Page:United States Statutes at Large Volume 91.djvu/1523

 PUBLIC LAW 95-210—DEC. 13, 1977

91 STAT. 144B9

42 USC 1396i. (d) Section 1910 of such Act is amended— .y...:^.y.^.'>(1) by amending the heading to read as follows: "CERTIFICATION^ AND APPROVAL OR SKILLED NURSING FACILITIES AND OF RURAL H E A L T H CLINICS";

(2) by striking out " (a) " and inserting in lieu thereof "(a) (1)"; (3) by striking out " (b) " and inserting in lieu thereof " (2) "; and (4) by adding at the end thereof the following new subsection: "(b)(1) Whenever the Secretary certifies a facility in a State to be qualified as a rural health clinic under title X VIII, such facility shall be deemed to meet the standards for certification as a rural health clinic for purposes of providing rural health clinic services under this title. "(2) The Secretary shall notify the State agency administering the medical assistance plan of his approval or disapproval of any facility in that State which has applied for certification by him as a qualified rural health clinic". (e) Section 1866(c)(2) of such Act is amended by striking out "section 1910" and inserting in lieu thereof "section 1910(a)". (f)(1) The amendments made by this section shall (except as otherwise provided in paragraph (2)) apply to medical assistance provided, under a State plan approved under title X IX of the Social Security Act, on and after the first day of the first calendar quarter that begins more than six months after the date of enactment of this Act. (2) In the case of a State plan for medical assistance under title X IX of the Social Security Act which the Secretary determines requires State legislation in order for the plan to meet the additional requirements imposed by the amendments made by this section, the State plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet these additional requirements before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of enactment of this Act.

Certification. 42 USC 1395.

Approval.

42 USC 1395cc. Effective date. 42 USC 1395cc note. 42 USC 1396.

DEMONSTRATION PROJECTS FOR PHYSICIAN-DIRECTED CLINICS I N URBAN MEDICALLY UNDERSERVED AREAS

SEC. 3. (a) The Secretary shall provide, through demonstration 42 USC 1395b-l projects, reimbursement on a cost basis for services provided by physi- note. cian-directed clinics in urban medically underserved areas for which payment may be made under title X VIII of the Social Security Act and, notwithstanding any other provision of such title, for services provided by a physician assistant or nurse practitioner employed by such clinics which would otherwise be covered under such title if provided by a physician. (b) The demonstration projects developed under subsection (a) shall Evaluation. be of sufficient scope and carried out on a broad enough scale to allow the Secretary to evaluate fully— (1) the relative advantages and disadvantages of reimbursement on the basis of costs and fee-for-service for physiciandirected clinics employing a physician assistant or nurse practitioner; (2) the appropriate method of determining the compensation for physician services on a cost basis for the purposes of reimbursement of services provided in such clinics; (3) the appropriate definition for such clinics;

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