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NOTES:
Source
(Aug. 14, 1935, ch. 531, title XVIII, § 1861, as added , title I, § 102(a), July 30, 1965, ; amended , § 7, Nov. 2, 1966, ; , title I, §§ 127(a),
129
(a), (b), (c)(9)(C), (10), (11),
,
, (b),
,
,
–(d), Jan. 2, 1968, , 852, 857, 858; , Jan. 12, 1971, ; , title II, §§ 211(b), (c)(2),
,
–(d), (f), 227(a), (c), (d)(1), (f), 234(a)–(f), 237(c), 244(c), 246(b), 248, 249(b), 251(a)(1), (b)(1), (c), 252(a), 256(b), 264(a), 265, 267, 273(a), 276(a), 278(a) (4)–(15), (b)(6), (10), (11), (13), 283(a), Oct. 30, 1972, , 1384, 1389, 1393, 1394, 1404–1407, 1412, 1413, 1416, 1423–1426, 1445–1447, 1449–1454, 1456; , title I, §§ 102,
,
, Dec. 31, 1975, , 1052, 1055; , §§ 3(a)(2),
,
,
, Oct. 25, 1977, , 1191, 1204, 1207; , § 1(d), (g), (h), Dec. 13, 1977, , 1487, 1488; , title V, § 501(a), Dec. 20, 1977, ; , § 4(d), June 13, 1978, ; , title IX, §§ 902(a)(1),
915
(a),
930
(k)–(n), (p), 931(c), (d), 933(c)–(e), 936(a), 937(a), 938(a), 948(a)(1), 949, 950, 951(a), (b), 952(a), formerly 952, Dec. 5, 1980, , 2623, 2632, 2633, 2635, 2639, 2640, 2643, 2645, 2646; , § 1(a)(1), (b)(3), Dec. 28, 1980, ; , title XXI, §§ 2102(a),
,
, (d),
,
2142
(a),
2143
(a),
2144
(a),
2193
(c)(9), Aug. 13, 1981, , 796–799, 828; , title I, §§ 101(a)(2), (d),
,
,
,
,
,
,
,
,
,
127
(1),
128
(a)(1), (d)(2),
, Sept. 3, 1982, , 350, 359, 366, 367, 394; , title III, § 309(a)(4), Jan. 12, 1983, ; , title VI, §§ 602(d),
, (d), Apr. 20, 1983, , 171, 172; , div. B, title III, §§ 2314(a),
2318
(a), (b),
2319
(a),
,
,
,
,
2335
(b),
2340
(a),
, (c),
,
, (b),
2354
(b)(18)–(29), July 18, 1984, , 1081, 1082, 1085, 1086, 1090, 1093, 1094, 1101; , § 3(a)(4), (b)(7), Nov. 8, 1984, , 3296; , title IX, §§ 9107(b),
9110
(a),
,
9219
(b)(1)(B), (3)(A), Apr. 7, 1986, , 162, 177, 182, 183; , title IX, §§ 9305(c)(1), (2),
9313
(a)(2),
9315
(a),
9320
(b), (c), (f),
9335
(c)(1),
9336
(a),
9337
(d),
9338
(a), Oct. 21, 1986, , 2002, 2005, 2013, 2015, 2030, 2033, 2034; , title IV, §§ 4009(e)(1), (f),
,
,
4039
(b),
4064
(e)(1),
4065
(a),
4070
(b)(1), (2),
,
,
4073
(a), (c),
4074
(a), (b),
4075
(a),
4076
(a),
4077
(a)(1), (b)(1), (4), formerly (5), 4078, 4084(c)(1), 4085(i)(9)–(14), 4201(a)(1), (b)(1), (d)(1), (2), (5), formerly (d), Dec. 22, 1987, , 1330–58, 1330–67, 1330–74, 1330–81, 1330–111, 1330–112, 1330–114, 1330–116, 1330–118 to 1330–121, 1330–132, 1330–133, 1330–160, 1330–174, as amended , title IV, § 411(h)(4)(D), (5)–(7)(A), (E), (F), (i)(3), (4)(C)(iii), (l)(1)(B), (C), July 1, 1988, , 801, as amended , title VI, § 608(d)(27)(B), Oct. 13, 1988, ; , title I, § 104(d)(4), title II, §§ 202(a),
, (e)(1),
,
,
, title IV, § 411(d)(1)(B)(i), (5)(A), (g)(3)(H), (h)(1)(B), (2), (3)(A), July 1, 1988, , 702, 721, 725, 730, 731, 773, 774, 785, 786; , title VI, § 608(d)(6)(A), (23)(B), Oct. 13, 1988, , 2421; , title VIII, §§ 8423(a),
8424
(a), Nov. 10, 1988, ; , title I, § 101(a), title II, § 201(a), Dec. 13, 1989, , 1981; , title VI, §§ 6003(g)(3)(A), (C)(i), (D)(x),
6110,
6112
(e)(1),
6113
(a)–(b)(2), 6114(a), (d), 6115(a), 6116(a)(1), 6131(a)(2), 6141(a), 6213(a)–(c), Dec. 19, 1989, , 2213, 2215–2219, 2221, 2225, 2250, 2251; , title IV, §§ 4008(h)(2)(A)(i),
, (b)(1),
,
,
, (d),
,
,
4161
(a)(1), (2), (5), (b)(1), (2),
4162
(a),
4163
(a),
,
4207
(d)(1), formerly 4027(d)(1), Nov. 5, 1990, , 1388–71, 1388–72, 1388–74, 1388–84, 1388–86 to 1388–88, 1388–93 to 1388–96, 1388–104, 1388–120, renumbered , title I, § 160(d)(4), Oct. 31, 1994, ; , title IV, § 401(c)(2), Nov. 16, 1990, ; , title XIII, §§ 13503(c)(1)(A),
,
,
, (b),
,
,
13564
(a)(2), (b)(1),
13565,
13566
(b), Aug. 10, 1993, , 586, 591, 592, 607; , title I, §§ 102(g)(4),
,
,
,
, (b),
, (4), (5), (f)(3), (4)(A), (6)(A), (B), (E),
158
(a)(1), Oct. 31, 1994, , 4405, 4407, 4427–4432, 4442; , § 4(b)(1), Oct. 11, 1996, ; , title IV, §§ 4102(a), (c),
,
,
, (b)(1),
,
, (2),
4205
(b)(1), (c)(1), (d)(1)–(3)(A), 4312(b)(1), (2), (d), (e), 4320, 4321(a), 4404(a), 4432(b)(5)(D), (E), 4444(a), 4445, 4446, 4451, 4454(a)(1), 4511(a)(1)–(2)(B), (d), 4512(a), 4513(a), 4522, 4531(a)(1), 4557(a), 4601(a), 4602(a)–(c), 4604(b), 4611(b), 4612(a), Aug. 5, 1997, , 366, 367, 373, 376, 377, 386, 387, 394, 400, 421–426, 442–444, 450, 463, 466, 472, 474; , div. J, title V, § 5101(a), (b), (d)(1), Oct. 21, 1998, , 2681–914; , div. B, § 1000(a)(6) [title II, §§ 201(k),
,
, title III, §§ 303(a),
,
321
(k)(7)–(9), title V, § 521], Nov. 29, 1999, , 1501A–341, 1501A–351, 1501A–354, 1501A–360, 1501A–361, 1501A–367, 1501A–386; , § 1(a)(6) [title I, §§ 101(a),
, (b),
,
, (b),
,
, title IV, §§ 430(b),
, title V, §§ 502(a),
541], Dec. 21, 2000, , 2763A–467, 2763A–468, 2763A–471, 2763A–473, 2763A–525, 2763A–529, 2763A–550.)
References in Text
Parts A and B of this subchapter, referred to in text, are classified to section
et seq. and section
et seq., respectively, of this title.
Section 4071(b) of the Omnibus Budget Reconciliation Act of 1987, referred to in subsec. (s)(10)(A), is section 4071(b) of , which is set out as a note below.
Section 4072(e) of the Omnibus Budget Reconciliation Act of 1987, referred to in subsec. (s)(12), is section 4072(e) of , which is set out as a note below.
The Public Health Service Act, referred to in subsec. (v)(1)(M), is act July 1, 1944, ch. 373, , as amended, which is classified generally to chapter 6A (§ 201 et seq.) of this title. Titles VI and XVI of the Public Health Service Act are classified generally to subchapters IV (§ 291 et seq.) and XIV (§ 300q et seq.), respectively, of chapter
of this title. For complete classification of this Act to the Code, see Short Title note set out under section
of this title and Tables.
Section
of this title, referred to in subsec. (v)(1)(T), was redesignated section
of this title by , div. B, § 1000(a)(6) [title II, §§ 201(a)(1),
], Nov. 29, 1999, , 1501A–336, 1501A–342.
Section
of this title, referred to in subsec. (v)(4), was repealed by , title VI, § 6017(2), Dec. 19, 1989, .
Part B of subchapter XI of this chapter, referred to in subsec. (w)(2), is classified to section
et seq. of this title.
Sections 329 and 330 of the Public Health Service Act, referred to in subsec. (aa)(2), (3)(B), were sections 329 and 330 of act July 1, 1944, which were classified, respectively, to sections
and
of this title and were omitted in the general amendment of subpart I (§ 254b et seq.) of part
of subchapter
of chapter
of this title by , § 2, Oct. 11, 1996, . Sections 2 and 3(a) of enacted new sections 330 and 330A of act July 1, 1944, which are classified, respectively, to sections
and
of this title.
Section 340 of the Public Health Service Act, referred to in subsec. (aa)(3)(B), was section 340 of act July 1, 1944, which was classified to section
of this title prior to repeal by , § 4(a)(3), Oct. 11, 1996, .
The Indian Self-Determination Act, referred to in subsec. (aa)(4)(D), is title I of , Jan. 4, 1975, , as amended, which is classified principally to part A (§ 450f et seq.) of subchapter
of chapter
of Title
, Indians. For complete classification of this Act to the Code, see Short Title note set out under section
of Title
and Tables.
The Indian Health Care Improvement Act, referred to in subsec. (aa)(4)(D), is , Sept. 30, 1976, , as amended. Title V of the Act is classified generally to subchapter IV (§ 1651 et seq.) of chapter
of Title
. For complete classification of this Act to the Code, see Short Title note set out under section
of Title
and Tables.
The Internal Revenue Code of 1986, referred to in subsec. (ss)(1)(A), is classified generally to Title 26, Internal Revenue Code.
Amendments
2000—Subsec. (s)(2)(A), (B). , § 1(a)(6) [title I, § 112(a)], substituted “(including drugs and biologicals which are not usually self-administered by the patient)” for “(including drugs and biologicals which cannot, as determined in accordance with regulations, be self-administered)”.
Subsec. (s)(2)(J). , § 1(a)(6) [title I, § 113(a)], struck out provisions limiting application to drugs furnished within 12 months after the date of the transplant procedure for drugs furnished before 1995, to within 18 months after the date of the transplant procedure for drugs furnished during 1995, to within 24 months after the date of the transplant procedure for drugs furnished during 1996, to within 30 months after the date of the transplant procedure for drugs furnished during 1997, and to within 36 months after the date of the transplant procedure plus additional number of months provided under section
for drugs furnished during any year after 1997.
Subsec. (s)(2)(U). , § 1(a)(6) [title I, § 102(a)], added subpar. (U).
Subsec. (s)(2)(V). , § 1(a)(6) [title I, § 105(a)], added subpar. (V).
Subsec. (t)(1). , § 1(a)(6) [title IV, § 430(b)], inserted “(including contrast agents)” after “only such drugs”.
Subsec. (v)(1)(L)(x). , § 1(a)(6) [title V, § 502(a)], struck out “2001,” after “ 2000,” and inserted at end “With respect to cost reporting periods beginning during fiscal year 2001, the update to any limit under this subparagraph shall be the home health market basket index.”
Subsec. (v)(1)(T)(ii). , § 1(a)(6) [title V, § 541(1)], struck out “and” at end.
Subsec. (v)(1)(T)(iii). , § 1(a)(6) [title V, § 541(2)], substituted “during fiscal year 2000” for “during a subsequent fiscal year” and “, and” for period at end.
Subsec. (v)(1)(T)(iv). , § 1(a)(6) [title V, § 541(3)], added cl. (iv).
Subsec. (ff)(3)(B). , § 1(a)(6) [title IV, § 431(a)], substituted “entity that—” for “entity—”, added cls. (i) to (iii), and struck out former cls. (i) and (ii) which read as follows:
“(i) providing the services described in section 1916(c)(4) of the Public Health Service Act; and
“(ii) meeting applicable licensing or certification requirements for community mental health centers in the State in which it is located.”
Subsec. (nn)(1), (2). , § 1(a)(6) [title I, § 101(a)], substituted “2 years” for “3 years”.
Subsec. (pp)(1)(C). , § 1(a)(6) [title I, § 103(a)(1)], substituted “Screening colonoscopy” for “In the case of an individual at high risk for colorectal cancer, screening colonoscopy”.
Subsec. (pp)(2). , § 1(a)(6) [title I, § 103(a)(2)], substituted “An” for “In paragraph (1)(C), an”.
Subsec. (uu). , § 1(a)(6) [title I, § 102(b)], added subsec. (uu).
Subsec. (vv). , § 1(a)(6) [title I, § 105(b)], added subsec. (vv).
1999—Subsec. (o)(7). , § 1000(a)(6) [title III, § 304(a)], amended par. (7) generally. Prior to amendment, par. (7) read as follows: “provides the Secretary on a continuing basis with a surety bond in a form specified by the Secretary and in an amount that is not less than $50,000; and”.
Subsec. (p)(1). , § 1000(a)(6) [title II, § 221(b)(1)(A)], substituted “, (3), or (4)” for “or (3)”.
Subsec. (r)(4). , § 1000(a)(6) [title II, § 221(b)(1)(B)], inserted “for purposes of subsection (p)(1) of this section and” after “but only”.
Subsec. (s)(2)(J)(v). , § 1000(a)(6) [title II, § 227(a)], inserted before semicolon at end “plus such additional number of months (if any) provided under section
of this title”.
Subsec. (s)(2)(T)(ii). , § 1000(a)(6) [title III, § 321(k)(7)], substituted semicolon for period at end.
Subsec. (v)(1)(L)(ix), (x). , § 1000(a)(6) [title III, § 303(a)], added cl. (ix) and redesignated former cl. (ix) as (x).
Subsec. (v)(1)(S)(ii)(I), (II). , § 1000(a)(6) [title II, § 201(k)], substituted “and until the first date that the prospective payment system under section
of this title is implemented” for “and during fiscal year 2000 before January 1, 2000”.
Subsec. (aa)(2)(I). , § 1000(a)(6) [title III, § 321(k)(8)], substituted semicolon for comma at end and realigned margins.
Subsec. (ee)(3). , § 1000(a)(6) [title V, § 521], added par. (3).
Subsec. (ss)(1)(G)(i). , § 1000(a)(6) [title III, § 321(k)(9)(B)], which directed substitution of “or” for “of”, was executed by making the substitution for “of” the second time appearing to reflect the probable intent of Congress.
, § 1000(a)(6) [title III, § 321(k)(9)(A)], substituted “owned” for “owed”.
1998—Subsec. (v)(1)(L)(i)(III) to (V). , § 5101(b), in subcl. (III) struck out “or” at end, in subcl. (IV) inserted “and before October 1, 1998,” after “1997,” and substituted “, or” for period at end, and added subcl. (V).
Subsec. (v)(1)(L)(v). , § 5101(a)(1), inserted “subject to clause (viii)(I),” before “the Secretary” in introductory provisions.
Subsec. (v)(1)(L)(vi)(I). , § 5101(a)(2), inserted “subject to clauses (viii)(II) and (viii)(III)” after “1994”.
Subsec. (v)(1)(L)(viii). , § 5101(a)(3), added cl. (viii).
Subsec. (v)(1)(L)(ix). , § 5101(d)(1), added cl. (ix).
1997—Subsec. (a). , § 4201(c)(1), substituted “critical access” for “rural primary care” in pars. (1) and (2).
Subsec. (b)(4). , § 4511(a)(2)(B), substituted “subsection (s)(2)(K)” for “clauses (i) or (iii) of subsection (s)(2)(K)”.
Subsec. (e). , § 4454(a)(1)(A), in fifth sentence after par. (9), substituted “includes a religious nonmedical health care institution (as defined in subsection (ss)(1) of this section),” for “includes a Christian Science sanatorium operated, or listed and certified, by the First Church of Christ, Scientist, Boston, Massachusetts,” and inserted “consistent with section
of this title” before the period.
, § 4201(c)(1), substituted “critical access” for “rural primary care” in last sentence.
Subsec. (h). , § 4432(b)(5)(D)(i), substituted “paragraphs (3), (6), and (7)” for “paragraphs (3) and (6)” in introductory provisions.
Subsec. (h)(7). , § 4432(b)(5)(D)(ii), inserted “, or by others under arrangements with them made by the facility” after “skilled nursing facilities”.
Subsec. (m). , § 4612(a), inserted at end of closing provisions “For purposes of paragraphs (1) and (4), the term ‘part-time or intermittent services’ means skilled nursing and home health aide services furnished any number of days per week as long as they are furnished (combined) less than 8 hours each day and 28 or fewer hours each week (or, subject to review on a case-by-case basis as to the need for care, less than 8 hours each day and 35 or fewer hours per week). For purposes of sections
and
of this title, ‘intermittent’ means skilled nursing care that is either provided or needed on fewer than 7 days each week, or less than 8 hours of each day for periods of 21 days or less (with extensions in exceptional circumstances when the need for additional care is finite and predictable).”
Subsec. (n). , § 4105(b)(1), inserted before semicolon in first sentence “, and includes blood-testing strips and blood glucose monitors for individuals with diabetes without regard to whether the individual has Type I or Type II diabetes or to the individual’s use of insulin (as determined under standards established by the Secretary in consultation with the appropriate organizations)”.
Subsec. (o). , § 4312(b)(1)(D), inserted at end of closing provisions “The Secretary may waive the requirement of a surety bond under paragraph (7) in the case of an agency or organization that provides a comparable surety bond under State law.”
Subsec. (o)(7), (8). , § 4312(b)(1)(A)–(C), added par. (7) and redesignated former par. (7) as (8).
Subsec. (p). , § 4312(e)(2), inserted at end of closing provisions “The Secretary may waive the requirement of a surety bond under paragraph (4)(A)(v) in the case of a clinic or agency that provides a comparable surety bond under State law.”
Subsec. (p)(4)(A)(v). , § 4312(e)(1), inserted “and provides the Secretary on a continuing basis with a surety bond in a form specified by the Secretary and in an amount that is not less than $50,000,” after “as the Secretary may find necessary,”.
Subsec. (r)(5). , § 4513(a), struck out “demonstrated by x-ray to exist” following “(to correct a subluxation”.
Subsec. (s)(2)(K)(i). , §§ 4511(a)(2)(A)(i),
, struck out “(I) in a hospital, skilled nursing facility, or nursing facility (as defined in section
of this title), (II) as an assistant at surgery, or (III) in a rural area (as defined in section
of this title) that is designated, under section 332(a)(1)(A) of the Public Health Service Act, as a health professional shortage area,” after “physician (as so defined)” and inserted at end “and such services and supplies furnished as incident to such services as would be covered under subparagraph (A) if furnished incident to a physician’s professional service; and but only if no facility or other provider charges or is paid any amounts with respect to the furnishing of such services,”.
Subsec. (s)(2)(K)(ii). , § 4511(a)(1), amended cl. (ii) generally. Prior to amendment, cl. (ii) read as follows: “services which would be physicians’ services if furnished by a physician (as defined in subsection (r)(1) of this section) and which are performed by a nurse practitioner (as defined in subsection (aa)(5) of this section) working in collaboration (as defined in subsection (aa)(6) of this section) with a physician (as defined in subsection (r)(1) of this section) in a skilled nursing facility or nursing facility (as defined in section
of this title) which the nurse practitioner is legally authorized to perform by the State in which the services are performed,”.
Subsec. (s)(2)(K)(iii), (iv). , § 4511(a)(2)(A)(ii), struck out cls. (iii) and (iv) which read as follows:
“(iii) services which would be physicians’ services if furnished by a physician (as defined in subsection (r)(1) of this section) and which are performed by a nurse practitioner or clinical nurse specialist (as defined in subsection (aa)(5) of this section) working in collaboration (as defined in subsection (aa)(6) of this section) with a physician (as defined in subsection (r)(1) of this section) in a rural area (as defined in section
of this title) which the nurse practitioner or clinical nurse specialist is authorized to perform by the State in which the services are performed, and such services and supplies furnished as an incident to such services as would be covered under subparagraph (A) if furnished as an incident to a physician’s professional service, and
“(iv) such services and supplies furnished as an incident to services described in clause (i) or (ii) as would be covered under subparagraph (A) if furnished as an incident to a physician’s professional service;”.
Subsec. (s)(2)(N) to (P). , § 4103(a)(1), struck out “and” at end of subpars. (N) and (O) and added subpar. (P).
Subsec. (s)(2)(R). , § 4104(a)(1)(A), added subpar. (R).
Subsec. (s)(2)(S). , § 4105(a)(1)(A), added subpar. (S).
Subsec. (s)(2)(T). , § 4557(a), added subpar. (T).
Subsec. (s)(12)(C). , § 4106(a)(1)(A), struck out “and” at end.
Subsec. (s)(14). , § 4102(c), inserted “and screening pelvic exam” after “screening pap smear”.
Subsec. (s)(15) to (17). , § 4106(a)(1)(B)–(D), added par. (15) and redesignated former pars. (15) and (16) as (16) and (17), respectively.
Subsec. (u). , § 4201(c)(1), substituted “critical access” for “rural primary care”.
Subsec. (v)(1)(H)(i). , § 4312(b)(2)(A), substituted “the surety bond requirement described in subsection (o)(7) of this section and the financial security requirement described in subsection (o)(8) of this section” for “the financial security requirement described in subsection (o)(7) of this section”.
Subsec. (v)(1)(H)(ii). , § 4312(b)(2)(B), substituted “the surety bond requirement described in subsection (o)(7) of this section and the financial security requirement described in subsection (o)(8) of this section apply” for “the financial security requirement described in subsection (o)(7) of this section applies”.
Subsec. (v)(1)(L)(i). , § 4602(a)(5), struck out closing provisions which read as follows: “of the mean of the labor-related and nonlabor per visit costs for free standing home health agencies.”
Subsec. (v)(1)(L)(i)(I). , § 4602(a)(1), (2), inserted “of the mean of the labor-related and nonlabor per visit costs for freestanding home health agencies” before comma at end and realigned margins.
Subsec. (v)(1)(L)(i)(II). , § 4602(a)(1), (3), substituted “of such mean,” for “, or” at end and realigned margins.
Subsec. (v)(1)(L)(i)(III). , § 4602(a)(1), (4), inserted “and before October 1, 1997,” after “July 1, 1987,”, substituted “of such mean, or” for comma at end, and realigned margins.
Subsec. (v)(1)(L)(i)(IV). , § 4602(a)(5), added subcl. (IV).
Subsec. (v)(1)(L)(iii). , § 4604(b), substituted “service is furnished” for “agency is located”.
, § 4602(b), inserted “, or on or after July 1, 1997, and before October 1, 1997” after “July 1, 1996”.
Subsec. (v)(1)(L)(iv). , § 4601(a), added cl. (iv).
Subsec. (v)(1)(L)(v) to (vii). , § 4602(c), added cls. (v) to (vii).
Subsec. (v)(1)(O)(i). , § 4404(a)(1), struck out “and (if applicable) a return on equity capital” after “capital indebtedness” and substituted “provider of services” for “hospital or skilled nursing facility”, “clause (iii)” for “clause (iv)”, and “the historical cost of the asset, as recognized under this subchapter, less depreciation allowed, to the owner of record as of August 5, 1997 (or, in the case of an asset not in existence as of August 5, 1997, the first owner of record of the asset after August 5, 1997).” for “the lesser of the allowable acquisition cost of such asset to the owner of record as of July 18, 1984 (or, in the case of an asset not in existence as of such date, the first owner of record of the asset after such date), or the acquisition cost of such asset to the new owner.”
Subsec. (v)(1)(O)(ii) to (iv). , § 4404(a)(2), (3), redesignated cls. (iii) and (iv) as (ii) and (iii), respectively, and struck out former cl. (ii) which read as follows: “Such regulations shall provide for recapture of depreciation in the same manner as provided under the regulations in effect on June 1, 1984.”
Subsec. (v)(1)(S)(ii)(I), (II). , § 4522, substituted “through 1999 and during fiscal year 2000 before January 1, 2000” for “through 1998”.
Subsec. (v)(1)(S)(ii)(III). , § 4201(c)(1), substituted “critical access” for “rural primary care”.
Subsec. (v)(1)(T). , § 4451, added subpar. (T).
Subsec. (v)(1)(U). , § 4531(a)(1), added subpar. (U).
Subsec. (v)(7)(D). , § 4432(b)(5)(E), inserted “subsections (a) through (c) of” before “section
of this title”.
Subsec. (v)(8). , § 4320, added par. (8).
Subsec. (w). , § 4201(c)(1), substituted “critical access” for “rural primary care” wherever appearing.
Subsec. (y). , § 4454(a)(1)(B)(i), substituted “Extended care in religious nonmedical health care institutions” for “Post-hospital extended care in Christian Science skilled nursing facilities” in heading.
Subsec. (y)(1). , § 4454(a)(1)(B)(iii), which directed the amendment of this subsec. by inserting “consistent with section
of this title” before the period, was executed by making the insertion in par. (1) to reflect the probable intent of Congress.
, § 4454(a)(1)(B)(ii), substituted “includes a religious nonmedical health care institution (as defined in subsection (ss)(1) of this section),” for “includes a Christian Science sanatorium operated, or listed and certified, by the First Church of Christ, Scientist, Boston, Massachusetts,”.
Subsec. (aa)(2). , § 4205(d)(3)(A), in second sentence of concluding provisions inserted before period at end “if it is determined, in accordance with criteria established by the Secretary in regulations, to be essential to the delivery of primary care services that would otherwise be unavailable in the geographic area served by the clinic”.
, § 4205(d)(1), (2), in cl. (i) of first sentence of concluding provisions substituted “Bureau of the Census) and in which there are insufficient numbers of needed health care practitioners (as determined by the Secretary), and that, within the previous 3-year period, has been designated” for “Bureau of the Census) and that is designated” and “personal health services or designated by the Secretary” for “personal health services, or that is designated by the Secretary”.
Subsec. (aa)(2)(I). , § 4205(b)(1), amended subpar. (I) generally. Prior to amendment, subpar. (I) read as follows: “has appropriate procedures for review of utilization of clinic services to the extent that the Secretary determines to be necessary and feasible;”.
