Page:United States Statutes at Large Volume 86.djvu/1477

From Wikisource
Jump to navigation Jump to search
This page needs to be proofread.

[86 STAT. 1435]
PUBLIC LAW 92-000—MMMM. DD, 1972
[86 STAT. 1435]

86

STAT.]

PUBLIC LAW 92-603-OCT. 30, 1972

" (e)(1) Each Professional Standards Review Organization shall utilize the services of, and accept the findings of, the review committees of a hospital or other operating health care facility or organization located in the area served by such organization, but only when and only to the extent and only for such time that such committees in such hospital or other operating health care facility or organization have demonstrated to the satisfaction of such organization their capacity effectively and in timely fashion to review activities in such hospital or other operating health care facility or organization (including the medical necessity of admissions, types and extent of services ordered, and lengths ef stay) so as to aid in accomplishing the purposes and responsibilities described in subsection (a)(1), except Avhere the Secretary disapproves, for good cause, such acceptance. " (2) The Secretary may prescribe regulations to carry out the provisions of this subsection. " (f)(1) An agreement entered into under this part between the Secretary and any organization under which such organization is designated as the Professional Standards Review Organization for any area shall provide that such organization will— " (A) perform such duties and functions and assume such responsibilities and comply with such other requirements as may be required by this part or under regulations of the Secretary promulgated to carry out the provisions of this part; and " (B) collect such data relevant to its functions and such information and keep and maintain such records in such form as the Secretary may require to carry out the purposes of this pait and to permit access to and use of any such records as the Secretary may require for such purposes. "(2) Any such agreement with an organization under this part shall provide that the Secretary make payments to such organization equal to the amount of expenses reasonably and necessarily incurred, as determined by the Secretary, by such organization in carrying out or preparing to carry out the duties and functions required by such agreement. " (g) Notwithstanding any other provision of this part, the responsibility for review of health care services of any Professional Standards Review Organization shall be the review of health care services provided by or in institutions, unless such Organization shall have made a request to the Secretary that it be charged with the duty and function of reviewing other health care services and the Secretary shall have approved such request. "XORMS OF H E A L T H CARE SERVICES FOR VARIOrS HJ.XESSES OR H E A L T H CONDITIONS

"SEC. 1156. (a) Each Professional Standards Review Organization shall apply professionally developed norms of care, diagnosis, and treatment based upon typical patterns of practice in its regions (including typical lengths-of-stay for institutional care by age and diagnosis) as principal points of evaluation and review. The National Professional Standards Review Council and the Secretary shall provide such technical assistance to the organization as will be helpful in utilizing and applying such norms of care, diagnosis, and treatment. Where the actual norms of care, diagnosis, and treatment in a Professional Standards Review Organization area are significantly different from professionally developed regional norms of care, diagnosis, and

1435 Review committees.

Regulations. Agreement requirements.