42 U.S.C. § 1395zz : US Code - Section 1395ZZ: Provider education and technical assistance

Search 42 U.S.C. § 1395zz : US Code - Section 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)
of this section, 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 of this chapter
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) (!1) 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 of this chapter
with respect to such activities and such provider of services or
supplier.