Page:United States Statutes at Large Volume 100 Part 3.djvu/239

 PUBLIC LAW 99-509—OCT. 21, 1986

100 STAT. 2047

(1) APPROPRIATE REVIEW OF COMPLAINTS REQUIRED.—Section

1154(a) of such Act (42 U.S.C. 1320c-3(a)), as amended by section 9352(b), is further amended by adding at the end the following new paragraph: "(14) The organization shall conduct an appropriate review of all written complaints about the quality of services (for which payment may otherwise be made under title XVIII) not meeting 42 USC 1395. professionally recognized standards of health care, if the complaint is filed with the organization by an individual entitled to benefits for such services under such title (or a person acting on the individual's behalf). The organization shall inform the individual (or representative) of the organization's final disposition of the complaint. Before the organization concludes that the quality of services does not meet professionally recognized standards of health care, the organization must provide the practitioner or person concerned with reasonable notice and opportunity for discussion.". (2) EFFECTIVE DATE.—The amendment made by paragraph (1) 42 USC 1320C-3 shall apply to complaints received on or after the first day of the note. first month that begins more than 9 months after the date of the enactment of this Act. (d) SHARING OF INFORMATION BY PEER REVIEW ORGANIZATIONS.—

(1) IN GENERAL.—Subparagraph (C) of section 1160(b)(1) of such Act (42 U.S.C. 1320c-9(b)(l)) is amended to read as follows: "(C) to assist appropriate State agencies recognized by the State and local Secretary as having responsibility for licensing or certifi- governments. '" cation of providers or practitioners or to assist national accreditation bodies acting pursuant to section 1865 in 42 USC 1395bb. accrediting providers for purposes of meeting the conditions described in title XVIII, which data and information shall be provided by the peer review organization to any such agency or body at the request of such agency or body relating to a specific case or to a possible pattern of substandard care, but only to the extent that such data and information are required by the agency or body to carry out its respective function which is within the jurisdiction of the agency or body under State law or under section 1865;". (2) EFFECTIVE DATE.—The amendments made by paragraph (1) 42 USC 1320C-9 shall apply to requests for data and information made on and note. after the end of the 6-month period beginning on the date of the enactment of this Act. (e) FUNDING OF ADDITIONAL PRO ACTIVITIES.— (1) THROUGH AGREEMENTS WITH HOSPITALS, SKILLED NURSING FACILITIES, A N D HOME HEALTH A G E N C I E S. — S e c t i o n 1 8 6 6 (a) o f SUCh

rf Act (42 U.S.C. 1395cc(a)) is amended— (A) in paragraph (1)(F)— (i) by redesignating clauses (i), (ii), and (iii), as subclauses (I), (II), and (III), respectively, (ii) by inserting "(i)" after "(F)", and (iii) by adding at the end the following new clause: "(ii) in the case of hospitals, skilled nursing facilities, and Contracts. home health agencies, to maintain an agreement with a utilization and quality control peer review organization (which has a contract with the Secretary under part B of title XI for the area 42 USC 1320c. in which the hospital, facility, or agency is located) to perform the functions described in paragraph (4)(A);"; and (B) by adding at the end the following new paragraph:

