BALANCED BUDGET ACT OF 1997
MEDICARE AND MEDICAID PROVISIONS
SUBTITLE D--ANTI-FRAUD AND ABUSE PROVISIONS AND
IMPROVEMENTS IN PROTECTING PROGRAM INTEGRITY
Chapter 2--Improvements in Protecting Program Integrity
Requirement to Furnish Diagnostic Information (Section 4317)
Provision
Requires non-physician practitioners to provide diagnostic codes for items and services furnished by the practitioner (already required for physicians). Requires physicians and non-physician practitioners to provide diagnostic or other medical information when ordering certain items or services furnished by another entity if such information is required by the Secretary (or the Secretary's fiscal agent) in order for payment to be made to the entity furnishing the item or service. This requirement applies to orders for clinical laboratory tests and other diagnostic procedures, durable medical equipment, braces and prosthetic devices.
Effective Date
January 1, 1998.