Page:United States Statutes at Large Volume 91.djvu/1522

 91 STAT. 1488

42 USC 1395x. 42 USC 1395aa. Ante, p. 1485.

Effective date. 42 USC 1395k note.

PUBLIC LAW 95-210—DEC. 13, 1977 (3) by adding the following new subparagraph at the end thereof: " (E) rural health clinic services;". (h) The second sentence of section 1861(s) of such Act is amended by inserting ", a rural health clinic," after "physician's office". (i) Section 1864(a) of such Act is amended— (1) by inserting "or whether a facility therein is a rural health clinic as defined in section 1861 (aa)(2)," in the first sentence after "home health agency,"; (2) by inserting "rural health clinic," in the second sentence after "nursing facility,"; (3) by inserting "rural health clinic," in the last sentence after "facility," the first and second times it appears; and (4) by striking out "such facility" in the last sentence and inserting in lieu thereof "such health care facility, rural health clinic". (j) The amendments made by this section shall apply to services rendered on or after the first day of the third calendar month which begins after the date of enactment of this Act. MEDICAID AMENDMENTS

42 USC 1396d. '

"Rural health clinic services" and "rural health clinic."

42 USC 1396a.

Ante, p. 1485.

SEC. 2. (a) Paragraph (2) of section 1905(a) of the Social Security Act is amended to read as follows: "(2)(A) outpatient hospital services, and (B) consistent with State law permitting such services, rural health clinic services (as defined in subsection (1)) and any other ambulatory services which are offered by a rural health clinic (as defined in subsection (1)) and which are otherwise included in the plan;". (b) Section 1905 of such Act is amended by adding after subsection (k) the following new subsection: "(1) The terms 'rural health clinic services' and 'rural health clinic' have the meanings given such terms in section 1861 (aa), except that (1) clause (ii) of section 1861 (aa)(2) shall not apply to such terms, and (2) the physician arrangement required under section 1861 (aa) (2)(B) shall only apply with respect to rural health clinic services and, with respect to other ambulatory care services, the physician arrangement required shall be only such as may be required under the State plan for those services.". (c) Section 1902(a) of such Act is amended— (1) by striking out the semicolon at the end of paragraph (13) and inserting in lieu thereof "; and", and by adding at the end of such paragraph the following new subparagraph: " (F) for payment for services described in section 1905(a) (2)(B) provided by a rural health clinic under the plan of 100 percent of costs which are reasonable and related to the cost of furnishing such services or based on such other tests of reasonableness, as the Secretary may prescribe in regulations under section 1833(a)(3), or, in the case of services to which those regulations do not apply, on such tests of reasonableness as the Secretary may prescribe in regulations under this subparagraph;"; and (2) by inserting ", or by reason of the fact that the plan provides for payment for rural health clinic services only if those services are provided by a rural health clinic" before the semicolon at the end of paragraph (23).

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