42 USC 1320a-3a - Disclosure requirements for other providers under part B of Medicare

U.S Code last checked for updates: Nov 22, 2024

§ 1320a–3a.

Disclosure requirements for other providers under part B of Medicare

(a)

Disclosure required to receive payment

No payment may be made under part B of subchapter XVIII for items or services furnished by any disclosing part B provider unless such provider has provided the Secretary with full and complete information—

(1)

on the identity of each person with an ownership or control interest in the provider or in any subcontractor (as defined by the Secretary in regulations) in which the provider directly or indirectly has a 5 percent or more ownership interest;

(2)

with respect to any person identified under paragraph (1) or any managing employee of the provider—

(A)

on the identity of any other entities providing items or services for which payment may be made under subchapter XVIII with respect to which such person or managing employee is a person with an ownership or control interest at the time such information is supplied or at any time during the 3-year period ending on the date such information is supplied, and

(B)

as to whether any penalties, assessments, or exclusions have been assessed against such person or managing employee under section 1320a–7, 1320a–7a, or 1320a–7b of this title; and

(3)

including the employer identification number (assigned pursuant to section 6109 of the Internal Revenue Code of 1986) and social security account number (assigned under section 405(c)(2)(B) of this title) of the disclosing part B provider and any person, managing employee, or other entity identified or described under paragraph (1) or (2).

(b)

Updates to information supplied

(c)

Verification

(1)

Transmittal by HHS

The Secretary shall transmit—

(A)

to the Commissioner of Social Security information concerning each social security account number (assigned under section 405(c)(2)(B) of this title), and

(B)

to the Secretary of the Treasury information concerning each employer identification number (assigned pursuant to section 6109 of the Internal Revenue Code of 1986),

supplied to the Secretary pursuant to subsection (a)(3) or section 1320a–3(c) 1

 See References in Text note below.

of this title to the extent necessary for verification of such information in accordance with paragraph (2).

(2)

Verification

(3)

Fees for verification

(d)

Definitions

For purposes of this section—

(1)

the term “disclosing part B provider” means any entity receiving payment on an assignment-related basis (or, for purposes of subsection (a)(3), any entity receiving payment) for furnishing items or services for which payment may be made under part B of subchapter XVIII, except that such term does not include an entity described in section 1320a–3(a)(2) of this title;

(2)

the term “managing employee” means, with respect to a provider, a person described in section 1320a–5(b) of this title; and

(3)

the term “person with an ownership or control interest” means, with respect to a provider—

(A)

a person described in section 1320a–3(a)(3) of this title, or

(B)

a person who has one of the 5 largest direct or indirect ownership or control interests in the provider.

(Aug. 14, 1935, ch. 531, title XI, § 1124A, as added Pub. L. 101–508, title IV, § 4164(b)(1), Nov. 5, 1990, 104 Stat. 1388–101; amended Pub. L. 103–432, title I, § 147(f)(7)(A)(i), Oct. 31, 1994, 108 Stat. 4432; Pub. L. 105–33, title IV, § 4313(b), (c), Aug. 5, 1997, 111 Stat. 388.)

cite as: 42 USC 1320a-3a