Page:United States Statutes at Large Volume 91.djvu/1232

 91 STAT. 1198 42 USC 1395y.

42 USC 1320C-6.

42 USC 1395CC. ' 42 USC 1320C-6. Effective date. 42USei320c-6 note.

PUBLIC LAW 95-142—OCT. 25, 1977 (b)(1) Section 1862(d)(1)(B) of such Act is amended by striking out ", with the concurrence of the appropriate program review team appointed pursuant to paragraph (4),". (2) Section 1862(d)(1)(C) of such Act is amended to read as follows: "(C) has furnished services or supplies which are determined by the Secretary, on the basis of reports transmitted to him in accordance with section 1157 of this Act (or, in the absence of any such report, on the basis of such data as he acquires in the administration of the program under this title), to be substantially in excess of the needs of individuals or to be of a quality which fails to meet professionally recognized standards of health care.". (3) Clause (F) of section 1866(b)(2) of such Act is amended to read as follows: " (F) that such provider has furnished services or supplies which are determined by the Secretary to be substantially in excess of the needs of individuals or to be of a quality which fails to meet professionally recognized standards of health care.". (4) Section 1157 of such Act is amended by striking out the last sentence. (c) The amendments made by this section shall take effect on the date of the enactment of this Act. AMENDMENTS RELATING TO FISCAL

42 USC 1395h.

INTERMEDIARIES

SEC. 14. (a) Section 1816 of the Social Security Act is amended— (1) by inserting "(and to providers assigned to such agency or organization under subsection (e)) " in the first sentence of subsection (a) after "to such providers" the second and third times it appears; Agreements. (2) by amending subsection (b) to read as follows: "(b) The Secretary shall not enter into or renew an agreement with any agency or organization under this section unless— " (1) he finds— " (A) after applying the standards, criteria, and proceJi^ dures developed under subsection (f), that to do so is consistent with the effective and efficient administration of this part, and > <J V "(B) that such agency or organization is willing and able to assist the providers to which payments are made through it under this part in the application of safeguards against unnecessary utilization of services furnished by them to individuals entitled to hospital insurance benefits under section 42 USC 426. 226, and the agreement provides for such assistance; and Information, "(2) such agency or organization agrees— availability. "(A) to furnish to the Secretary such of the information acquired by it in carrying out its agreement under this section, and "(B) to provide the Secretary with access to all such data, information, and claims processing operations, as the Secretary may find necessary in performing his functions under this part."; (3) by inserting "after applying the standards, criteria, and i^ra. j4 procedures developed under subsection (f) and" in subsection (e)(2) before "after reasonable notice"; (4) by redesignating subsections (e), (f), and (g) as subsections (g), (h), and (i), respectively; and

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