Subsec. (aa)(5). , § 4511(d), designated existing provisions as subpar. (A), substituted “The term ‘physician assistant’ and the term ‘nurse practitioner’ mean, for purposes of this subchapter, a physician assistant or nurse practitioner who performs” for “The term ‘physician assistant’, the term ‘nurse practitioner’, and the term ‘clinical nurse specialist’ mean, for purposes of this subchapter, a physician assistant, nurse practitioner, or clinical nurse specialist who performs”, and added subpar. (B).
Subsec. (aa)(7)(B). , § 4205(c)(1), inserted before period at end “, or if the facility has not yet been determined to meet the requirements (including subparagraph (J) of the first sentence of paragraph (2)) of a rural health clinic”.
Subsec. (cc)(2). , § 4312(d)(4), inserted concluding provisions.
Subsec. (cc)(2)(I), (J). , § 4312(d)(1)–(3), added subpar. (I) and redesignated former subpar. (I) as (J).
Subsec. (dd)(1)(I). , § 4444(a), added subpar. (I).
Subsec. (dd)(2)(A)(ii)(I). , § 4445(1), substituted “subparagraphs (A), (C), and (H)” for “subparagraphs (A), (C), (F), and (H)”.
Subsec. (dd)(2)(B)(i). , § 4445(2), in concluding provisions, inserted “or, in the case of a physician described in subclause (I), under contract with” after “employed by”.
Subsec. (dd)(5)(B). , § 4446(1), inserted “or (C)” after “subparagraph (A)” in two places.
Subsec. (dd)(5)(C). , § 4446(2), added subpar. (C).
Subsec. (ee)(2)(D). , § 4321(a)(1), inserted before period at end “, including the availability of home health services through individuals and entities that participate in the program under this subchapter and that serve the area in which the patient resides and that request to be listed by the hospital as available”.
Subsec. (ee)(2)(H). , § 4321(a)(2), added subpar. (H).
Subsec. (mm). , § 4201(c)(2), amended heading and text of subsec. (mm) generally. Prior to amendment, text read as follows:
“(1) The term ‘rural primary care hospital’ means a facility designated by the Secretary as a rural primary care hospital under section
of this title.
“(2) The term ‘inpatient rural primary care hospital services’ means items and services, furnished to an inpatient of a rural primary care hospital by such a hospital, that would be inpatient hospital services if furnished to an inpatient of a hospital by a hospital.
“(3) The term ‘outpatient rural primary care hospital services’ means medical and other health services furnished by a rural primary care hospital.”
Subsec. (nn). , § 4102(a), substituted “Screening pap smear; screening pelvic exam” for “Screening pap smear” in heading, designated existing provisions as par. (1), inserted “or vaginal” after “cervical” in two places, substituted “3 years, or during the preceding year in the case of a woman described in paragraph (3).” for “3 years (or such shorter period as the Secretary may specify in the case of a woman who is at high risk of developing cervical or vaginal cancer (as determined pursuant to factors identified by the Secretary)).”, and added pars. (2) and (3).
Subsec. (oo). , § 4103(a)(2), added subsec. (oo).
Subsec. (pp). , § 4104(a)(1)(B), added subsec. (pp).
Subsec. (qq). , § 4105(a)(1)(B), added subsec. (qq).
Subsec. (rr). , § 4106(a)(2), added subsec. (rr).
Subsec. (ss). , § 4454(a)(1)(C), added subsec. (ss).
Subsec. (tt). , § 4611(b), added subsec. (tt).
1996—Subsec. (aa)(4)(A)(i). substituted “section
330 (other than subsection (h))” for “section
329,
330, or
340”.
Subsec. (aa)(4)(A)(ii)(II). which directed amendment of subcl. (I) by substituting “section
330 (other than subsection (h))” for “section
329,
330, or
340”, was executed to subcl. (II) to reflect the probable intent of Congress.
1994—Subsec. (a)(1). , § 102(g)(4)(A), substituted “inpatient hospital services, inpatient rural primary care hospital services” for “inpatient hospital services”.
Subsec. (a)(2). , § 102(g)(4)(B), substituted “hospital or rural primary care hospital” for “hospital”.
Subsec. (b)(3). , § 147(f)(3), made technical amendment to , § 4157(a). See 1990 Amendment note below.
Subsec. (b)(4). , § 147(f)(3), made technical amendment to , § 4157(a). See 1990 Amendment note below.
, § 147(e)(4), substituted “clauses (i) or (iii) of subsection (s)(2)(K) of this section” for “subsection (s)(2)(K)(i) of this section”.
Subsec. (e)(4). , § 104, substituted “physician, except that a patient receiving qualified psychologist services (as defined in subsection (ii) of this section) may be under the care of a clinical psychologist with respect to such services to the extent permitted under State law;” for “physician;”.
Subsec. (h)(3). , § 146(b)(1), substituted “or occupational therapy or speech-language pathology services” for “, occupational, or speech therapy”.
Subsec. (m)(2). , § 146(b)(2), substituted “or occupational therapy or speech-language pathology services” for “, occupational, or speech therapy”.
Subsec. (m)(5). , § 147(f)(6)(B)(ii), substituted “and a covered osteoporosis drug (as defined in subsection (kk) of this section), but excluding other drugs” for “but excluding drugs”.
Subsec. (p). , § 146(b)(3), substituted “speech-language pathology services” for “speech pathology services” after “term ‘outpatient physical therapy services’ also includes” in third sentence of closing provisions.
Subsec. (s)(2)(K)(iii). , § 147(e)(1), made an amendment identical to that made by , § 4161(a)(5)(A), substituting “subsection (aa)(5)” for “subsection (aa)(3)” and “subsection (aa)(6)” for “subsection (aa)(4)”.
Subsec. (s)(2)(N). , § 147(f)(6)(B)(iii)(I), inserted “and” at end.
Subsec. (s)(2)(O), (P). , § 147(f)(6)(B)(iii)(II), redesignated subpar. (P) as (O) and struck out former subpar. (O) which read as follows: “a covered osteoporosis drug and its administration (as defined in subsection (jj) of this section) furnished on or after January 1, 1991, and on or before December 31, 1995; and”.
Subsec. (s)(3). , § 145(b), inserted “and including diagnostic mammography if conducted by a facility that has a certificate (or provisional certificate) issued under section 354 of the Public Health Service Act” after “necessary”.
Subsec. (v)(1)(L)(iii). , § 158(a)(1), substituted “and determined using the survey of the most recent available wages and wage-related costs of hospitals” for “as of such date to hospitals”.
Subsec. (aa)(2). , § 147(f)(4)(A), in last sentence of closing provisions, substituted “approval as such a clinic” for “certification as such a clinic” and “Secretary’s approval or disapproval” for “the Secretary’s approval or disapproval of the certification”.
Subsec. (aa)(5). , § 147(e)(5), substituted “this subchapter” for “this chapter”.
Subsec. (cc)(1)(B). , § 146(b)(4), substituted “speech-language pathology services” for “speech pathology services”.
Subsec. (dd)(1)(B). , § 146(b)(5), substituted “therapy, or speech-language pathology services” for “therapy or speech-language pathology”.
Subsec. (ee)(2)(D). , § 107(a), inserted “, including hospice services,” after “post-hospital services”.
Subsec. (jj). , § 147(f)(6)(E), redesignated subsec. (jj), defining “covered osteoporosis drug”, as (kk).
, § 147(f)(6)(A), (B)(i), amended subsec. (jj), defining “covered osteoporosis drug”, in introductory provisions, by striking out “a bone fracture related to” before “post-menopausal osteoporosis” and substituting “individual by a home health agency if” for “individual if”, and in par. (1), by substituting “individual has suffered a bone fracture related to post-menopausal osteoporosis and that the individual” for “patient”.
Subsec. (kk). , § 147(f)(6)(E), redesignated subsec. (jj), defining “covered osteoporosis drug”, as (kk).
Subsec. (ll). , § 146(a), added subsec. (ll).
1993—Subsec. (s)(2)(J). , § 13565, substituted “subchapter, but only in the case of drugs furnished—” and cls. (i) to (v) for “subchapter, within 1 year after the date of the transplant procedure;”.
Subsec. (s)(2)(P). , § 13566(b), substituted “dialysis” for “home dialysis” and realigned margin.
Subsec. (s)(2)(Q). , § 13553(a), added subpar. (Q).
Subsec. (t). , § 13553(b), designated existing provisions as par. (1), inserted “and paragraph (2)”, and added par. (2).
Subsec. (v)(1)(B). , § 13503(c)(1), amended subpar. (B) generally. Prior to amendment, subpar. (B) read as follows: “Such regulations in the case of extended care services furnished by proprietary facilities shall include provision for specific recognition of a reasonable return on equity capital, including necessary working capital, invested in the facility and used in the furnishing of such services, in lieu of other allowances to the extent that they reflect similar items. The rate of return recognized pursuant to the preceding sentence for determining the reasonable cost of any services furnished in any cost reporting period shall be equal to the average of the rates of interest, for each of the months any part of which is included in the period, on obligations issued for purchase by the Federal Hospital Insurance Trust Fund.”
Subsec. (v)(1)(L)(ii). , § 13564(b)(1), struck out “, with appropriate adjustment for administrative and general costs of hospital-based agencies” after “discipline specific basis”.
Subsec. (v)(1)(L)(iii). , § 13564(a)(2), substituted “thereafter (but not for cost reporting periods beginning on or after July 1, 1994, and before July 1, 1996)” for “thereafter”.
Subsec. (v)(1)(S)(ii)(I). , § 13521, substituted “fiscal years 1992 through 1998” for “fiscal year 1992, 1993, 1994, or 1995”.
Subsec. (v)(1)(S)(ii)(II). , § 13522, substituted “fiscal years 1991 through 1998” for “fiscal years 1991, 1992, 1993, 1994, or 1995”.
Subsec. (aa)(4)(D). , § 13556(a), added subpar. (D).
Subsec. (gg)(2). , § 13554(a), substituted a period for “, and performs services in the area of management of the care of mothers and babies throughout the maternity cycle.”
1990—Subsec. (b)(3). , § 4157(a)(1), as amended by , § 147(f)(3), struck out “(including clinical psychologist (as defined by the Secretary))” after “the hospital or by others”.
Subsec. (b)(4). , § 4157(a)(2), as amended by , § 147(f)(3), substituted “, services described by subsection (s)(2)(K)(i) of this section, certified nurse-midwife services, qualified psychologist services, and services of a certified registered nurse anesthetist; and” for “and anesthesia services provided by a certified registered nurse anesthetist; and”.
Subsec. (n). , § 4152(a)(2), inserted at end “With respect to a seat-lift chair, such term includes only the seat-lift mechanism and does not include the chair.”
Subsec. (s)(2)(E). , § 4161(a)(1), inserted “and Federally qualified health center services” after “clinic services”.
Subsec. (s)(2)(H)(i). , § 4161(a)(5)(A), substituted “subsection (aa)(5)” for “subsection (aa)(3)”.
Subsec. (s)(2)(K)(i). substituted “health professional shortage area” for “health manpower shortage area”.
, § 4161(a)(5)(A), substituted “subsection (aa)(5)” for “subsection (aa)(3)”.
Subsec. (s)(2)(K)(ii). , § 4161(a)(5)(A), substituted “subsection (aa)(5)” for “subsection (aa)(3)” and “subsection (aa)(6)” for “subsection (aa)(4)”.
Subsec. (s)(2)(K)(iii). , § 4161(a)(5)(A), substituted “subsection (aa)(5)” for “subsection (aa)(3)” and “subsection (aa)(6)” for “subsection (aa)(4)”.
, § 4155(a)(3), added cl. (iii). Former cl. (iii) redesignated (iv).
Subsec. (s)(2)(K)(iv). , § 4155(a)(2), redesignated cl. (iii) as (iv).
Subsec. (s)(2)(O). , § 4156(a)(1), added subpar. (O).
Subsec. (s)(2)(P). , § 4201(d)(1), added subpar. (P).
Subsec. (s)(8). , § 4153(b)(2)(A), inserted “, and including one pair of conventional eyeglasses or contact lenses furnished subsequent to each cataract surgery with insertion of an intraocular lens” after “such devices”.
Subsec. (s)(13). , § 4163(a)(1), added par. (13).
Subsec. (v)(1)(E). , § 4008(h)(2)(A)(i), substituted “the costs (including the costs of services required to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident eligible for benefits under this subchapter) of such facilities” for “the costs of such facilities” in second sentence.
Subsec. (v)(1)(L)(iii). , § 4207(d)(1), formerly § 4027(d)(1), as renumbered by , § 160(d)(4), amended cl. (iii) generally. Prior to amendment, cl. (iii) read as follows: “In establishing limits under this subparagraph, the Secretary shall—
“(I) utilize a wage index that is based on verified wage data obtained from home health agencies, and
“(II) base such limits on the most recent verified wage data available, which data may be for cost reporting periods beginning no earlier than July 1, 1985.
In the case of a home health agency that refuses to provide data, or deliberately provides false data, respecting wages for purposes of this clause upon the request of the Secretary, the Secretary may withhold up to 5 percent of the amount of the payments otherwise payable to the agency under this subchapter until such date as the Secretary determines that such data has been satisfactorily provided.”
