42 USC 1395zz - Provider education and technical assistance

United States Code

USC most recently checked for updates: Sep 09, 2024

§ 1395yy. Payment to skilled nursing facilities for routine service costs

§ 1395aaa. Contract with a consensus-based entity regarding performance measurement

U.S. Code
Notes

§ 1395zz.

Provider education and technical assistance

(a)

Coordination of education funding

The Secretary shall coordinate the educational activities provided through medicare contractors (as defined in subsection (g), including under section 1395ddd of this title) in order to maximize the effectiveness of Federal education efforts for providers of services and suppliers.

(b)

Enhanced education and training

(1)

Additional resources

There are authorized to be appropriated to the Secretary (in appropriate part from the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund) such sums as may be necessary for fiscal years beginning with fiscal year 2005.

(2)

Use

The funds made available under paragraph (1) shall be used to increase the conduct by medicare contractors of education and training of providers of services and suppliers regarding billing, coding, and other appropriate items and may also be used to improve the accuracy, consistency, and timeliness of contractor responses.

(c)

Tailoring education and training activities for small providers or suppliers

(1)

In general

Insofar as a medicare contractor conducts education and training activities, it shall tailor such activities to meet the special needs of small providers of services or suppliers (as defined in paragraph (2)). Such education and training activities for small providers of services and suppliers may include the provision of technical assistance (such as review of billing systems and internal controls to determine program compliance and to suggest more efficient and effective means of achieving such compliance).

(2)

Small provider of services or supplier

In this subsection, the term “small provider of services or supplier” means—

(A)

a provider of services with fewer than 25 full-time-equivalent employees; or

(B)

a supplier with fewer than 10 full-time-equivalent employees.

(d)

Internet websites; FAQs

The Secretary, and each medicare contractor insofar as it provides services (including claims processing) for providers of services or suppliers, shall maintain an Internet website which—

(1)

provides answers in an easily accessible format to frequently asked questions, and

(2)

includes other published materials of the contractor,

that relate to providers of services and suppliers under the programs under this subchapter (and subchapter XI insofar as it relates to such programs).

(e)

Encouragement of participation in education program activities

A medicare contractor may not use a record of attendance at (or failure to attend) educational activities or other information gathered during an educational program conducted under this section or otherwise by the Secretary to select or track providers of services or suppliers for the purpose of conducting any type of audit or prepayment review.

(f)

Construction

Nothing in this section or section 1395ddd(g) of this title shall be construed as providing for disclosure by a medicare contractor—

(1)

of the screens used for identifying claims that will be subject to medical review; or

(2)

of information that would compromise pending law enforcement activities or reveal findings of law enforcement-related audits.

(g)

Definitions

For purposes of this section, the term “medicare contractor” includes the following:

(1)

A medicare administrative contractor with a contract under section 1395kk–1 of this title, including a fiscal intermediary with a contract under section 1395h of this title and a carrier with a contract under section 1395u of this title.

(2)

An eligible entity with a contract under section 1395ddd of this title.

Such term does not include, with respect to activities of a specific provider of services or supplier an entity that has no authority under this subchapter or subchapter IX with respect to such activities and such provider of services or supplier.

(Aug. 14, 1935, ch. 531, title XVIII, § 1889, as added and amended Pub. L. 108–173, title IX, § 921(a)(1), (d)(1), (e)(1), (f)(1), Dec. 8, 2003, 117 Stat. 2388, 2391.)

cite as: 42 USC 1395zz