Page:United States Statutes at Large Volume 87.djvu/949

 87 STAT.]

PUBLIC LAW 9 3 - 2 2 2 - D E C. 29, 1973

and other health professionals of the process followed in the provision of health services; "(9) provide medical social services for its members and encourage and actively provide for its members health education services, education in the appropriate use of health services, and education in the contribution each member can make to the maintenance of his own health; "(10) provide, or make arrangements for, continuing education for its health professional staff; and "(11) provide, in accordance with regulations of the Secretary (including safeguards concerning the confidentiality of the doctorpatient relationship), an effective procedure for developing, compiling, evaluating, and reporting to the Secretary, statistics and other information (which the Secretary shall publish and disseminate on an annual basis and which the health maintenance organization shall disclose, in a manner acceptable to the Secretary, to its members and the general public) relating to (A) the cost of its operations, (B) the patterns of utilization of its services, (C) the availability, accessibility, and acceptability of its services, (D) to the extent practical, developments in the health status of its members, and (E) such other matters as the Secretary may require. "DEFINITIONS

"SEC. 1802. For purposes of this title: "(1) The term 'basic health services' means— " (A) physician services (including consultant and referral services by a physician); " (B) inpatient and outpatient hospital services; " (C) medically necessary emergency health services; " (D) short-term (not to exceed twenty visits), outpatient evaluative and crisis intervention mental health services; " (E) medical treatment and referral services (including referral services to appropriate ancillary services) for the abuse of or addiction to alcohol and drugs; " (F) diagnostic laboratory and diagnostic and therapeutic radiologic services; " (G) home health services; and " (H) preventive health services (including voluntary family planning services, infertility services, preventive dental care for children, and children's eye examinations conducted to determine the need for vision correction). If a service of a physician described in the preceding sentence may also be provided under applicable State law by a dentist, optometrist, or podiatrist, a health maintenance organization may provide such service through a dentist, optometrist, or podiatrist (as the case may be) licensed to provide such service. For purposes of this paragraph, the term 'home health services' means health services provided at a member's home by health care personnel, as prescribed or directed by the responsible physician or other authority designated by the health maintenance organization. A health maintenance organization is authorized, in connection with the prescription of drugs, to maintain, re\'iew, and evaluate (in accordance with regulations of the Secretary) a drug use profile of its members receiving such service, evaluate patter-ns of drug utilization to assure optimum drug therapy, and provide for instruction of its members and of health professionals in the use of prescription and non-prescription drugs. "(2) The term 'supplemental health services' means— " (A) services of facilities for intermediate and long-term care;

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