Page:United States Statutes at Large Volume 100 Part 3.djvu/238

 100 STAT. 2046

PUBLIC LAW 99-509—OCT. 21, 1986

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"(iii) the level of effort expended under the contract shall be, to the extent practicable, not less than the level of effort that would otherwise be required under the third sentence of subparagraph (B) if this subparagraph did not gpply.". (3) IDENTIFICATION OF METHODS FOR IDENTIFYING CASES OF SUBSTANDARD CARE.—Section 1154 of such Act (42 U.S.C.

42 USC 1320C-3 note. 42 USC 1320c.

42 USC 1395. 42 USC 1320C-3 ^° ' contracts. 42 USC 1320C-3 note.

contracts.

sii



1320C-3), as amended by sections 9343(d)(2) and 9351(a), is amended by adding at the end the following new subsection: "(f) The Secretary, in consultation with appropriate experts, shall identify methods that would be available to assist peer review organizations (under subsection (a)(4)) in identifying those cases which are more likely than others to be associated with a quality of services which does not meet professionally recognized standards of health care.". (4) SMALL-AREA ANALYSIS.—The Secretary of Health and Human Services shall provide, to at least 12 utilization and quality control peer review organizations with contracts under " part B of title XI of the Social Security Act, data and data processing assistance to allow each of these organizations to review and analyze small-area variations, in the service area of the organization, in the utilization of hospital and other health care services for which payment is made under title XVIII of such Act. (5) CONFORMING AMENDMENT.—Section 9405 of the Consolidated Omnibus Budget Reconciliation Act of 1986 is amended by striking "January" and inserting "April", (6) EFFECTIVE DATES.—(A)(i) Except as provided in clause (ii), the amendments made by paragraphs (1) and (2)(D) shall apply to contracts as of January 1, 1987. (ii) The amendment made by paragraph (1) shall not be construed as requiring, before January 1, 1989, the review of physicians' services, other than physicians' services furnished in a hospital, other inpatient facility, ambulatory surgical center, or rural health clinic, (B) The amendment made by paragraph (2)(B) shall apply to contracts as of April 1, 1987. (C) The amendment made by paragraph (2)(C) shall apply to review activities conducted by organizations on or after January 1, 1988. w if (D) The amendment made by paragraph (3) becomes effective on the date of the enactment of this Act. (b) REQUIRING BOARDS.—

REPRESENTATIVE

ON PEER

REVIEW

(1) IN GENERAL.—Section 1152 of such Act (42 U.S.C. 1320c-l) is amended— (A) by striking "and" at the end of paragraph (1), (B) by striking the period at the end of paragraph (2) and inserting "; and", and (C) by adding at the end the following new paragraph: "(3) has at least one individual who is a representative of consumers on its governing body.". (2) EFFECTIVE DATE.—The amendment made by paragraph (1) shall apply to contracts entered into or renewed on or after January 1, 1987.

contracts. 42 USC 1320C-1 note(c)

s.^'M',i:)80 5it

CONSUMER

IMPROVING PEER REVIEW RESPONSIVENESS TO BENEFICIARY

COMPLAINTS.—

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