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The law › Title 42, The Public Health and Welfare › Chapter 7

42 U.S.C. 1395pp: Limitation on liability where claims are disallowed

Created in 1972 by Public Law 92-603. Changed by 9 later laws. No bill we track in this Congress changes it.

3 other sections of the Code cite this one, including 42 U.S.C. 1320c–3, 42 U.S.C. 1395l, 42 U.S.C. 1395ff.

1 part of federal rules cite it as their authority, written by Centers for Medicare & Medicaid Services, Department of Health and Human Services (1).

This Congress

No bill we track in the 119th Congress changes this section.

    How it got here

    2014

    • Pub. L. 113–185 added subsec. (i). (Improving Medicare Post-Acute Care Transformation Act of 2014" or the "IMPACT Act of 2014) Law text · (i)

    2011

    • Pub. L. 112–40, §261(a)(3)(A), substituted "quality improvement" for "utilization and quality control peer review" in concluding provisions. Law text · (a)
    • Pub. L. 112–40, §261(a)(3)(B), substituted "quality improvement" for "quality control and peer review". Law text · (e)

    1997

    • Pub. L. 105–33 substituted "subsection is—" for "subsection is,", redesignated remaining text as par. (1) and former pars. (1) and (2) as subpars. (A) and (B), respectively, of par. (1), realigned margins, substituted "; and" for period at end, and added par. (2). (Balanced Budget Act of 1997) Law text · (g)

    1994

    • Pub. L. 103–432 added subsec. (h). · (h)

    1989

    • Pub. L. 101–239, §6214(a)(1), struck out "with respect to any coverage denial described in subsection (g) of this section" before period at end. · (f)
    • Pub. L. 101–239, §6214(a)(2), designated existing provisions as subpar. (A) and added subpar. (B). · (f)
    • Pub. L. 101–239, §6214(b), added par. (6). · (f)

    1987

    • Pub. L. 100–203 struck out ", subject to the deductible and coinsurance provisions of this subchapter," after "(referred to in such paragraphs)" and inserted at end "No item or service for which an individual is indemnified under this subsection shall be taken into account in applying … · (b)

    1986

    • Pub. L. 99–509, §9305(g)(1)(A)–(C), inserted in par. (1) "or by reason of a coverage denial described in subsection (g)", and in concluding provisions inserted "and as though the coverage denial described in subsection (g) had not occurred" and "or by reason of a coverage denial descri… · (a)
    • Pub. L. 99–509, §9305(g)(1)(D), inserted "or by reason of a coverage denial described in subsection (g)". · (c)
    • Pub. L. 99–509, §9341(a)(3), substituted "sections 1395ff(b) and 1395u(b)(3)(C) of this title (as may be applicable)" for "section 1395ff(b) of this title (when the determination is under part A) or section 1395u(b)(3)(C) of this title (when the determination is under part B)". · (d)
    • Pub. L. 99–509, §9305(g)(1)(E), added subsecs. (f) and (g). · (f), (g)

    1982

    • Pub. L. 97–248, §145, inserted provisions relating to imputing knowledge to provider or other person furnishing items or services for which payment may not be made that payment may not be made if the provider or other person has been notified that a pattern of inappropriate utilization… · (a)
    • Pub. L. 97–248, §148(e), substituted "quality control and peer review organization" for "professional standards review organization". · (e)

    1980

    • Pub. L. 96–499 added subsec. (e). · (e)

    Text, outline and history from the official U.S. Code (2024 edition) on GovInfo, published by the Office of the Law Revision Counsel. Changes made after that edition appear under This Congress.