Subsec. (v)(1)(S)(ii)(I). , § 4151(a)(1), inserted before period at end “, by 15 percent for payments attributable to portions of cost reporting periods occurring during fiscal year 1991, and by 10 percent for payments attributable to portions of cost reporting periods occurring during fiscal year 1992, 1993, 1994, or 1995”.
Subsec. (v)(1)(S)(ii)(II). , § 4151(b)(1)(D), added subcl. (II). Former subcl. (II) redesignated (III).
, § 4151(b)(1)(A), substituted “Subclauses (I) and (II)” for “Subclause (I)” and “costs of hospital outpatient services provided by any hospital” for “capital-related costs of any hospital”.
, § 4151(a)(2), substituted “section
of this title or a rural primary care hospital (as defined in subsection (mm)(1) of this section)” for “section
of this title)”.
Subsec. (v)(1)(S)(ii)(III). , § 4151(b)(1)(C), redesignated former subcl. (II) as (III). Former subcl. (III) redesignated (IV).
, § 4151(b)(1)(B), substituted “subclauses (I) and (II)” for “subclause (I)” and “the costs reflected” for “capital-related costs reflected”.
Subsec. (v)(1)(S)(ii)(IV). , § 4151(b)(1)(C), redesignated subcl. (III) as (IV).
Subsec. (aa). , § 4161(a)(2)(A), inserted “and Federally qualified health center services” after “clinic services” in heading.
Subsec. (aa)(1)(B). , § 4161(a)(5)(B), substituted “paragraph (5)” for “paragraph (3)”.
Subsec. (aa)(2). substituted “health professional shortage area” for “health manpower shortage area” in second sentence.
, § 4161(b)(1), inserted at end “If a State agency has determined under section
of this title that a facility is a rural health clinic and the facility has applied to the Secretary for certification as such a clinic, the Secretary shall notify the facility of the the Secretary’s approval or disapproval of the certification not later than 60 days after the date of the State agency determination or the application (whichever is later).”
Subsec. (aa)(3). , § 4161(a)(2)(C), added par. (3). Former par. (3) redesignated (5).
, § 4161(a)(2)(B), which directed amendment of par. (3) by substituting “the previous provisions of this subsection” for “paragraphs (1) and (2)”, could not be executed because the words “paragraphs (1) and (2)” did not appear after amendment by , § 4155(d). See below.
, § 4155(d), substituted “The term ‘physician assistant’, the term ‘nurse practitioner’, and the term ‘clinical nurse specialist’ mean, for purposes of this chapter, a physician assistant, nurse practitioner, or clinical nurse specialist who performs” for “The term ‘physician assistant’ and the term ‘nurse practitioner’ mean, for the purposes of paragraphs (1) and (2), a physician assistant or nurse practitioner who performs”.
Subsec. (aa)(4) to (6). , § 4161(a)(2)(B), (C), added par. (4) and redesignated former pars. (3) and (4) as (5) and (6), respectively.
Subsec. (aa)(7). , § 4161(b)(2), added par. (7).
Subsec. (ff)(3). , § 4162(a), designated existing provision as subpar. (A), substituted “outpatients or by a community mental health center (as defined in subparagraph (B)),” for “outpatients”, and added subpar. (B).
Subsec. (jj). , § 4163(a)(2), added subsec. (jj) defining “screening mammography”.
, § 4156(a)(2), added subsec. (jj) defining “covered osteoporosis drug”.
1989—Subsec. (a). , § 101(a), repealed , § 104(d)(4)(A), and provided that the provisions of law amended or repealed by such section are restored or revived as if such section had not been enacted, see 1988 Amendment note below.
Subsec. (e). , § 6003(g)(3)(D)(x)(I), inserted at end “The term ‘hospital’ does not include, unless the context otherwise requires, a rural primary care hospital (as defined in subsection (mm)(1) of this section).”
, § 101(a), repealed , § 104(d)(4)(B), and provided that the provisions of law amended or repealed by such section are restored or revived as if such section had not been enacted, see 1988 Amendment note below.
Subsec. (i). , § 201(a), repealed , § 104(d)(4)(C), and provided that the provisions of law amended or repealed by such section are restored or revived as if such section had not been enacted, see 1988 Amendment note below.
Subsec. (m). , § 201(a), repealed , § 206(a), and provided that the provisions of law amended or repealed by such section are restored or revived as if such section had not been enacted, see 1988 Amendment note below.
Subsec. (m)(5). , § 6112(e)(1), amended par. (5) generally. Prior to amendment, par. (5) read as follows: “medical supplies (other than drugs and biologicals) and durable medical equipment, while under such a plan;”.
Subsec. (s). , § 6141(a)(1), substituted “, including a laboratory that is part of” for “which is independent of a physician’s office, a laboratory not independent of a physician’s office that has a volume of clinical diagnostic laboratory tests exceeding 5,000 per year,” in provisions following par. (14).
Subsec. (s)(2)(H)(ii). , § 6113(b)(2)(A), substituted “subsection (hh)(2)” for “subsection (hh)”.
Subsec. (s)(2)(J). , § 6114(a)(1), struck out “and” at end.
, § 201(a), repealed , § 202(a)(1), and provided that the provisions of law amended or repealed by such section are restored or revived as if such section had not been enacted, see 1988 Amendment note below.
Subsec. (s)(2)(K). , § 6114(a)(2), added cl. (ii), redesignated former cl. (ii) as (iii), and substituted “to services described in clause (i) or (ii)” for “to such services” in cl. (iii).
Subsec. (s)(2)(N). , § 6113(b)(1), added subpar. (N).
Subsec. (s)(12). , § 6131(a)(2), inserted “with inserts” after “custom molded shoes” in introductory provisions.
Subsec. (s)(13). , § 201(a), which repealed , § 204(a)(1)(B)–(D), and directed that the provisions of law amended or repealed by such section are restored or revived as if such section had not been enacted, was executed by striking out par. (13) as added by , § 204(a)(1)(B)–(D), but former par. (13) which was redesignated (14) was not restored in view of intervening redesignation as (15) by , § 6115(a)(1)(C), see 1988 Amendment note below.
Subsec. (s)(14). , § 6115(a)(1)(A), (B), (D), added par. (14). Former par. (14) redesignated (15).
, § 201(a), which repealed , § 204(a)(1)(A), and directed that the provisions of law amended or repealed by such section are restored or revived as if such section had not been enacted, was not executed in view of intervening redesignation of par. (14) as (15) by , § 6115(a)(1)(C), see 1988 Amendment note below.
Subsec. (s)(15). , § 6115(a)(1)(C), redesignated par. (14) as (15). Former par. (15) redesignated (16).
, § 201(a), which repealed , § 204(a)(1)(A), and directed that the provisions of law amended or repealed by such section are restored or revived as if such section had not been enacted, was not executed in view of intervening redesignation of par. (15) as (16) by , § 6115(a)(1)(C), see 1988 Amendment note below.
Subsec. (s)(16). , § 6141(a)(2), (3), added subpar. (A) and designated existing provisions as subpar. (B).
, § 6115(a)(1)(C), redesignated par. (15) as (16).
Subsec. (t). , § 201(a), repealed , § 202(a)(2), and provided that the provisions of law amended or repealed by such section are restored or revived as if such section had not been enacted, see 1988 Amendment note below.
Subsec. (u). , § 6003(g)(3)(C)(i), inserted “rural primary care hospital,” after “hospital,”.
, § 201(a), repealed , § 203(e)(1), and provided that the provisions of law amended or repealed by such section are restored or revived as if such section had not been enacted, see 1988 Amendment note below.
Subsec. (v)(1)(G)(i). , § 101(a), repealed , § 104(d)(4)(D), and provided that the provisions of law amended or repealed by such section are restored or revived as if such section had not been enacted, see 1988 Amendment note below.
Subsec. (v)(1)(S). , § 6110, designated existing provisions as cl. (i) and added cl. (ii).
Subsec. (v)(2)(A), (3). , § 101(a), repealed , § 104(d)(4)(D), and provided that the provisions of law amended or repealed by such section are restored or revived as if such section had not been enacted, see 1988 Amendment note below.
Subsec. (w)(1). , § 6003(g)(3)(D) (x)(II), inserted “rural primary care hospital,” after “hospital,”.
Subsec. (w)(2). , § 6003(g)(3)(D) (x)(III), substituted “hospital or rural primary care hospital” for “hospital” in six places.
Subsec. (y). , § 101(a), repealed , § 104(d)(4)(E), and provided that the provisions of law amended or repealed by such section are restored or revived as if such section had not been enacted, see 1988 Amendment note below.
Subsec. (aa)(1)(B). , § 6213(b), substituted “(as defined in paragraph (3)), by” for “(as defined in paragraph (3)), or by” and inserted “or by a clinical social worker (as defined in subsection (hh)(1) of this section),” after “Secretary)”.
Subsec. (aa)(2). , § 6213(c), in second sentence substituted “designated by the chief executive officer of the State and certified by the Secretary as an area with a shortage of personal health services, or that is designated by the Secretary” for “designated by the Secretary”, “section 330(b)(3) or 1302(7) of the Public Health Service Act,” for “section 1302(7) of the Public Health Service Act or”, and “medical care manpower, (III) as a high impact area described in section 329(a)(5) of that Act, or (IV) as an area which includes a population group which the Secretary determines has a health manpower shortage under section 332(a)(1)(B) of that Act,” for “medical care manpower,”.
Subsec. (aa)(2)(J), (K). , § 6213(a), added subpar. (J) and redesignated former subpar. (J) as (K).
Subsec. (aa)(4). , § 6114(d), added par. (4).
Subsec. (hh). , § 6113(b)(2)(B), inserted “; clinical social worker services” after “social worker” in heading, redesignated existing provisions as par. (1), redesignated former pars. (1) to (3) as subpars. (A) to (C), respectively, in subpar. (C), redesignated former subpars. (A) and (B) as cls. (i) and (ii), respectively, in cl. (ii), redesignated former cls. (i) and (ii) as subcls. (I) and (II), respectively, and added par. (2).
Subsec. (ii). , § 6113(a), struck out “on-site at a community mental health center (as such term is used in the Public Health Service Act), and such services that are necessarily furnished off-site (other than at an off-site office of such psychologist) as part of a treatment plan because of the inability of the individual furnished such services to travel to the center by reason of physical or mental impairment, because of institutionalization, or because of similar circumstances of the individual,” after “as defined by the Secretary)”.
Subsecs. (jj) to (ll). , § 201(a), repealed , §§ 203(b),
,
, and provided that the provisions of law amended or repealed by such sections are restored or revived as if such sections had not been enacted, see 1988 Amendment notes below.
Subsec. (mm). , § 6003(g)(3)(A), added subsec. (mm).
Subsec. (mm)(3). , § 6116(a)(1), added par. (3).
Subsec. (nn). , § 6115(a)(2), added subsec. (nn).
1988—Subsec. (a). , § 104(d)(4)(A), struck out subsec. (a) which defined “spell of illness”.
Subsec. (a)(2). , § 411(l)(1)(B)(i), (ii), redesignated and amended , § 4201(d)(1), see 1987 Amendment note below.
Subsec. (e). , § 104(d)(4)(B), substituted “and paragraph (7) of this subsection” for “paragraph (7) of this subsection, and subsection (i) of this section” in introductory provisions, struck out second sentence which read as follows: “For purposes of subsection (a)(2) of this section, such term includes any institution which meets the requirements of paragraph (1) of this subsection.”, substituted “and section
of this title” for “section
of this title, and subsection (i) of this section” in third sentence, and struck out “, except for purposes of subsection (a)(2) of this section,” after “such term shall not” in fifth sentence.
Subsec. (i). , § 104(d)(4)(C), struck out subsec. (i) which defined “post-hospital extended care services”.
Subsec. (m). , § 206(a), inserted at end “For purposes of paragraphs (1) and (4) and sections
and
of this title, nursing care and home health aide services shall be considered to be provided or needed on an ‘intermittent’ basis if they are provided or needed less than 7 days each week and, in the case they are provided or needed for 7 days each week, if they are provided or needed for a period of up to 38 consecutive days.”
Subsec. (n). , § 411(l)(1)(C), as added by , § 608(d)(27)(B), added , § 4201(d)(5), see 1987 Amendment note below.
, § 411(l)(1)(B)(iii), added , § 4201(d)(2), see 1987 Amendment note below.
, § 411(d)(1)(B)(i), inserted “; except that such term does not include such equipment furnished by a supplier who has used, for the demonstration and use of specific equipment, an individual who has not met such minimum training standards as the Secretary may establish with respect to the demonstration and use of such specific equipment” before period at end.
Subsec. (p). , § 8424(a), inserted at end “Nothing in this subsection shall be construed as requiring, with respect to outpatients who are not entitled to benefits under this subchapter, a physical therapist to provide outpatient physical therapy services only to outpatients who are under the care of a physician or pursuant to a plan of care established by a physician.”
Subsec. (s). , § 411(g)(3)(H), inserted a comma before “year” in provisions immediately preceding par. (13).
Subsec. (s)(2)(H)(ii). , § 411(h)(5)(A), amended , § 4074(a), see 1987 Amendment note below.
Subsec. (s)(2)(J). , § 202(a)(1), amended subpar. (J) generally, substituting “covered outpatient drugs (as defined in subsection (t) of this section); and” for former provision which related to prescription drugs used in immunosuppressive therapy.
Subsec. (s)(2)(K)(i). , § 411(h)(6), amended , § 4076(a), see 1987 Amendment note below.
Subsec. (s)(2)(K)(i)(I). , § 608(d)(23)(B), substituted “nursing facility (as defined in section
of this title)” for “intermediate care facility (as defined in section
of this title)”.
