Page:United States Statutes at Large Volume 95.djvu/819

 PUBLIC LAW 97-35—AUG. 13, 1981

95 STAT. 793

CHAPTER 3-PROFESSIONAL STANDARDS REVIEW ORGANIZATIONS (PSRO'S) MAKING DELEGATED REVIEW OPTIONAL

SEC. 2111. Section 1155(e) of the Social Security Act is amended by 42 USC i320c-4. striking out "shall utilize" and inserting in lieu thereof "may utilize. ASSESSMENT OP PSRO PERFORMANCE

SEC. 2112. (a)(1) Section 1154 of the Social Security Act is amended 42 USC 1320C-3. by adding at the end the following new subsection: "(g)(1) The Secretary shall, not later than September 30, 1981, identify and specify those requirements imposed by the Secretary with respect to the performance of Professional Standards Review Organizations which the Secretary will use for the assessment of the performance of such Organizations under this subsection. Such requirements shall include requirements relating to the effectiveness of such Organizations in (A) monitoring the quality of patient care, (B) reducing unnecessary utilization, and (C) managing its activities efficiently. "(2) Based on such requirements, the Secretary shall assess and determine the relative performance of each of such Organizations designated, conditionally or otherwise, as of September 30, 1981. "(3) If the Secretary determines that such an Organization has a relatively ineffective or inefficient performance, the Secretary may refuse to renew an agreement with the Organization under this part, except that, in exercising the Secretary's authority under this paragraph in fiscal year 1982, the sum of the number of Organizations with respect to which agreements are not renewed under this paragraph and under any other provision of this Act in the fiscal year may not exceed 30 percent of the number of such Organizations with agreements under this part on May 1, 1981.". 42 USC 1320C-1. (2)(A) Section 1152(d) of such Act is amended— (i) by striking out "for a term of 12 months" and inserting in lieu thereof "for a term of not longer than 12 months"; (ii) by striking out "at such time and upon such reasonable notice to the organization as may be prescribed in regulations" and inserting in lieu thereof "upon 90 days notice to the organization"; and (iii) by striking out "(after providing such organization with an opportunity for a formal hearing on the matter)". (B) Sections 1152(d) and 1154(d) of such Act are each amended by adding at the end the following sentence: "A termination of an agreement by the Secretary under this subsection shall not be subject to judicial review.". (C) The amendment made by subparagraph (A)(iii) shall apply to Effective date. agreements entered into on or after the date of the enactment of this 42 USC 1320C-1 note. Act. (D) The Secretary of Health and Human Services shall, not later 42 USC 1320C-3 than September 30, 1982, report to the Congress on his assessment note. (under section 1154(g) of the Social Security Act) of the relative performance of Professional Standards Review Organizations and on any determinations made not to renew agreements with such Organizations on the basis of such performance. (b)(1) The first sentence of subsection (b) of section 1154 of such Act 42 USC i320c-3 is amended—

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