A or B, under a contract under section 1876, 
or under a MA plan (other than an MSA plan). 
‘‘(C) SCOPE OF SERVICES.—The contract 
identifies the medicare covered professional 
services and the period (if any) to be covered 
under the contract, but does not cover any serv-
ices furnished—
‘‘(i) before the contract is entered 
into; or 
‘‘(ii) for the treatment of an emer-
gency medical condition (as defined in sec-
tion 1867(e)(1)(A)), unless the contract 
was entered into before the onset of the 
emergency medical condition. 
‘‘(D) CLEAR DISCLOSURE OF TERMS.—The 
contract clearly indicates that by signing the 
contract the medicare beneficiary—
‘‘(i) agrees not to submit a claim (or 
to request that anyone submit a claim) 
under part A or B (or under section 1876 
or under a MA plan, other than an MSA 
plan) for services covered under the con-
tract; 
‘‘(ii) agrees to be responsible, whether 
through insurance or otherwise, for pay-
ment for such services and understands 
that no reimbursement will be provided 
under such part, contract, or plan for such 
services; 
‘‘(iii) acknowledges that no limits 
under this title (including limits under 
paragraph (1) and (3) of section 1848(g)) 
will apply to amounts that may be charged 
for such services; 
‘‘(iv) acknowledges that medicare sup-
plemental policies under section 1882 do 
not, and other supplemental health plans 
and policies may elect not to, make pay-
ments for such services because payment is 
not made under this title; and 
‘‘(v) acknowledges that the beneficiary 
has the right to have such services pro-
vided by (or under the supervision of) 
other physicians or health care practi-
tioners for whom payment would be made 
under such part, contract, or plan. 
Such contract shall also clearly indicate whether 
the physician or practitioner involved is ex-
cluded from participation under this title.
‘‘(3) MODIFICATIONS.—The parties to a private 
contract may mutually agree at any time to modify 
or terminate the contract on a prospective basis, 
consistent with the provisions of paragraphs (1) and 
(2). 
‘‘(4) NO REQUIREMENTS FOR SERVICES FUR-
NISHED TO MSA PLAN ENROLLEES.—The require-
ments of paragraphs (1) and (2) do not apply to any 
contract or arrangement for the provision of services 
to a medicare beneficiary enrolled in an MA plan 
under part C. 
‘‘(5) DEFINITIONS.—In this subsection:
‘‘(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) 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’’; 
(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