Page:United States Statutes at Large Volume 94 Part 2.djvu/1358

 94 STAT. 2636

42 USC I395x.

42 USC 1395Z.

PUBLIC LAW 96-499—DEC. 5, 1980

a comprehensive outpatient rehabilitation facility under a plan (for furnishing such items and services to such individual) established and periodically reviewed by a physician— "(A) physicians' services; "(B) physical therapy, occupational therapy, speech pathology services, and respiratory therapy; "(C) prosthetic and orthotic devices, including testing, fitting, or training in the use of prosthetic and orthotic devices; "(D) social and psychological services; "(E) nursing care provided by or under the supervision of a registered professional nurse; (F) drugs and biologicals which cannot, as determined in accordance with regulations, be self administered; "(G) supplies, appliances, and equipment, including the purchase or rental of equipment; and "(H) such other items and services as are medically necessary for the rehabilitation of the patient and are ordinarily furnished by comprehensive outpatient rehabilitation facilities, excluding, however, any item or service if it would not be included under subsection (b) if furnished to an outpatient of a hospital. "(2) The term 'comprehensive outpatient rehabilitation facility' means a facility which— "(A) is primarily engaged in providing (by or under the supervision of physicians) diagnostic, therapeutic, and restorative services to outpatients for the rehabilitation of injured, disabled, or sick persons; "(B) provides at least the following comprehensive outpatient rehabilitation services: (i) physicians' services (rendered by physicians, as defined in section 1861(r)(l), who are available at the facility on a full- or part-time basis); (ii) physical therapy; and (iii) social or psychological services; "(C) maintains clinical records on all patients; "(D) has policies established by a group of professional personnel (associated with the facility), including one or more physicians defined in subsection (r)(l) to govern the comprehensive outpatient rehabilitation services it furnishes, and provides for the carrying out of such policies by a full- or part-time physician referred to in subparagraph (B)(i); "(E) has a requirement that every patient must be under the care of a physician; "(F) in the case of a facility in any State in which State or applicable local law provides for the licensing of facilities of this nature (i) is licensed pursuant to such law, or (ii) is approved by the agency of such State or locality, responsible for licensing facilities of this nature, as meeting the standard establishment for such licensing; "(G) has in effect a utilization review plan in accordance with regulations prescribed by the Secretary; (H) has in effect an overall plan and budget that meets the requirements of subsection (z); and (I) meets such other conditions of participation as the Secretary may find necessary in the interest of the health and safety of individuals who are furnished services by such facility, including conditions concerning qualifications of personnel in these facilities.". (f) Section 1863 of such Act is amended by striking out "and (o)(6)" in the first sentence and inserting in lieu thereof "(o)(6), and (cc)(2)(I)".

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