(a) An issuer shall comply with section 1882(c)(3) of the federal Social Security Act, as enacted by section 4081(b)(2)(C) of the Omnibus Budget Reconciliation Act of 1987 (OBRA), Public Law 100-203, by:
- (1) accepting a notice from a Medicare carrier on duly assigned claims submitted by Medicare participating physicians and suppliers as a claim for benefits in place of any other claim form otherwise required and making a payment determination on the basis of the information contained in that notice;
- (2) notifying the Medicare participating physician or supplier and the beneficiary of the payment determination;
- (3) paying the Medicare participating physician or supplier directly;
- (4) furnishing, at the time of enrollment, each enrollee with a card listing the policy or certificate name, number, and a central mailing address to which notices from a Medicare carrier may be sent;
- (5) paying user fees for claim notices that are transmitted electronically or otherwise; and
- (6) providing to the secretary of health and human services, at least annually, a central mailing address to which all claims may be sent by Medicare carriers.
- (b) Compliance with the requirements in paragraph (a) shall be certified on the Medicare supplement insurance experience reporting form.