) 
of 
such
paragraph—
(I) by striking ‘‘hospital’s’’ and
inserting ‘‘provider’s’’;
(II) by striking ‘‘the hospital’’
each place it appears and inserting
‘‘the provider’’; and
(III) by striking ‘‘continued hos-
pital care’’ and inserting ‘‘continued
care’’;
(viii) in paragraph (3)(B)—
(I) in the matter preceding clause
(i), by striking ‘‘an inpatient in the
hospital’’ and inserting ‘‘a patient
being furnished items or services by
the provider’’; and
(II) in clause (i), by striking
‘‘hospital’’ and inserting ‘‘provider’’;
and
(ix) in paragraph (4)—
(I) by striking ‘‘the hospital’’ and
inserting ‘‘the provider’’; and
(II) by striking ‘‘inpatient hos-
pital services’’ and inserting ‘‘items or
services’’.
(C) CONDITION
OF
PARTICIPATION
FOR
ALL
PROVIDERS, 
SUPPLIERS, 
AND
MEDICARE+CHOICE
ORGANIZATIONS.—Section
1886(a) of the Social Security Act (42 U.S.C.
1395ww(a)) is amended—
(i) in paragraph (1)(F)(ii), by striking
‘‘and home health agencies,’’ and ‘‘or agen-
cy’’ and inserting ‘‘home health agencies,
other provider of services, suppliers, and
Medicare+Choice organizations offering
Medicare+Choice plans under part ’’ and
‘‘agency, other provider of services, sup-
plier, or Medicare+Choice organization’’,
respectively; and
(ii) in paragraph (3), by striking ‘‘or
agency’’ each place it appears and insert-
ing ‘‘agency, other provider of services,
supplier, or Medicare+Choice organiza-
tion’’.
(D) CONDUCT
OF
PROVIDER
AND
SUP-
PLIER PROFILING.—Section 1154(a) of the So-
cial Security Act (42 U.S.C. 1320c–3(a)) is
amended by adding at the end the following
new paragraph:
‘‘(17) The organization shall monitor and pro-
file billing patterns of providers of services within
each area or locality and provide comparative data
to providers of services whose utilization patterns
vary significantly from other providers of services in
the same payment area or locality.’’.
(2) PROHIBITION ON CONDUCT OF FRAUD AND
ABUSE
INVESTIGATIONS.—Section 1154(a) of the
Social Security Act (42 U.S.C. 1320c–3(a)) is
amended by inserting after paragraph (11) the fol-
lowing new paragraph:
‘‘(12) The organization shall not conduct activi-
ties that the Secretary, acting through the Office of
the Inspector General of the Department of Health
and Human Services, and the Attorney General con-
duct under sections 1128C, 1128D, or 1128E with
respective to the program to control fraud and abuse
established and carried out under those sections and
under the Medicare Integrity Program under section
1893.’’.
(3) AUTHORIZING THE SECRETARY TO APPROVE
CONTRACT OBJECTIVES.—(A) Section 1153(c)(7) of
the Social Security Act (42 U.S.C. 1320c–2(c)(7)) is
amended—
(i) by striking ‘‘shall’’ and inserting
‘‘may’’; and
(ii) by striking ‘‘negotiated’’ each place it
appears.
(B) Section 1154(a)(4)(A) of such Act (42
U.S.C. 1320c–3(a)(4)(A)) is amended by striking
‘‘after consultation with the Secretary’’ and insert-
ing ‘‘upon approval of the Secretary’’.
(4) CLARIFYING THE AUTHORITY OF THE SEC-
RETARY TO REQUIRE ORGANIZATIONS TO CONSIDER
CERTAIN
CRITERIA
AND
CASES.—Section
1154(a)(4)(A) of the Social Security Act (42 U.S.C.
1320c–3(a)(4)(A)), 
as 
amended 
by 
paragraph
(3)(B), is further amended by inserting after the
first sentence the following: ‘‘IN carrying out the
previous sentence, the organization shall consider
types and kinds of cases and shall apply such guide-
lines as the Secretary determines appropriate, in-
cluding national, professionally-developed standards
of care.’’.
(5) ELIMINATION OF REQUIREMENT FOR MAN-
DATORY PRIOR APPROVAL FOR USE OF ASSISTANT
AT
CATARACT
SURGERY.—Section 1862(a)(15) of
the Social Security Act (42 U.S.C. 1395y(a)(15)) is
amended by striking ‘‘(A) which are for’’ and all
that follows through ‘‘(B) which are for’’ and insert-
ing ‘‘which are for’’.
(6) ELIMINATION
OF
ON
SITE
REVIEW
RE-
QUIREMENT.—Section 1154(a) of the Social Security
Act (42 U.S.C. 1320c–3(a)) is amended by striking
paragraph (15).
(7) CLARIFYING THE AUTHORITY OF THE SEC-
RETARY TO DECLINE TO RENEW A CONTRACT WITH
AN ORGANIZATION FOR REASONS OTHER THAN POOR
PERFORMANCE.—Section 1153(c)(4) of the Social
Security Act (42 U.S.C. 1320c–2(c)(4)) is amended
by inserting ‘‘on the basis of the organization’s per-
formance or of any other criteria the Secretary de-
termines appropriate’’ after ‘‘if the Secretary intends
not to renew a contract’’.
(8) ELIMINATION OF DUPLICATIVE REPORTING
REQUIREMENT.—Title XI of the Social Security Act
(42 U.S.C. 1301 et seq.) is amended by striking sec-
tion 1161.
(9) EFFECTIVE DATE.—The amendments made
by this subsection take effect the date of the enact-
ment of this Act and apply to contracts entered into
or renewed on or after that date.
Æ