Page:United States Statutes at Large Volume 86.djvu/1433

 86 STAT. ]

PUBLIC LAW 92-603-OCT. 30, 1972

1391

reimbursement, as may be determined by the Secretary, and shall be made in such installments and on such conditions as the Secretary Hnds necessary to carry out the purpose of this subsection. With respect to any such grant, payment, or other expenditure, the amount to be paid from each of such trust funds (and from funds appropriated under such titles V and X IX) shall be determined by the Secretary, i^g^^^'^ ^°^' giving due regard to the purposes of the experiment or project involved. (5) The Secretary shall submit to the Congress no later than July Report to Con1, 1974, a full report on the experiments and demonstration projects carried out under this subsection and on the experience of other programs with respect to prospective reimbursement together with any related data and materials which he may consider appropriate. Such report shall include detailed recommendations with respect to the specific methods which could be used in the full implementation of a system of prospective payment to providers of services under the programs involved. (b)(1) Section 402(a) of the Social Security Amendments of 1967 si Stat. 930. is amended to read as follows: ^^ ^^^ i395b-i. " (a)(1) The Secretary of Health, Education, and Welfare is authorized, either directly or through grants to public or nonprofit private agencies, institutions, and organizations or contracts with public or private agencies, institutions, and organizations, to develop and engage in experiments and demonstration projects for the following purposes: " (A) to determine whether, and if so which, changes in methods of payment or reimbursement (other than those dealt with in section 222(a) of the Social Security Amendments of 1972) for ^"^e, p. 1390. health care and services under health programs established by the Social Security Act, including a change to methods based on ^^ ^^^- ^^^^ negotiated rates, would have the effect of increasing the efficiency and economy of health services under such programs through the creation of additional incentives to these ends without adversely affecting the quality of such services; " (B) to determine whether payments for services other than those for which payment may be made under such programs (and which are incidental to services for which payment may be made under such programs) would, in the judgment of the Secretary, result in more economical provision and more effective utilization of services for which payment may be made under such program, where such services are furnished by organizations and institutions which have the capability of providing— " (i) comprehensive health care services, "(ii) mental health care services (as defined by section 401(c) of the Mental Retardation Facilities and Community Health Centers Construction Act of 1963), 77 Stat. 296. "(iii) ambulatory health care services (including surgical ^^ ^^^ ^691. services provided on an outpatient basis), or "(iv) institutional services which may substitute, at lower cost, for hospital care; " (C) to determine whether the rates of payment or reimbursement for health care services, approved by a State for purposes of the administration of one or more of its laws, when utilized to determine the amount to be paid for services furnished in such State under the health programs established by the Social Security Act, would have the effect of reducing the costs of such programs without adversely affecting the quality of such services; " (D) to determine whether payments under such programs based on a single combined rate of reimbursement or charge for

