Page:United States Statutes at Large Volume 96 Part 1.djvu/383

 PUBLIC LAW 97-248—SEPT. 3, 1982 services, to the extent that such payment is otherwise allowed under this paragraph, if such services, as determined under regulations of the Secretary— "(I) are required due to exceptional medical circumstances, "(II) are performed by team physicians needed to perform complex medical procedures, or "(III) constitute concurrent medical care relating to a medical condition which requires the presence of, and active care by, a physician of another specialty during surgery, and under such other circumstances as the Secretary determines by regulation to be appropriate. "(ii) For purposes of this subparagraph, the term 'assistant at surgery' means a physician who actively assists the physician in charge of a case in performing a surgical procedure. "(iii) Tlje Secretary shall determine appropriate methods of reimbursement of assistants at surgery where such services are reimbursable under this part.". (b)(1) The amendment made by subsection (a) is effective with respect to services performed on or after October 1, 1982. (2) The Secretary of Health and Human Services shall first issue such final regulations (whether on an interim or other basis) before October 1, 1982, as may be necessary to implement the amendment made by subsection (a) on a timely basis. If such regulations are promulgated on an interim final basis, the Secretary shall take such steps as may be necessary to provide opportunity for public comment, and appropriate revision based thereon, so as to provide that such regulations are not on an interim basis later than January 31, 1983.

96 STAT. 341

"Assistant at surgery."

Effective date. 42 USC 1395u note.

PAYMENTS TO HEALTH MAINTENANCE ORGANIZATIONS A N D COMPETITIVE MEDICAL PLANS

SEC. 114. (a) Section 1876 of the Social Security Act is amended to 42 USC 1395mm. read as follows: PAYMENTS TO HEALTH MAINTENANCE ORGANIZATIONS A N D COMPETITIVE MEDICAL PLANS

"SEC. 1876. (a)(l)(A) The Secretary shall annually determine— "(i) a per capita rate of payment for each class of individuals who are enrolled under this section with an eligible organization which has entered into a risk-sharing contract and who are entitled to benefits under part A and enrolled under part B, and "(ii) a per capita rate of payment for each class of individuals who are so enrolled with such an organization and who are enrolled under part B only. For purposes of this section, the term 'risk-sharing contract' means a contract entered into under subsection (g) and the term 'reasonable cost reimbursement contract' means a contract entered into under subsection (h). "(B) The Secretary shall define appropriate classes of members, based on age, disability status, and such other factors as the Secretary determines to be appropriate, so as to ensure actuarial equivalence. The Secretary may add to, modify, or substitute for such classes, if such changes will improve the determination of actuarial equivalence.

42 USC 1395c, 1395J.

Definitions.

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