Page:United States Statutes at Large Volume 87.djvu/963

 87 STAT. ]

PUBLIC LAW 93-222-DEC. 29, 1973

comply with the requirements of subsection (a) shall be considered a willful violation of section 15 of the Fair Labor Standards Act of 1938. " (d) For purposes of this section, the term '(qualified health maintenance organization' means (1) a health mamtenance organization which has provided assurances satisfactory to the Secretary that it provides basic and supplemental health services to its members in the manner prescribed by section 1301(b) and that it is organized and operated in the manner prescribed by section 1301(c), and (^2) an entity which proposes to become a health maintenance organization and which the Secretary determines will wh<^.n it becomes operational provide basic and supplemental health services to its members in the manner prescribed by section 1301(b) and will be organized and operated in the manner prescribed by section 1301(c). u RESTRICTIVE STATE LAWS AND PRACTICES

"SEC. 1311. (a) In the case of any entity— "(1) which cannot do business as a health maintenance organization in a State in which it proposes to furnish basic and supplemental health services because that State by law, regulation, or otherwise— " (A) requires as a condition to doing business in that State that a medical society approve the furnishing of services by the entity, " (B) requires that physicians constitute all or a percentage of its governing body, " (C) requires that all physicians or a percentage of physicians in the locale participate or be permitted to participate in the provision of services for the entity, or " (D) requires that the entity meet requirements for insurers of health care services doing business in that State respecting initial capitalization and establishment of financial reserves against insolvency, and "(2) for which a grant, contract, loan, or loan guarantee was made under this title or which is a qualified health maintenance organization for purposes of section 1310 (relating to employees' health benefits plans), such requirements shall not apply to that entity so as to prevent it from operating as a health maintenance organization in accordance with section 1301. "(b) No State may establish or enforce any law which prevents a health maintenance organization for which a grant, contract, loan, or loan guarantee was made under this title or which is a qualified health maintenance organization for purposes of section 1310 (relating to employees' health benefits plans), from soliciting members through advertising its services, charges, or other nonprofessional aspects of its operation. This subsection does not authorize any advertising which identifies, refers to, or makes any qualitative judgment concerning, any health professional who provides services for a health maintenance organization. " C O N T I N U E D REGULATION OF HEALTH MAINTENANCE ORGANIZATIONS

"SEC. 1312. (a) If the Secretary determines that an entity which received a grant, contract, loan, or loan guarantee under this title as a health maintenance organization or which was included in a health benefits plan offered to employees pursuant to section 1310— "(1) fails to provide basic and supplemental services to its members,

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gg^^tff^'gi^g"^^' 29 USC 21's. . 'g^"°^"!®^ Ince ^gan\zation."

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