Page:United States Statutes at Large Volume 91.djvu/1223

 PUBLIC LAW 95-142—OCT. 25, 1977

91 STAT. 1189

the single State agency which administers or supervises the administration of the State plan approved under title X IX for that State is not performing effective review of the quality and necessity of health care services provided in such facilities and institutions, or (ii) the State requests such organization to assume such responsibility. "(B) A Professional Standards Review Organization located in a State has the function and duty to assume responsibility for the review under paragraph (1) of professional activities in intermediate care facilities in the State that are also skilled nursing facilities (as defined in section 1861(j)), to the extent that the Secretary finds that the performance of such function by the single State agency (described in subparagraph (A)) for that State is inefficient.". (e) Section 1160(b)(1) of such Act is amended by striking out "practitioner or provider" and inserting in lieu thereof "health care practitioner or hospital, or other health care facility, agency, or organization" each time it appeare therein, (f) Section 1163(a)(2) of such Act is amended to read as follows: "(2) Members of the Council shall be appointed for a term of three years, except that the Secretary may provide, in the case of any terms scheduled to expire after January 1, 1978, for such shorter terms as will ensure that (on a continuing basis) the terms of no more than four members expire in any year. Members of the Council shall be eligible for reappointment.". (g) Section 1163 of such Act is amended by striking out subsection (f). (h) Section 1166 of such Act is amended— (1) by striking out "or (2)" in subsection (a) and inserting inlieuthereof ", (2)"; (2) by inserting the following immediately before the period at the end of subsection (a): ", or (3) in accordance with subsection (b) "; (3) by redesignating subsection (b) as subsection (c); (4) by inserting the following new subsection immediately after subsection (a); " (b) A Professional Standards Review Organization shall provide, in accordance with procedures established by the Secretary, data and information— "(1) to assist Federal and State agencies recognized by the Secretary as having responsibility for identifying and investigating cases or patterns of fraud or abuse, which data and information shall be provided by such organization to such agencies at the request of such agencies at the discretion of such Organization on the basis of its findings with respect to evidence of fraud or abuse; and " (2) to assist the Secretary, and such Federal and State agencies recognized by the Secretary as having health planning or related responsibilities under Federal or State law (including health systems agencies and State health planning and development agencies), in carrying out appropriate health care planning and related activities, which data and information shall be provided in such format and manner as may be prescribed by the Secretary or agreed upon by the responsible Federal and State agencies and such Organization, and shall be in the form of aggregate statistical data (without identifying any individual) on a geographic, institutional, or other basis reflecting the volume and frequency of services furnished, as well as the demographic characteristics of the population subject to review by such Organization.

42 USC 1396.

Post, ^p. 1207. 42 USC 1320C-9.

42 USC 1320C-12.

Data and information.

42 USC

1320C-15.

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