Page:United States Statutes at Large Volume 94 Part 2.djvu/1351

 PUBLIC LAW 96-499—DEC. 5, 1980

94 STAT. 2629

ices) and, in addition, review of such other health care services as the Secretary may require" in the second sentence and inserting in lieu thereof "only if the Secretary finds that it is substantially carrying out in a satisfactory manner the activities and functions required of that Professional Standards Review Organization under this part". (2) Subsection (c) of such section is amended by inserting "of that organization" after "required under this part". (3) Such section if further amended by adding at the end the following new subsection: "(0(1) The Secretary shall establish a program (hereinafter in this Review program subsection referred to as the 'program') for the evaluation of the costeffectiveness of review of particular health care services by Professional Standards Review Organizations. "(2) In order to demonstrate the cost-effectiveness of requiring review of particular health care services before such review is generally required, the program shall be designed in a manner so that the Secretary will require particular Professional Standards Review Organizations, chosen by a statistically valid method that will permit a valid evaluation of the cost-effectiveness of such review, to review particular health care services. "(3) The program shall provide for the evaluation of cost-effectiveness of the review of particular health care services under the program, particularly in comparison with areas in which such review was not required or performed. "(4) Based upon such evaluation, or upon an evaluation of comparable statistical validity, and a finding that review of particular health care services is cost-effective or yields other significant benefits, the Secretary shall specify such particular health care services which Professional Standards Review Organizations (either generally or under such conditions and circumstances as the Secretary may specify) have the duty and function of reviewing under this part. "(5) For purposes of this subsection, the term 'particular health "Particular care services' does not include health care services (other than health care services." ancillary, ambulatory care, and long-term care services) provided by or in hospitals or alcohol detoxification facility services.". 42 USC 1320C-4. (b) Section 1155(a) of such Act is amended— (1) by striking out "at the earliest date practicable" in paragraph (1) and inserting in lieu thereof "to the extent and at the Ante, p. 2628. time specified by the Secretary under section 1154(f)"; (2) by inserting ", consistent with section 1154(f)," in paragraph (7)(A) after "only"; and (3) by inserting "(consistent with section 1154(f))" in paragraph (7)(B) after "to the extent". Repeal. (c) Subsection (g) of section 1155 of such Act is repealed. (d) Section 1155 of such Act is amended by adding at the end thereof 42 USC 1320C-4. the following new subsection: "(h) If the Secretary has designated an organization (other than under section 1154) as a Professional Standards Review Organization, 42 USC 1320C-3. but that organization has not assumed responsibility for the review of particular activities in its area included in subsection (a)(1), the Secretary may designate another qualified Professional Standards Review Organization (in reasonable proximity to the providers and practitioners whose services are to be reviewed) to assume the responsibility for the review of some or all of those particular activities.".

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