Subsec. (s)(2)(M). , § 411(h)(7)(A), made technical amendment to directory language of , § 4077(b)(1), see 1987 Amendment note below.
Subsec. (s)(10)(A). , § 411(h)(2), inserted “, subject to section 4071(b) of the Omnibus Budget Reconciliation Act of 1987,” before “influenza vaccine”.
Subsec. (s)(12). , § 411(h)(3)(A), inserted “subject to section 4072(e) of the Omnibus Budget Reconciliation Act of 1987,” in introductory provisions.
Subsec. (s)(13). , § 204(a)(1)(B)–(D), added par. (13) relating to screening mammography (as defined in subsection (kk) of this section). Former par. (13) redesignated (14).
Subsec. (s)(14). , § 204(a)(1)(A), redesignated par. (13) as (14). Former par. (14) redesignated (15).
Subsec. (s)(15). , § 411(i)(4)(C)(iii), amended directory language of , § 4085(i)(11), to correct an error, see 1987 Amendment note below.
, § 204(a)(1)(A), redesignated par. (14) as (15).
Subsec. (s)(16). , § 411(i)(4)(C)(iii), amended directory language of , § 4085(i)(11), to correct an error, see 1987 Amendment note below.
Subsec. (t). , § 202(a)(2), designated existing provisions as par. (1), inserted “and paragraph (2)”, and added pars. (2) to (4) defining “covered outpatient drug” and “covered home IV drug”.
Subsec. (u). , § 203(e)(1), inserted “home intravenous drug therapy provider,” after “hospice program,”.
Subsec. (v)(1)(G)(i). , § 104(d)(4)(D), struck out “post-hospital” before “extended care services” in four places.
Subsec. (v)(1)(L)(iii). , § 411(d)(5)(A), substituted “verified” for “audited” in subcls. (I) and (II) and inserted at end “In the case of a home health agency that refuses to provide data, or deliberately provides false data, respecting wages for purposes of this clause upon the request of the Secretary, the Secretary may withhold up to 5 percent of the amount of the payments otherwise payable to the agency under this subchapter until such date as the Secretary determines that such data has been satisfactorily provided.”
Subsec. (v)(2)(A), (3). , § 104(d)(4)(D), struck out “post-hospital” before “extended care services”.
Subsec. (y). , § 104(d)(4)(E)(i), substituted “Extended care” for “Post-hospital extended care” in heading.
Subsec. (y)(1). , § 104(d)(4)(E)(ii), struck out “(except for purposes of subsection (a)(2) of this section)” after “Massachusetts, but only”.
Subsec. (y)(2). , § 104(d)(4)(E)(i), (iii), (iv), struck out “post-hospital” before “extended care services” in two places, substituted “year” for “spell of illness” and “spell” wherever each appeared, and substituted “45 days” for “30 days”.
Subsec. (y)(3). , § 104(d)(4)(E)(i), (iii), (v), struck out “post-hospital” before “extended care services” and substituted “year” for “spell of illness”, “the coinsurance amount established under section
of this title for each day before the 46th day” for “one-eighth of the inpatient hospital deductible for each day before the 31st day”, and “year” for “spell”.
Subsec. (y)(4). , § 104(d)(4)(E)(vi), struck out par. (4) which provided that certain determinations about services provided by an institution described in par. (1) be made under regulations.
Subsec. (bb)(2). , § 411(i)(3), added , § 4084(c)(1), see 1987 Amendment note below.
Subsec. (ff). , § 411(h)(1)(B)(i), inserted heading.
Subsec. (ff)(3). , § 411(h)(1)(B)(ii), substituted “furnished by a hospital to its outpatients” for “hospital-based or hospital-affiliated (as defined by the Secretary)”.
Subsec. (gg). , § 411(h)(4)(D), amended , § 4073(c), see 1987 Amendment note below.
Subsec. (hh). , § 411(h)(5)(B), amended , § 4074(b), see 1987 Amendment note below.
Subsec. (ii). , § 8423(a), inserted “on-site” before “at a community mental health center” and “, and such services that are necessarily furnished off-site (other than at an off-site office of such psychologist) as part of a treatment plan because of the inability of the individual furnished such services to travel to the center by reason of physical or mental impairment, because of institutionalization, or because of similar circumstances of the individual,” after “Public Health Service Act)”.
, § 411(h)(7)(E), (F), redesignated and amended , § 4077(b)(4), see 1987 Amendment note below.
Subsec. (jj). , § 608(d)(6)(A), inserted heading.
, § 203(b), added subsec. (jj) relating to home intravenous drug therapy services.
Subsec. (kk). , § 204(a)(2), added subsec. (kk) relating to screening mammography.
Subsec. (ll). , § 205(b), added subsec. (ll) relating to in-home care furnished to chronically dependent individual.
1987—Subsec. (a)(2). , § 4201(d)(1), formerly § 4201(d), as redesignated and amended by , § 411(l)(1)(B)(i), (ii), substituted “facility described in section
1396i–3
(a)(1) of this title or subsection (y)(1) of this section” for “skilled nursing facility”.
Subsec. (b)(3). , § 4009(e)(1), inserted “(including clinical psychologist (as defined by the Secretary))” before “under arrangements”.
Subsec. (b)(4). , § 4085(i)(9), substituted “and anesthesia” for “, anesthesia” and “certified registered nurse” for “certified certified registered nurse”.
Subsec. (b)(6). , § 4039(b)(2), substituted “Council on Podiatric Medical Education of the American Podiatric Medical Association” for “Council on Podiatry Education of the American Podiatry Association”.
Subsec. (e)(4). , § 4009(f), inserted “with respect to whom payment may be made under this subchapter” after “patient”.
Subsec. (g). , § 4085(i)(10), made technical amendment to heading.
Subsec. (j). , § 4201(a)(1), amended subsec. generally, substituting provision defining “skilled nursing facility” as having the meaning given such term in section
of this title for provision defining “skilled nursing facility” as, except for purposes of subsec. (a)(2) of this section, an institution or a distinct part of an institution which has in effect a transfer agreement, meeting the requirements of subsec. (l) of this section, with one or more hospitals having agreements in effect under section
of this title and which meet a specified list of criteria.
Subsec. (n). , § 4201(d)(2), (5), as added by , § 411(l)(1)(B)(iii), and , § 411(l)(1)(C), as added by , § 608(d)(27)(B), made similar amendments, resulting in the substitution of “subsection (e)(1) of this section or section
of this title” for “subsection (e)(1) or (j)(1) of this section” in introductory provisions.
Subsec. (o)(6). , § 4021(a), inserted “the conditions of participation specified in section
of this title and” after “meets”.
Subsec. (r)(3). , § 4039(b)(1), substituted “subsections (k), (m), (p)(1), and (s) of this section and sections
,
, and
of this title” for “subsection (s) of this section”, and struck out “; and for the purposes of subsections (k), (m), and (p)(1) of this section and sections
,
, and
of this title but only if his performance of functions under subsections (k), (m), and (p)(1) of this section and sections
,
, and
of this title is consistent with the policy of the institution or agency with respect to which he performs them and with the functions which he is legally authorized to perform”.
Subsec. (s). , § 4085(i)(11), substituted in closing provisions “which would not be included under subsection (b) of this section if it were furnished to an inpatient of a hospital.” for “which—” before par. (15) and struck out pars. (15) and (16).
, § 4064(e)(1), inserted “a laboratory not independent of a physician’s office that has a volume of clinical diagnostic laboratory tests exceeding 5,000 per year” in provisions preceding par. (13).
Subsec. (s)(2)(B). , § 4070(b)(1), inserted “and partial hospitalization services incident to such services” before semicolon.
Subsec. (s)(2)(H)(ii). , § 4074(a), as amended by , § 411(h)(5)(A), inserted “or by a clinical social worker (as defined in subsection (hh) of this section)” after “clinical psychologist (as defined by the Secretary)”, and substituted “incident to such clinical psychologist’s services or clinical social worker’s services” for “incident to his services”.
Subsec. (s)(2)(J). , § 4075(a), substituted “prescription drugs used in immunosuppressive therapy” for “immunosuppressive drugs”.
Subsec. (s)(2)(K)(i). , § 4076(a), as amended by , § 411(h)(6), inserted “(I)” and substituted “, (II) as an assistant at surgery, or (III) in a rural area (as defined in section
of this title) that is designated, under section 332(a)(1)(A) of the Public Health Service Act, as a health manpower shortage area,” for “or as an assistant at surgery”.
Subsec. (s)(2)(L). , § 4073(a), added subpar. (L).
Subsec. (s)(2)(M). , § 4077(b)(1), as amended by , § 411(h)(7)(A), added subpar. (M).
Subsec. (s)(10)(A). , § 4071(a), inserted “and influenza vaccine and its administration” before semicolon.
Subsec. (s)(12). , § 4072(a), added par. (12). Former par. (12) redesignated (13).
Subsec. (s)(13), (14). , § 4072(a)(1), redesignated pars. (12) and (13) as (13) and (14), respectively. Former par. (14) redesignated (15).
Subsec. (s)(15). , § 4085(i)(11), as amended by , § 411(i)(4)(C)(iii), struck out par. (15) which read as follows: “would not be included under subsection (b) of this section if it were furnished to an inpatient of a hospital; or”.
, § 4072(a)(1), redesignated par. (14) as (15). Former par. (15) redesignated (16).
Subsec. (s)(16). , § 4085(i)(11), as amended by , § 411(i)(4)(C)(iii), struck out par. (16) which read as follows: “is furnished under arrangements referred to in such paragraph (2)(C) unless furnished in the hospital or in other facilities operated by or under the supervision of the hospital or its organized medical staff.”
, § 4072(a)(1), redesignated par. (15) as (16).
Subsec. (v)(1)(E). , § 4201(b)(1), inserted at end “Notwithstanding the previous sentence, such regulations with respect to skilled nursing facilities shall take into account (in a manner consistent with subparagraph (A) and based on patient-days of services furnished) the costs of such facilities complying with the requirements of subsections (b), (c), and (d) of section
of this title (including the costs of conducting nurse aide training and competency evaluation programs and competency evaluation programs).”
Subsec. (v)(1)(L)(iii). , § 4026(a)(1), added cl. (iii).
Subsec. (v)(1)(S). , § 4065(a), added subpar. (S).
Subsec. (v)(5)(A). , § 4085(i)(12), substituted “subsection (p)” and “subsection (g)” for “section
” and “section
”, respectively.
Subsec. (aa)(1)(B). , § 4077(a)(1), substituted “physician assistant or a nurse practitioner (as defined in paragraph (3)), or by a clinical psychologist (as defined by the Secretary),” for “physician assistant or by a nurse practitioner”.
Subsec. (bb). , § 4085(i)(13), made technical amendment to heading.
Subsec. (bb)(2). , § 4084(c)(1), as added by , § 411(i)(3), inserted at end “Such term also includes, as prescribed by the Secretary, an anesthesiologist assistant.”
Subsec. (cc)(1). , § 4078, inserted provision at end relating to location requirements in case of physical therapy, occupational therapy, and speech pathology services.
Subsec. (ee). , § 4085(i)(14), made technical amendment to heading.
Subsec. (ff). , § 4070(b)(2), added subsec. (ff).
Subsec. (gg). , § 4073(c), as amended by , § 411(h)(4)(D), added subsec. (gg).
Subsec. (hh). , § 4074(b), as amended by , § 411(h)(5)(B), added subsec. (hh).
Subsec. (ii). , § 4077(b)(4), formerly § 4077(b)(5), as redesignated and amended by , § 411(h)(7)(E), (F), added subsec. (ii).
1986—Subsec. (b)(4). , § 9320(f), inserted before the semicolon at end “, anesthesia services provided by a certified registered nurse anesthetist”.
Subsec. (e)(6). , § 9305(c)(1), inserted “(A)” after “(6)” and cl. (B).
Subsec. (g). , § 9337(d)(1), added subsec. (g).
Subsec. (n). , § 9219(b)(1)(B), substituted “as his home” for “at his home”.
Subsec. (r)(4). , § 9336(a), amended cl. (4) generally. Prior to amendment, cl. (4) read as follows: “a doctor of optometry who is legally authorized to practice optometry by the State in which he performs such function, but only with respect to services related to the condition of aphakia, or”.
Subsec. (s)(2)(D). , § 9337(d)(2), inserted “and outpatient occupational therapy services”.
Subsec. (s)(2)(J). , § 9335(c)(1), added subpar. (J).
Subsec. (s)(2)(K). , § 9338(a), added subpar. (K).
Subsec. (s)(11) to (15). , § 9320(b), added par. (11) and redesignated former pars. (11) to (14) as (12) to (15), respectively.
Subsec. (v)(1)(B). , § 9107(b)(2), substituted “any cost reporting period shall be equal to” for “any fiscal period shall not exceed one and one-half times” and “the period” for “such fiscal period”.
Subsec. (v)(1)(G)(i). , § 9219(b)(3)(A), inserted “on the basis of” after “(during such period)” in provisions following subcl. (III).
Subsec. (v)(1)(L). , § 9315(a), inserted “(i)” after “(L)”, struck out “the 75th percentile of such costs per visit for free standing home health agencies, or, in the judgment of the Secretary, such lower percentile or such comparable or lower limit (based on or related to the mean of the costs of such agencies or otherwise) as the Secretary may determine.”, and substituted in lieu “for cost reporting periods beginning on or after—
“(I) July 1, 1985, and before July 1, 1986, 120 percent,
“(II) July 1, 1986, and before July 1, 1987, 115 percent, or
“(III) July 1, 1987, 112 percent,
of the mean of the labor-related and nonlabor per visit costs for free standing home health agencies.
