Page:United States Statutes at Large Volume 86.djvu/1446

 1404 Retroactive adjustment.

Ante, p. 1396.

79 Stat. 294. 42 USC 1395f.

79 Stat. 302. 42 USC 1395/. Ante, p. 1393.

Ante, p. 1396, 42 USC 1396b.

Technical assistance to States,

Effective date.

PUBLIC LAW 92-603-OCT. 30, 1972

[86 STAT.

(3) If the Secretary determines that the per capita cost of any such organization in any contract year for providing services to individuals described in paragraph (2), when combined with the cost of the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund in such year for providing out-of-plan services to such individuals, is less than or greater than the adjusted average per capita cost (as defined in section 1876(a)(3) of such Act) of providing such services, the resulting savings shall be apportioned between such organization and such Trust Funds, or the resulting losses shall be absorbed by such organization, in the manner prescribed in section 1876(a)(3) of such Act. (c)(1) Section 1814(a) of such Act is amended by striking out "Except as provided in subsection (d), " and inserting in lieu thereof the following: "Except as provided in subsection (d) and in section 1876,". (2) Section 1833(a) of such Act is amended by striking out "Subject to " and inserting in lieu thereof the following: "Except as provided in section 1876, and subject to". (d) Section 1875(b) of the Social Security Act, as amended by section 222(c) of this Act, is further amended— (1) by inserting "the operation and administration of health maintenance organizations authorized by section 226 of the Social Security Amendments of 1972," after the word "including"; and (2) by striking out "1971" and inserting in lieu thereof "1972". (e) Section 1903 of such Act, as amended by sections 207, 224, and 290 of this Act, is further amended by adding after subsection (j) the following new subsection: " (k) The Secretary is authorized to provide at the request of any State (and without cost to such State) such technical and actuarial assistance as may be necessary to assist such State to contract with any health maintenance organization which meets the requirements of section 1876 for the purpose of providing medical care and services to individuals who are entitled to medical assistance under this title." (f) The amendments made by this section shall be effective with respect to services provided on or after July 1, 1973. PAYMENT UNDER MEDICARE FOR SERVICES OF PHYSICIANS RENDERED AT A TEACHING HOSPITAL

42 USC 1395X.

SEC. 227. (a) Section 1861(b) of the Social Security Act is amended by striking out the second sentence and inserting in lieu thereof the following: "Paragraph (4) shall not apply to services provided in a hospital by— "(6) an intern or a resident-in-training under a teaching program approved by the Council on Medical Education of the American Medical Association or, in the case of an osteopathic hospital, approved by the Committee on Hospitals of the Bureau of Professional Education of the American Osteopathic Association, or, in the case of services in a hospital or osteopathic hospital by an intern or resident-in-training in the field of dentistry, approved by the Council on Dental Education of the American Dental Association; or "(7) a physician where the hospital has a teaching program approved as specified in paragraph (6), unless (A) such inpatient is a private patient (as defined in regulations), or (B) the hospital establishes that during the two-year period ending December 31, 1967, and each year thereafter all inpatients have been

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