86 STAT. ]
PUBLIC LAW 92-603-OCT. 30, 1972
1393
For purposes of this subsection, 'health programs established by the Definition. Social Security Act' means the program established by title X V l II of such Act, a program established by a plan of a State approved ^2 USC 1395. under title X IX of such Act, and a program established by a plan ^2 USC 1396. of a State approved under title V of such Act. ^^ use 701. "(2) Grants, payments under contracts, and other expenditures made for experiments and demonstration projects under paragraph (1) shall be made in appropriate part from the Federal Hospital Insurance Trust F u n d (established by section 1817 of the Social Security Act) and the Federal Supplementary Medical Insurance 42 USC 13951, Trust Fund (established by section 1841 of the Social Security Act) 42 USC 1395t. and from funds appropriated under titles V and X IX of such Act. Grants and payments under contracts may be made either in advance or by way of reimbursement, as may be determined by the Secretary, and shall be made in such installments and on such conditions as the Secretary finds necessary to caiTy out the purpose of this section. With lespect to any such grant, payment, or other expenditure, the amount to be paid from each of such trust funds (and from funds appropriated under such titles V and X IX) shall be determined by the Secretary, giving due regard to the purposes of the experiment or project involved." (2) Section 402(b) of such amendments is amended— 42 USC i395b.i, (A) by striking out "experiment" each time it appears and inserting in lieu thereof "experiment or demonstration project"; (B) by striking out "experiments" and inserting in lieu thereof "experiments and projects"; and (C) by striking out "reasonable charge" and inserting in lieu thereof "reasonable charge, or to reimbursement or payment only for such services or items as may be specified in the experiment". (c) Section 1875(b) of the Social S^ecurity Act is amended— _ 42 USC 1395H. (1) by striking out "experimentation" and inserting in lieu thereof "experiments and demonstration projects", and (2) by inserting "and the experiments and demonstration projects authorized by section 222(a) of the Social Security Amendments of 1972" after "1967". ^"'^' "• ^^^°LIMITATIONS OX COVERAGE OF COSTS UNDER MEDICARE
SEC. 223. (a) The first sentence of section 1861(v)(1) of the Social Security Act is amended by inserting immediately before "determined" where it first appears the following: "the cost actually incurred, excluding therefrom any part of incurred cost found to be unnecessary in the efficient delivery of needed health services, and shall be". (b) The third sentence of section 1861(v)(1) of such Act is amended by striking out the comma after "services," where it last appears and inserting in lieu thereof the following: "may provide 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 reasonable 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 title,". (c) The fourth sentence of section 1861(v)(1) of such Act is amended by inserting after "services" when it first appears the following: " (excluding therefrom any such costs, including standby costs, which are determined in accordance with regulations to be unnecessary in the efficient delivery of services covered by the insurance programs established under this title)".
42 USC 139Sx.
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