“(ii) Effective for cost reporting periods beginning on or after July 1, 1986, such limitations shall be applied on an aggregate basis for the agency, rather than on a discipline specific basis, with appropriate adjustment for administrative and general costs of hospital-based agencies.”
Subsec. (v)(1)(O)(i). , § 9110(a)(1), inserted “, except as provided in clause (iv),” after “such regulations shall provide”.
Subsec. (v)(1)(O)(iv). , § 9110(a)(2), added cl. (iv).
Subsec. (v)(1)(P). , § 9107(b)(1), added subpar. (P).
Subsec. (v)(1)(Q). , § 9202(i)(1), added subpar. (Q).
Subsec. (v)(1)(R). , § 9313(a)(2), added subpar. (R).
Subsec. (v)(5)(A). , § 9337(d)(3), inserted “(including through the operation of subsection (g) of this section)” after “subsection (p) of this section”.
Subsec. (bb). , § 9320(c), added subsec. (bb).
Subsec. (ee). , § 9305(c)(2), added subsec. (ee).
1984—Subsec. (d). , § 2335(b)(1), struck out subsec. (d) which defined “inpatient tuberculosis hospital services” as inpatient hospital services furnished to an inpatient of a tuberculosis hospital.
Subsec. (e). , § 2335(b)(2), struck out “or tuberculosis unless it is a tuberculosis hospital (as defined in subsection (g) of this section) or” before “unless it is a psychiatric hospital” in provisions following par. (9).
Subsec. (f). , § 2340(a), struck out par. (5) which provided that “psychiatric hospital” meant an institution which was accredited by the Joint Commission on Accreditation of Hospitals, and struck out “if the institution is accredited by the Joint Commission on Accreditation of Hospitals or if such distinct part meets requirements equivalent to such accreditation requirements as determined by the Secretary” in concluding provisions.
Subsec. (g). , § 2335(b)(1), struck out subsec. (g) which defined “tuberculosis hospital”.
Subsec. (j). , § 2335(b)(3), in provisions following par. (15), struck out “or tuberculosis” after “treatment of mental diseases”.
Subsec. (j)(2). , § 2354(b)(18), substituted “provision for” for “provision of”.
Subsec. (j)(13). , § 2354(b)(19), substituted “an institution” for “a nursing home”.
Subsec. (m)(5). , § 2321(e)(1), which directed the substitution of “and durable medical equipment” for “, and the use of medical applicances” was executed by making the substitution for “, and the use of medical appliances” as the probable intent of Congress.
Subsec. (n). , § 2321(e)(3), added subsec. (n).
Subsec. (p)(1). , § 2341(a), substituted “paragraph (1) or (3) of subsection (r) of this section” for “subsection (r)(1) of this section”.
Subsec. (p)(2). , § 2342(a), substituted “by a physician as so defined) or by a qualified physical therapist and is periodically reviewed by a physician (as so defined)” for “, and is periodically reviewed, by a physician (as so defined)”.
Subsec. (r)(3). , § 3(b)(7), substituted “under subsections (k), (m), and (p)(1) of this section and sections
,
, and
of this title” for “under subsections (k) and (m) and sections
and
of this title” before “is consistent with the policy”.
, § 2341(c), substituted “for the purposes of subsections (k), (m), and (p)(1) of this section” for “for the purposes of subsections (k) and (m) of this section”, and substituted “sections
,
, and
of this title but only if” for “sections
and
of this title but only if”.
Subsec. (s)(2)(H). , § 2322(a), designated existing provisions as cl. (i) and added cl. (ii).
Subsec. (s)(2)(I). , § 2324(a), added subpar. (I).
Subsec. (s)(6). , § 2321(e)(2), struck out provision which included iron lungs, oxygen tents, etc. with durable medical equipment. See subsec. (n) of this section.
Subsec. (s)(10). , § 2323(a), designated existing provisions as subpar. (A) and added subpar. (B).
Subsec. (u). , § 2354(b)(20), struck out “or” before “home health agency”.
Subsec. (v)(1)(B). , § 2354(b)(21)(A), realigned margin of subpar. (B).
Subsec. (v)(1)(C). , § 2354(b)(21)(B), realigned margins of subpar. (C).
Subsec. (v)(1)(C)(i). , § 2354(b)(22), inserted a dash after “but only if”.
Subsec. (v)(1)(D). , § 2354(b)(21)(B), realigned margin of subpar. (D).
, § 2354(b)(21)(C), inserted a comma after “section
of this title”.
Subsec. (v)(1)(E). , § 2319(a)(1), struck out cl. (i) which directed that such regulations provide that any determination of reasonable cost with respect to services provided by hospital-based skilled nursing facilities be made on the basis of a single standard based on the reasonableness of costs incurred by free standing skilled nursing facilities, subject to such adjustments as deemed appropriate by the Secretary, and struck out the designation “(ii)”.
, § 2354(b)(23), as amended by , § 3(a)(4), substituted “use” for “uses”.
Subsec. (v)(1)(I)(i), (ii). , § 2354(b)(24), substituted “by the Secretary, or upon request by the Comptroller General” for “to the Secretary, or upon request to the Comptroller General”.
Subsec. (v)(1)(K). , § 2318(a), (b), designated existing provisions as cl. (i), substituted therein “as defined in clause (ii)” for “provided in an emergency room”, and added cl. (ii).
Subsec. (v)(1)(O). , § 2314(a), added subpar. (O).
Subsec. (v)(3). , § 2354(b)(25), substituted “semi-private” for “semiprivate” after “furnished in”.
Subsec. (v)(7)(D). , § 2319(a)(2), added subpar. (D).
Subsec. (z)(2). , § 2354(b)(26), substituted “paragraph (1)” for “subparagraph (1)”.
Subsec. (aa)(2)(I). , § 2354(b)(27), substituted “utilization” for “ultilization”.
Subsec. (cc)(1)(F). , § 2354(b)(28), substituted “self-administered” for “self administered”.
Subsec. (cc)(1)(G). , § 2321(e)(4), substituted “and durable medical equipment” for “, appliances, and equipment, including the purchase or rental of equipment”.
Subsec. (cc)(2)(F). , § 2354(b)(29), substituted “standards established” for “standard establishment”.
Subsec. (dd)(2)(A)(ii)(I). , § 2343(a), inserted “except as otherwise provided in paragraph (5),”.
Subsec. (dd)(5). , § 2343(b), added par. (5).
1983—Subsec. (v)(1)(G)(i). , § 602(d)(1), substituted “the amount otherwise payable under part A with respect to” for “on the basis of the reasonable cost of” in provisions following subcl. (III).
Subsec. (v)(2)(A). , § 602(d)(2), substituted “the amount that would be taken into account with respect to” for “an amount equal to the reasonable cost of”.
Subsec. (v)(2)(B). , § 602(d)(3), struck out “the equivalent of the reasonable cost of” after “only”.
Subsec. (v)(3). , § 602(d)(4), substituted “the amount otherwise payable under this subchapter for such bed and board furnished in semiprivate accommodations” for “the reasonable cost of such bed and board furnished in semiprivate accommodations (determined pursuant to paragraph (1))”.
Subsec. (v)(7)(C). amended directory language of , § 109(b)(2), to correct typographical error, and did not involve any change in text. See 1982 Amendment note below.
Subsec. (z)(2). , § 607(d), designated existing provisions as subpar. (A) and added subpar. (B).
, § 607(b)(2), substituted “$600,000 (or such lesser amount as may be established by the State under section
of this title in which the hospital is located)” for “$100,000”.
1982—Subsec. (e)(C). , § 128(d)(2), substituted “(i) may” for “may (i),”.
Subsec. (s)(2)(H). , § 114(b), added subpar. (H).
Subsec. (u). , § 122(d)(1), inserted “hospice program,” after “home health agency,”.
Subsec. (v)(1)(E). , § 102(a), struck out provisions that this subparagraph would not apply to any skilled nursing facility that either was a distinct part of or directly operated by a hospital or was in a close, formal satellite relationship with a participating hospital, and in the case of the latter, the reasonable cost of any services furnished by such facility as determined by the Secretary under this subsection would not exceed 150 percent of the costs determined by the application of this subparagraph, redesignated the remainder as cl. (ii), and added cl. (i).
Subsec. (v)(1)(G)(i). , § 148(b), substituted “quality control and peer review organization” for “Professional Standards Review Organization”.
Subsec. (v)(1)(H)(iii). , § 109(b)(1), struck out “(I)” and “, or (II) which determines the amount payable by the home health agency on the basis of a percentage of the agency’s reimbursement or claim for reimbursement for services furnished by the agency”.
Subsec. (v)(1)(I). , § 127(1), amended directory language of , § 952, by inserting “(a)” after “952”, and did not involve any change in text. See 1980 Amendment note below.
Subsec. (v)(1)(J). , § 103(a), substituted provisions that cost regulations may not provide for any inpatient routine salary cost differential as a reimbursable cost for hospitals and skilled nursing facilities for provisions that such regulations would provide that an inpatient routine nursing salary cost differential would be allowable as a reimbursable cost of hospitals, at a rate not to exceed 5 percent, to be applied under the same methodology used for the nursing salary cost differential for the month of April 1981.
Subsec. (v)(1)(L). , § 101(a)(2), struck out cl. (i) which provided that the Secretary, in determining the amount of the payments that could be made under this subchapter with respect to routine operating costs for the provision of general inpatient hospital services, could not recognize as reasonable, routine operating costs for the provision of general inpatient hospital services by a hospital to the extent these costs exceeded 108 percent of the mean of such routine operating costs per diem for hospitals, or, in the judgment of the Secretary, such lower percentage or such comparable or lower limit as the Secretary could determine, and struck out “(ii)”.
, § 105(a), inserted “free standing” after “costs per visit for”.
Subsec. (v)(1)(M). , § 106(a), added subpar. (M).
Subsec. (v)(1)(N). , § 107(a), added subpar. (N).
Subsec. (v)(7). , § 101(d), redesignated existing provisions as subpar. (A) and added subpar. (B).
Subsec. (v)(7)(C). , § 108(a)(2), added subpar. (C).
, § 109(b)(2), as amended by , § 309(a)(4), inserted “and for payments under certain percentage arrangements”.
Subsec. (w)(1). , § 122(d)(2), substituted “home health agency, or hospice program” for “or home health agency”.
Subsec. (w)(2). , § 148(b), substituted “quality control and peer review organization” for “Professional Standards Review Organization”.
Subsec. (cc)(1). , § 128(a)(1), substituted “inpatient” for “outpatient” in provisions following subpar. (H).
Subsec. (dd). , § 122(d)(3), added subsec. (dd).
1981—Subsec. (u). , § 2121(c), struck out “detoxification facility,” after “home health agency,”.
Subsec. (v)(1)(G)(i). , § 2102(a)(1), substituted “there is not an excess of hospital beds in such hospital and (subject to clause (iv)) there is not an excess of hospital beds in the area of such hospital” for “the hospital had (during the immediately preceding calendar year) an average daily occupancy rate of 80 percent or more” in provision following subcl. (III).
, § 2114, substituted “the Secretary or such agent as the Secretary may designate” for “an organization or agency with review responsibility as is otherwise provided for under part A of subchapter XI of this chapter” in provision preceding subcl. (I).
Subsec. (v)(1)(G)(iv). , § 2102(a)(2), substituted provisions that the determination under cl. (i) of this subparagraph, in the case of a public hospital, whether or not there is an excess of hospital beds in the area of such hospital, be made on the basis of only the public hospitals which are in the area of the hospital and which are under common ownership with that hospital for provisions that public hospitals under common ownership may elect to be treated as a single hospital, and beginning two years after the date this subparagraph is first applied with respect to a hospital, the Secretary, to the extent feasible, shall not treat as an inpatient an individual with respect to whom payment was made to the hospital only because of this subparagraph or section
of this title for such determination.
Subsec. (v)(1)(J). , § 2141(a), added subpar. (J).
Subsec. (v)(1)(K). , § 2142(a), added subpar. (K).
Subsec. (v)(1)(L). , § 2143(a), added subpar. (L).
, § 2144(a), designated existing provisions as cl. (i) and added cl. (ii).
Subsec. (w)(2). , § 2193(c)(9), substituted “subchapter XIX of this chapter” for “subchapter V or XIX of this chapter”.
Subsec. (bb). , § 2121(d), struck out subsec. (bb) which defined “alcohol detoxification facility services” and “detoxification facility”.
1980—Subsec. (b)(7). , § 948(a)(1), provided that par. (4) was not to apply to services provided in a hospital by a physician where the hospital had a teaching program approved as specified in par. (6) if the hospital elected to receive payment for reasonable costs of such services and all physicians in such hospital agreed not to bill charges for professional services rendered in such hospital to individuals covered under the insurance program established by this subchapter.
Subsec. (e). , § 930(k), substituted “subsection (i)” for “subsections (i) and (n)” in text preceding par. (1) and in text following par. (9).
, § 949, in text following par. (9), inserted provision defining “hospital” as a facility of fifty beds or less located in an area determined by the Secretary to meet definition relating to a rural area described in subpar. (A) of par. (5) and prescribing exceptions to such definition.
