§ 1395vv. Withholding payments from certain medicaid providers

Legislative history

Reconstructed from this section’s Code source credit and amendment notes, resolved against the local Statutes at Large. Editorial notes are evidence, not the law that made the change.

1. 1981

   Medicare and Medicaid Amendments of 1981

   Pub. L. 97–35 title XXI § 2104 · 95 Stat. 357

   Enacted · 42 U.S.C. § 1395vv

   (Aug. 14, 1935, ch. 531, title XVIII, § 1885, as added Pub. L. 97–35, title XXI, § 2104, Aug. 13, 1981, 95 Stat. 788.)

   Source evidence

   Code source credit
   (Aug. 14, 1935, ch. 531, title XVIII, § 1885, as added Pub. L. 97–35, title XXI, § 2104, Aug. 13, 1981, 95 Stat. 788.)

   Enacted provision · exact public law section
   Sec. 2104. withholding of payments for certain medicaid providers Part C of title XVIII of the Social Security Act is amended by adding after section 1884 (added by section 2101 of this subtitle) the following new section: “Sec. 1885. “withholding of payments for certain medicaid providers (a) The Secretary may adjust, in accordance with this section, payments under parts A and B to any institution which has in effect an agreement with the Secretary under section 1866, and any person who has accepted payment on the basis of an assignment 42 USC 1395u. under section 1842(b)(3)(B)(ii), where such institution or person— “(1) has (or previously had) in effect an agreement with a State agency to furnish medical care and services under a State plan 42 USC 1396. approved under title XIX, and “(2) from which (or from whom) such State agency (A) has been unable to recover overpayments made under the State plan, or (B) has been unable to collect the information necessary to enable it to determine the amount (if any) of the overpayments made to such institution or person under the State plan. “(b) The Secretary shall by regulation provide procedures for implementation of this section, which procedures shall— “(1) assure that the authority under this section is exercised only on behalf of a State agency which demonstrates to the Secretary’s satisfaction that it has provided adequate notice of a determination or of a need for information, and an opportunity to appeal such determination or to provide such information, “(2) determine the amount of the payment to which the institution or person would otherwise be entitled under this title which shall be treated as a setoff against overpayments under title XIX, and “(3) assure the restoration to the institution or person of amounts withheld under this section which are ultimately determined to be in excess of overpayments under title XIX and to which the institution or person would otherwise be entitled under this title. “(c) Notwithstanding any other provision of this Act, from the trust 42 USC 1395i, 1395t. funds established under sections 1817 and 1841, as appropriate, the Secretary shall pay to the appropriate State agency amounts recovered under this section to offset the State agency’s overpayment under title XIX. Such payments shall be accounted for by the State agency as recoveries of overpayments under the State plan.”.

1 of 1 references resolved to an enrolled provision