Page:United States Statutes at Large Volume 86.djvu/1458

 1416 42 USC 1396a.

Ante, pp. 1395, 1410, 1412.

42 USC 1395X, 1395.

42 USC 1395x. 42 USC 1396.

Effective dates.

PUBLIC LAW 92-603-OCT. 30, 1972

[86 STAT.

(2) Section 1902(a) (30) of such Act is amended by inserting " (including but not limited to utilization review plans as provided for in section 1903(i)(4)) " after "plan" where it first appears. (b) Section 506(f) of such Act (as added by section 224(d) and amended by sections 229(d) and 233(d) of this Act) is further amended by striking out the period at the end of paragraph (3) and inserting in lieu thereof "; or", and by adding after paragraph (3) the following new paragraph: "(4) with respect to any amount expended for services furnished under the plan by a hospital unless such hospital has in effect a utilization review plan which meets the requirement imposed by section 1861(k) for purposes of title X VIII; and if such hospital has in effect such a utilization review plan for purposes of title X VIII, such plan shall serve as the plan required by this subsection (with the same standards and procedures and the same review committee or ^roup) as a condition of payment under this title; the Secretary is authorized to waive the requirements of this paragraph in any State if the State agency demonstrates to his satisfaction that it has in operation utilization review procedures which are superior in their effectiveness to the procedures required under section 1861(k). " (c) Section 1861(k) of such Act is amended by adding at the end thereof the following new sentence: "If the Secretary determines that the utilization review procedures established pursuant to title X IX are superior in their effectiveness to the procedures required under this section, he may, to the extent that he deems it appropriate, require for purposes of this title that the procedures established pursuant to title X IX be utilized instead of the procedures required by this section." (d)(1) The amendments made by subsections (a)(1) and (b) shall apply with respect to services furnished in calendar quarters beginning after June 30, 1973. (2) The amendment made by subsection (a)(2) shall be effective July 1, 1973. NOTIFICATION OF UNNECESSARY ADMISSION TO A HOSPITAL OR EXTENDED CARE FACILITY UNDER MEDICARE

42 USC 1395f.

Effective date.

SEC. 238. (a) Section 1814(a)(7) of the Social Security Act is amended by striking out "as described in section 1861(k)(4) " and inserting in lieu thereof "as described in section 1861(k)(4), including any finding made in the course of a sample or other review of admissions to the institution". (b) The amendment made by subsection (a) shall apply with respect to ^rvices furnished after the second month following the month in which this Act is enacted. USE OF STATE HEALTH AGENCY TO PERFORM CERTAIN FUNCTIONS UNDER MEDICAID AND UNDER MATERNAL AND CHILD HEALTH PROGRAM

42 USC 1396a.

42 USC 1395aa.

SEC. 239. (a) Section 1902(a)(9) of the Social Security Act is amended to read as follows: "(9) provide—• " (A) that the State health agency, or other appropriate State medical agency (whichever is utilized by the Secretary for the purpose specified in the first sentence of section 1864 (a)), shall be responsible for establishing and maintaining health standards lor private or public institutions in which

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