Subsec. (i). , § 950, substituted “30 days” for “14 days” in three places and struck out former cl. (B) which related to admission to skilled nursing facilities within 28 days after hospital discharge of an individual unable to be admitted to such facilities within 14 days because of a shortage of appropriate bed space, and redesignated former cl. (C) as (B).
Subsec. (j)(13). , § 915(a), substituted “such edition (as is specified by the Secretary in regulations) of the Life Safety Code of the National Fire Protection Association” for “the Life Safety Code of the National Fire Protection Association (23rd edition, 1973)”.
Subsec. (k)(2)(A). , § 951(b), inserted “(of which at least two must be physicians described in subsection (r)(1) of this section)” after “two or more physicians”.
Subsec. (m)(4). , § 930(l), inserted “who has successfully completed a training program approved by the Secretary” after “health aide”.
Subsec. (n). , § 930(m), struck out subsec. (n) which defined “post-hospital home health services”.
Subsec. (o). , § 930(n)(2), in provisions following par. (7), struck out provision that “home health agency” was not to include a private organization which was not a nonprofit organization exempt from Federal income taxation under section
of title
unless it were licensed pursuant to State law and met such additional standards and requirements as prescribed by regulations.
Subsec. (o)(7). , § 930(n)(1), added par. (7).
Subsec. (r)(2). , § 936(a), amended cl. (2) generally to expand definition of “physician” to include doctors of dental surgery or dental medicine acting within the scope of their licenses.
Subsec. (r)(3). , § 951(a), substituted provisions relating to doctors of podiatric medicine for provisions relating to doctors of podiatry and surgical chiropody.
Subsec. (r)(4). , § 937(a), substituted “services related to the condition of aphakia” for “establishing the necessity for prosthetic lenses”.
Subsec. (s)(2)(G). , § 938(a), added subpar. (G).
Subsec. (s)(10) to (14). , § 1(a)(1), added par. (10) and redesignated former pars. (10) to (13) as (11) to (14), respectively.
Subsec. (u). , § 933(c), inserted “comprehensive outpatient rehabilitation facility,” after “nursing facility”.
, § 931(c), inserted “detoxification facility,”.
Subsec. (v)(1)(G). , § 902(a)(1), added subpar. (G).
Subsec. (v)(1)(H). , § 930(p), added subpar. (H).
Subsec. (v)(1)(I). , § 952(a), formerly § 952, as redesignated by , § 127(1), added subpar. (I).
Subsec. (z). , § 933(d), which purported to substitute “skilled nursing facility, comprehensive outpatient rehabilitation facility,” for “extended care facility,” was executed by inserting “comprehensive outpatient rehabilitation facility,” after “skilled nursing facility,” as the probable intent of Congress, in view of the substitution of “skilled nursing facility” for “extended care facility” by section 278(b)(6) of .
Subsec. (aa)(1)(A). , § 1(b)(3), inserted reference to items and services described in subsection (s)(10) of this section.
Subsec. (bb). , § 931(d), added subsec. (bb).
Subsec. (cc). , § 933(e), added subsec. (cc).
1978—Subsec. (s)(2)(F). added subpar. (F).
1977—Subsec. (j)(11). , § 3(a)(2), substituted provisions relating to compliance with requirements of section
of this title, for provisions relating disclosure of ownership, corporate status, etc., information to the Secretary or his delegate.
Subsec. (j)(13). , § 21(a), struck out “; and” after “nursing facilities”.
Subsec. (j)(14). , § 21(a), added par. (14).
Subsec. (s). , § 1(g), (h), added subpar. (E) of par. (2) and in provisions following par. (9) inserted “, a rural health clinic,” after “independent of a physician’s office”.
Subsec. (s)(6). inserted “(which may include a power-operated vehicle that may be appropriately used as a wheelchair, but only where the use of such a vehicle is determined to be necessary on the basis of the individual’s medical and physical condition and the vehicle meets such safety requirements as the Secretary may prescribe)” after “wheelchairs”.
Subsec. (v)(1)(F). , § 19(b)(1), added subpar. (F).
Subsec. (w)(2). , § 5(m), inserted “part B of this subchapter or under” after “or entitled to have payment made for such services under”.
Subsec. (aa). , § 1(d), added subsec. (aa).
1975—Subsec. (e)(5). , § 102, substituted “January 1, 1979” for “January 1, 1976”.
Subsec. (j)(13). , § 106(a), substituted “23d edition, 1973” for “21st edition, 1967”.
Subsec. (w). , § 112(a)(1), designated existing provisions as par. (1) and added par. (2).
1972—Subsec. (a)(2). , § 278(a)(4), substituted “skilled nursing facility” for “extended care facility” and “a” for “an”.
Subsec. (b)(6). , §§ 227(a),
, redesignated existing second sentence of subsec. (b) as par. (6) and in subsec. (b)(6) as so designated inserted reference to services in a hospital or osteopathic hospital by an intern or resident-in-training in the field of podiatry, approved by the Council on Podiatry Education of the American Podiatry Association.
Subsec. (b)(7). , § 227(a), added par. (7).
Subsec. (e). , § 211(b), inserted reference to section
of this title in the provisions preceding par. (1), inserted reference to sections
of this title after “For purposes of sections
and
of this title (including determination of whether an individual received inpatient hospital services or diagnostic services for purposes of such sections),”, and inserted provisions for accreditation by the Joint Commission on Accreditation of Hospitals.
Subsec. (e)(8). , § 234(a), added par. (8). Former par. (8) redesignated (9).
Subsec. (e)(9). , §§ 234(a),
, redesignated former par. (8) as (9) and struck out provisions requiring that other requirements not be higher than the comparable requirements prescribed for the accreditation of hospitals by the Joint Commission on Accreditation of Hospitals.
Subsecs. (f)(2), (g)(2). , § 234(b), (c), inserted reference to par. (9) of subsec. (e) of this section.
Subsec. (h). , § 278(a)(5), substituted “skilled nursing facility” for “extended care facility”, “skilled nursing facilities” for “extended care facilities” and “a” for “an”.
Subsec. (i). , §§ 248,
, (b)(10), extended the class of persons qualifying to be deemed as having been an inpatient in a hospital immediately before transfer therefrom by designating as clause (A) the existing requirement that the person have been admitted to the skilled nursing facility within 14 days after discharge from such hospital and adding cls. (B) and (C) and substituted “skilled nursing facility” for “extended care facility”.
Subsec. (j). , § 278(a)(7), substituted “skilled nursing facility” for “extended care facility” in provisions preceding par. (1).
Subsec. (j)(10). , § 234(d), added par. (10). Former par. (10) redesignated par. (11) by section 234(d)(2) of and again redesignated par. (15) by section 246(b)(2) of .
Subsec. (j)(11) to (13). , § 246(b)(3), added pars. (11) to (13).
Subsec. (j)(15). , §§ 234(d),
, (4),
,
,
, redesignated former par. (10) as (11), amended par. (11) as thus redesignated by inserting provisions that the Secretary shall not require as a condition of participation that medical social services be furnished in any such institution, redesignated such par. (11) as thus amended as par. (15), and inserted provision that all information concerning skilled nursing facilities required to be filed with the Secretary be made available to Federal and state employees for purposes consistent with the effective administration of programs established under subchapters XVIII and XIX and inserted provision for the waiver of the registered nurse requirement in skilled nursing facilities in rural areas.
Subsec. (k). , §§ 237(c),
, inserted provisions authorizing the Secretary to utilize the procedures established under subchapter XIX of this chapter if such procedures were determined to be superior in their effectiveness and substituted “skilled nursing facility” for “extended care facility”, “skilled nursing facilities” for “extended care facilities”, and “a” for “an”.
Subsec. (l). , § 278(a)(9), substituted “skilled nursing facility” for “extended care facility” and “a” for “an”.
Subsec. (m)(7). , § 278(a)(10), substituted “skilled nursing facility” for “extended care facility”.
Subsec. (n). , § 278(a)(11), substituted “skilled nursing facility” for “extended care facility” and “a” for “an”.
Subsec. (o)(5), (6). , § 234(e), added par. (5) and redesignated former par. (5) as (6).
Subsec. (p). , §§ 251(a)(1), (b)(1),
, inserted provisions covering physical therapy services of a licensed physical therapist other than under an arrangement with and under the supervision of a provider of services, clinic, rehabilitation agency, or public health agency, inserted “In addition, such term includes physical therapy services which meet the requirements of the first sentence of this subsection except that they are furnished to an individual as an inpatient of a hospital or extended care facility”, and extended definition of “outpatient physical therapy services” to include outpatient speech pathology services.
Subsec. (q). , § 227(f), substituted “subsection (b)(6) of this section” for “the last sentence of subsection (b) of this section” in parenthetical phrase.
Subsec. (r). , §§ 211(c)(2),
,
,
, inserted “or (C) the certification required by section
of this title,” inserted provision so as to include doctors in one of the specified arts legally authorized to practice such art in the country in which inpatient hospital services referred to in section
are furnished, added cl. (4) covering doctors of optometry who are legally authorized to practice optometry by the State in which they perform such functions, but only with respect to establishing the necessity for prosthetic lenses, and added cl. (5) providing for the inclusion of chiropractor services.
Subsec. (s)(8). , § 252(a), inserted “(including colostomy bags and supplies directly related to colostomy care)” after “organ”.
Subsec. (u). , §§ 227(d)(1),
, substituted “skilled nursing facility, or home health agency, or, for purposes of sections
and
of this title, a fund.” for “extended care facility, or home health agency.”.
Subsec. (v)(1). , §§ 223(a), (b), (c), (d),
, (2), (3), (4),
,
, inserted definition of the costs of services, inserted provision that the regulation for the establishment of limits on the direct or indirect overall incurred costs or incurred costs of specific items or services or groups of items or services to be recognized as reasonably based on estimates of the costs necessary in the efficient delivery of needed health services to individuals covered by the insurance programs established under this subchapter, inserted parenthetical provisions covering exclusion of costs, substituted “the necessary costs of efficiently delivering covered services covered by the insurance programs” for “the costs with respect to individuals covered by the insurance programs”, designated existing provisions as subpars. (A) and (B), and added subpars. (C), (D), and (E), and substituted “skilled nursing facilities” for “extended care facilities”.
Subsec. (v)(3). , § 278(a)(13), substituted “skilled nursing facility” for “extended care facility”.
Subsec. (v)(4). , § 223(f), added par. (4). Former par. (4) redesignated (6).
Subsec. (v)(5). , § 251(c), added par. (5).
Subsec. (v)(6). , §§ 223(f),
, redesignated former par. (4) as (6).
Subsec. (v)(7). , §§ 221(c)(4),
,
, added par. (7).
Subsecs. (w), (y). , § 278(a)(14), (15), substituted “skilled nursing facility” for “extended care facility” and “a” for “an”.
Subsec. (z). , §§ 234(b),
, added subsec. (z) and substituted “skilled nursing facility” for “extended care facility”.
1971—Subsec. (e)(5). authorized the Secretary, until January 1, 1976, to waive the requirement relating to the provision of 24 hour nursing service rendered or supervised by a registered professional nurse.
1968—Subsec. (e). , § 129(c)(9)(C), inserted reference to section
in first and third sentences and inserted “or diagnostic services” after “hospital services” in third sentence.
, § 143(a), in second sentence after par. (8), changed definition of hospitals for purposes of making payments for emergency hospital services by deleting provision that hospital meet requirements of pars. (1) to (4), by requiring that such hospitals have full-time nursing services, be licensed as a hospital, and be primarily engaged in providing not nursing care and related services but medical or rehabilitative care by or under the supervision of a doctor of medicine or osteopathy.
Subsec. (p). , §§ 129(c)(10),
, struck out definition of “outpatient hospital diagnostic services” and inserted definition of “outpatient physical therapy services”, respectively.
Subsec. (r)(3). , § 127(a), added cl. (3).
Subsec. (s). , § 144(a)–(c), struck out “(unless they would otherwise constitute inpatient hospital services, extended care services, or home health services)” after “items or services” in text preceding par. (1), inserted after “hospital” in sentence following par. (9) “which, for purposes of this sentence, means an institution considered a hospital for purposes of section
of this title)”, and inserted sentence following par. (13) providing that medical and other health services (other than physicians’ services and services incident to physicians’ services) furnished a patient of a facility which meets the definition of a hospital for emergency services will be covered under the medical insurance program only if such facility satisfies such health and safety requirements as are appropriate for the item or service furnished as the Secretary may determine are necessary.
Subsec. (s)(2)(A) to (C). , § 129(a), designated existing provisions as subpars. (A) and (B) and added subpar. (C).
Subsec. (s)(2)(D). , § 133(a), added subpar. (D).
Subsec. (s)(3). , § 134(a), included in medical and other health services diagnostic X-ray tests furnished in the patient’s home under the supervision of a physician if the tests meet such health and safety conditions as the Secretary finds necessary.
Subsec. (s)(6). , § 132(a), provided that payments may be made with respect to expenses incurred in the purchase as well as in the rental of durable medical equipment.
, § 144(d), inserted “other than in institution that meets the requirements of subsection (e)(1) or (j)(1) of this section”.
Subsec. (s)(12), (13). , § 129(b), added pars. (12) and (13) which excluded from the diagnostic services referred to in par. (2)(C) (other than physician’s services) certain items or service.
Subsec. (y)(3). , § 129(c)(11), substituted “1395e(a)(3)” for “1395e(a)(4)”.
