bzgl. den Gesetzen parallel angefragt. Der Vortrag in Marseille steht an, aber trotzdem sollte man unabhängig davon nicht die Gesetzeslinie komplett aus den Augen lassen, vor allem, wenn Sie eine Erstattung sofort bringen könnte.
Hier mein Schreiben :
Hello xxx,
Thank you so much for your answer. I am not a native speaker of the american language, so what I don't quite understand :
Sec. 1 and Sec. 2 I understand. Here you will find scientifically proven details concerning colorectal cancer.
Sec. 3 gives me some difficulties.
I tried to follow the step by inserting the text passage in Section 1833(a)(1)(Y) of the Social Security Act (42 U.S.C. 1395l(a)(1)(Y)).
If I see it correctly, the text should look like this:
(a) Except as provided in section 1876, and subject to the succeeding provisions of this section, there shall be paid from the Federal Supplementary Medical Insurance Trust Fund, in the case of each individual who is covered under the insurance program established by this part and incurs expenses for services with respect to which benefits are payable under this part, amounts equal to—
(1) in the case of services described in section 1832(a)(1)—80 percent of the reasonable charges for the services; except that(Y) with respect to preventive services described in subparagraphs (A) and (B) of section 1861(ddd)(3), including a colorectal cancer screening test (regardless of the code that is billed for the establishment of a diagnosis as a result of the test, or for the removal of tissue or other procedure that is furnished in connection with, as a result of, and in the same clinical encounter as the screening test), that are appropriate for the individual and, in the case of such services described in subparagraph (A), are recommended with a grade of A or B by the United States Preventive Services Task Force for any indication or population, the amount paid shall be 100 percent of
(i) except as provided in clause (ii), the lesser of the actual charge for the services or the amount determined under the fee schedule that applies to such services under this part, and
(ii) in the case of such services that are covered OPD services (as defined in subsection (t)(1)(B)), the amount determined under subsection (t),
Does this addition refer only to colonoscopy or also to other tests like gfobt, fit, cologuard, Epi pro colon etc ?
Yours sincerely
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