or practitioner would not apply with respect to any items or services furnished under the contract. (3) Beneficiary protections (A) In general Paragraph (1) shall not apply to any contract unless— (i) the contract is in writing, is signed by the Medicare beneficiary and the eligible professional, and establishes all terms of the contract (including specific payment for items and services covered by the contract) before any item or service is provided pursuant to the contract, and the beneficiary shall be held harmless for any subsequent payment charged for an item or service in excess of the amount established under the contract during the period the contract is in effect