Page:United States Statutes at Large Volume 93.djvu/652

 93 STAT. 620 "Health maintenance organization. 42 USC 300e-9.

42 USC 300m-l.

42 USC 300n-l. 42 USC 300m-6 note. Ante, p. 614.

Report to congressional committees. Regulations. 42 USC 300m-6 note. Ante, p. 614.

PUBLIC LAW 96-79—OCT. 4, 1979 "(8) The term 'health maintenance organization' means a public or private organization, organized under the laws of any State, which— "(A) is a qualified health maintenance organization under section 1310(d); or "(B)(i) provides or otherwise makes available to enrolled participants health care services, including at least the following basic health care services: usual physician services, hospitalization, laboratory, X-ray, emergency and preventive services, and out of area coverage; (ii) is compensated (except for copayments) for the provision of the basic health care services listed in clause (i) to enrolled participants by a payment which is paid on a periodic basis without regard to the date the health care services are provided and which is fixed without regard to the frequency, extent, or kind of health service actually provided; and (iii) provides physicians' services primarily (I) directly through physicians who are either employees or partners of such organization, or (II) through arrangements with individual physicians or one or more groups of physicians (organized on a group practice or individual practice basis).". (4)(A) Section 1522(b)(13) is amended (i) by striking out "(3),", (ii) by inserting "in a timely manner" after "reviewed" in subparagraph (A), and (iii) by inserting after "agencies," in subparagraph (A) the following: "or, if there is no such State law,". (B) Section 1522(b)(13)(B) is amended by inserting "under subparagraph (A)" after "the reviewing agency". (5) Section 1532(c)(8) is amended by striking out "for which assistance may be provided under title XIII", (c) The Comptroller General shall conduct an evaluation of the exemption authority provided by section 1527(b) of the Public Health Service Act. In conducting the evaluation, the Comptroller General shall determine— (1) the health maintenance organizations, combinations of health maintenance organizations, and health care facilities which have applied to receive an exemption under that section, (2) the services, facilities, and equipment with respect to which applications have been submitted under that section, (3) the impact of the exemption on existing contractual arrangements between health maintenance organizations and health care facilities and on plans of such organizations respecting such arrangements, and (4) the impact of the exemption on health care delivery systems, including its impact on the cost, availability, accessibility, and quality of health care. The Comptroller General shall report the results of the evaluation to the Committee on Labor and Human Resources of the Senate and the Committee on Interstate and Foreign Commerce of the House of Representatives not later than February 1, 1982. (d) Within one hundred and eighty days of the date of the enactment of this Act, the Secretary of Health, Education, and Welfare shall promulgate such regulations as may be necessary to enable the States to establish certificate of need programs which meet the requirements of section 1527 of the Public Health Service Act. APPROPRIATENESS REVIEW

42 USC 300/-2.

SEC. 118. (a)(1) Section 1513(g)(1) is amended by striking out "all institutional health services offered in the health service area of the agency" and inserting in lieu thereof "at least those institutional and home health services which are offered in the health service area of