1966—Subsec. (v)(1). inserted provisions which required that, in the case of extended care services furnished by proprietary facilities, the regulations include provision for specific recognition of a reasonable return on equity capital and which placed a limitation on the rate of return of one and one-half times the average of the rates of interest on obligations issued for purchase by the Federal Hospital Insurance Trust Fund.
Effective Date of 2000 Amendment
, § 1(a)(6) [title I, § 101(b)], Dec. 21, 2000, , 2763A–468, provided that: “The amendments made by subsection (a) [amending this section] shall apply to items and services furnished on or after July 1, 2001.”
, § 1(a)(6) [title I, § 102(d)], Dec. 21, 2000, , 2763A–468, provided that: “The amendments made by this section [amending this section and section
of this title] shall apply to services furnished on or after January 1, 2002.”
Amendment by section
[title I, § 103(a)] of applicable to colorectal cancer screening services provided on or after July 1, 2001, see section
[title I, § 103(c)] of , set out as a note under section
of this title.
Amendment by section
[title I, § 105(a), (b)] of applicable to services furnished on or after Jan. 1, 2002, see section
[title I, § 105(e)] of , set out as a note under section
of this title.
, § 1(a)(6) [title I, § 112(b)], Dec. 21, 2000, , 2763A–473, provided that: “The amendment made by subsection (a) [amending this section] shall apply to drugs and biologicals administered on or after the date of the enactment of this Act [Dec. 21, 2000].”
, § 1(a)(6) [title I, § 113(c)], Dec. 21, 2000, , 2763A–473, provided that: “The amendment made by subsection (a) [amending this section] shall apply to drugs furnished on or after the date of the enactment of this Act [Dec. 21, 2000].”
Amendment by section
[title IV, § 430(b)] of applicable to items and services furnished on or after July 1, 2001, see section
[title IV, § 430(c)] of , set out as a note under section
of this title.
, § 1(a)(6) [title IV, § 431(b)], Dec. 21, 2000, , 2763A–525, provided that: “The amendment made by subsection (a) [amending this section] shall apply with respect to community mental health centers with respect to services furnished on or after the first day of the third month beginning after the date of the enactment of this Act [Dec. 21, 2000].”
Effective Date of 1999 Amendment
Amendment by section
1000
(a)(6) [title II, § 201(k)] of effective as if included in enactment of the Balanced Budget Act of 1997, , except as otherwise provided, see § 1000(a)(6) [title II, § 201(m)] of , set out as a note under section
of this title.
, div. B, § 1000(a)(6) [title II, § 221(b)(2)], Nov. 29, 1999, , 1501A–351, provided that: “The amendments made by paragraph (1) [amending this section] apply to services furnished on or after January 1, 2000.”
, div. B, § 1000(a)(6) [title III, § 303(c)], Nov. 29, 1999, , 1501A–361, provided that: “The amendments made by this section [amending this section and section
of this title] shall apply to services furnished by home health agencies for cost reporting periods beginning on or after October 1, 1999.”
, div. B, § 1000(a)(6) [title III, § 304(c)], Nov. 29, 1999, , 1501A–361, provided that: “The amendments made by this section [amending this section and enacting section
1320b–7f of this title] take effect on the date of the enactment of this Act [Nov. 29, 1999], and in applying section 1861(o)(7) of the Social Security Act ( U.S.C.
), as amended by subsection (a), the Secretary of Health and Human Services may take into account the previous period for which a home health agency had a surety bond in effect under such section before such date.”
Amendment by section
1000
(a)(6) [title III, § 321(k)(7)–(9)] of effective as if included in the enactment of the Balanced Budget Act of 1997, , except as otherwise provided, see section
1000
(a)(6) [title III, § 321(m)] of , set out as a note under section
of this title.
Effective Date of 1997 Amendment
Amendment by section 4102(a), (c) of applicable to items and services furnished on or after Jan. 1, 1998, see section 4102(e) of , set out as a note under section
of this title.
Amendment by section 4103(a) of applicable to items and services furnished on or after Jan. 1, 2000, see section 4103(e) of , set out as a note under section
of this title.
Amendment by section 4104(a)(1) of applicable to items and services furnished on or after Jan. 1, 1998, see section 4104(e) of , set out as a note under section
of this title.
Amendment by section 4105(a)(1), (b)(1) of applicable to items and services furnished on or after July 1, 1998, see section 4105(d)(1) of , set out as a note under section
of this title.
Section 4106(d) of provided that: “The amendments made by this section [amending this section and sections
,
,
, and
of this title] shall apply to bone mass measurements performed on or after July 1, 1998.”
Amendment by section 4201(c)(1), (2) of applicable to services furnished on or after Oct. 1, 1997, see section 4201(d) of , set out as a note under section
of this title.
Section 4205(b)(2) of provided that: “The amendment made by paragraph (1) [amending this section] shall take effect on January 1, 1998.”
Section 4205(c)(2) of provided that: “The amendment made by paragraph (1) [amending this section] applies to waiver requests made on or after January 1, 1998.”
Section 4205(d)(4) of provided that:
“(A) In general.—Except as otherwise provided, the amendments made by the preceding paragraphs [amending this section and section
of this title] take effect on the date of the enactment of this Act [Aug. 5, 1997].
“(B) Current rural health clinics.—The amendments made by the preceding paragraphs take effect, with respect to entities that are rural health clinics under title XVIII of the Social Security Act ( U.S.C. et seq.) on the date of enactment of this Act, on the date of the enactment of this Act [sic].
“(C) Grandfathered clinics.—
“(i) In general.—The amendment made by paragraph (3)(A) [amending this section] shall take effect on the effective date of regulations issued by the Secretary under clause (ii).
“(ii) Regulations.—The Secretary shall issue final regulations implementing paragraph (3)(A) that shall take effect no later than January 1, 1999.”
Amendment by section 4312(d), (e) of effective Aug. 5, 1997, and may be applied with respect to items and services furnished on or after Jan. 1, 1998, see section 4312(f)(3) of , set out as a note under section
of this title.
Section 4312(f)(2) of provided that: “The amendments made by subsection (b) [amending this section] shall apply to home health agencies with respect to services furnished on or after January 1, 1998. The Secretary of Health and Human Services shall modify participation agreements under section 1866(a)(1) of the Social Security Act ( U.S.C.
) with respect to home health agencies to provide for implementation of such amendments on a timely basis.”
Section 4321(d)(1) of provided that: “The amendments made by subsection (a) [amending this section] shall apply to discharges occurring on or after the date which is 90 days after the date of the enactment of this Act [Aug. 5, 1997].”
Section 4404(b) of provided that: “The amendments made by subsection (a) [amending this section] apply to changes of ownership that occur after the third month beginning after the date of enactment of this section [Aug. 5, 1997].”
Amendment by section 4432(b)(5)(D), (E) of applicable to items and services furnished on or after July 1, 1998, see section 4432(d) of , set out as a note under section
of this title.
Section 4444(b) of provided that: “The amendment made by subsection (a) [amending this section] shall apply with respect to items or services furnished on or after April 1, 1998.”
Amendment by sections 4445 and 4446 of applicable to benefits provided on or after Aug. 5, 1997, except as otherwise provided, see section 4449 of , set out as a note under section
of this title.
Amendment by section 4454(a)(1) of effective Aug. 5, 1997, and applicable to items and services furnished on or after such date, with provision that Secretary of Health and Human Services issue regulations to carry out such amendment by not later than July 1, 1998, see section 4454(d) of , set out as an Effective Date note under section
of this title.
Amendment by section
–(2)(B), (d) of applicable to services furnished and supplies provided on and after Jan. 1, 1998, see section 4511(e) of , set out as a note under section
of this title.
Amendment by section 4512(a) of applicable to services furnished and supplies provided on and after Jan. 1, 1998, see section 4512(d) of , set out as a note under section
of this title.
Section 4513(b) of provided that: “The amendment made by subsection (a) [amending this section] applies to services furnished on or after January 1, 2000.”
Section 4557(b) of provided that: “The amendments made by subsection (a) [amending this section] shall apply to items and services furnished on or after January 1, 1998.”
Section 4604(c) of provided that: “The amendments made by this section [amending this section and section
of this title] apply to cost reporting periods beginning on or after October 1, 1997.”
Amendment by section 4611(b) of applicable to services furnished on or after Jan. 1, 1998, and for purposes of applying such amendment, any home health spell of illness that began, but did not end, before such date, to be considered to have begun as of such date, see section 4611(f) of , set out as a note under section
of this title.
Section 4612(b) of provided that: “The amendment made by subsection (a) [amending this section] applies to services furnished on or after October 1, 1997.”
Effective Date of 1996 Amendment
Amendment by effective Oct. 1, 1996, see section 5 of , as amended, set out as a note under section
of this title.
Effective Date of 1994 Amendment
Section 107(b) of provided that: “The amendment made by subsection (a) [amending this section] shall apply to services furnished on or after the first day of the first month beginning more than one year after the date of the enactment of this Act [Oct. 31, 1994].”
Amendment by section 145(b) of applicable to mammography furnished by the facility on and after the first date that the certificate requirements of section
of this title apply to such mammography conducted by such facility, see section 145(d) of , set out as a note under section
of this title.
Section 146(c) of provided that: “The amendments made by this section [amending this section] shall take effect on January 1, 1995.”
Amendment by section 147(e)(1), (4), (5), (f)(3), (4)(A), (6)(A), (B), (E) of effective as if included in the enactment of , see section 147(g) of , set out as a note under section
of this title.
Section 158(a)(2) of provided that: “The amendment made by paragraph (1) [amending this section] shall apply with respect to cost reporting periods beginning on or after July 1, 1996.”
Effective Date of 1993 Amendment
Section 13503(c)(2) of provided that: “The amendments made by paragraph (1) [amending this section and section
of this title] shall take effect October 1, 1993.”
Section 13553(c) of provided that: “The amendments made by subsections (a) and (b) [amending this section] shall apply to items furnished on or after January 1, 1994.”
Section 13554(b) of provided that: “The amendment made by subsection (a) [amending this section] shall apply to services furnished on or after January 1, 1994.”
Section 13556(b) of provided that: “The amendments made by subsection (a) [amending this section] shall take effect as if included in the enactment of section 4161(a)(2)(C) of OBRA–1990 [].”
Section 13564(b)(2) of provided that: “The amendment made by paragraph (1) [amending this section] shall apply to cost reporting periods beginning on or after October 1, 1993.”
Section 13566(c) of provided that: “The amendments made by this section [amending this section and section
of this title] shall apply to erythropoietin furnished on or after January 1, 1994.”
Effective Date of 1990 Amendment
Amendment by section 4008(h)(2)(A)(i) of effective as if included in the enactment of the Omnibus Budget Reconciliation Act of 1987, , see section 4008(h)(2)(P) of , set out as a note under section
of this title.
Amendment by section 4152(a)(2) of applicable to items furnished on or after Jan. 1, 1991, see section 4152(a)(3) of , set out as a note under section
of this title.
Section 4153(b)(2)(C) of provided that: “The amendments made by subparagraphs (A) and (B) [amending this section and section
of this title] shall apply to items furnished on or after January 1, 1991.”
Amendment by section 4155(a), (d) of applicable to services furnished on or after Jan. 1, 1991, see section 4155(e) of , set out as a note under section
of this title.
Amendment by section 4157(a) of applicable to services furnished on or after Jan. 1, 1991, see section 4157(d) of , set out as a note under section
of this title.
Amendment by section 4161(a)(1), (2), (5) of applicable to services furnished on or after Oct. 1, 1991, see section 4161(a)(8) of , set out as a note under section
of this title.
Section 4161(b)(5) of provided that: “This subsection [amending this section and section
of this title and enacting provisions set out as a note below] shall take effect on October 1, 1991, except that the amendment made by paragraph (4) [amending section
of this title] shall apply to cost reports for periods beginning on or after October 1, 1991.”
Amendment by section 4162(a) of applicable with respect to partial hospitalization services provided on or after Oct. 1, 1991, see section 4162(c) of , set out as a note under section
of this title.
Amendment by section 4163(a) of applicable to screening mammography performed on or after Jan. 1, 1991, see section 4163(e) of , set out as a note under section
of this title.
Section
[(4)] of provided that: “The amendments made by paragraphs (1) and (2) [amending this section and section
of this title] shall apply to items and services furnished on or after July 1, 1991.”
Section
4207
(d)(4), formerly 4027(d)(3), of , as renumbered and amended by , title I, § 160(d)(4), (10), Oct. 31, 1994, , provided that: “The amendment made by paragraph (1) [amending this section] shall apply with respect to home health agency cost reporting periods beginning on or after July 1, 1991.”
Effective Date of 1989 Amendments
Amendment by section 6112(e)(1) of applicable with respect to items furnished on or after Jan. 1, 1990, see section 6112(e)(4) of , set out as a note under section
of this title.
Amendment by section
6113
(a)–(b)(2) of applicable to services furnished on or after July 1, 1990, see section 6113(e) of , set out as a note under section
of this title.
Amendment by section 6114(a), (d) of applicable to services furnished on or after Apr. 1, 1990, see section 6114(f) of , set out as a note under section
of this title.
Section 6115(d) of provided that: “The amendments made by this section [amending this section and sections
,
,
,
, and
of this title] shall apply to screening pap smears performed on or after July 1, 1990.”
Amendment by section 6131(a)(2) of applicable with respect to therapeutic shoes and inserts furnished on or after July 1, 1989, with additional provisions regarding applicability of the increase under section
of this title, see section 6131(c) of , set out as a note under section
of this title.
Section 6141(b) of provided that: “The amendments made by subsection (a) [amending this section] shall