Page:United States Statutes at Large Volume 95.djvu/600

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

PUBLIC LAW 97-000—MMMM. DD, 1981

95 STAT. 574 42 USC 300e.

42 USC 300e-9.

PUBLIC LAW 97-35—AUG. 13, 1981 (d)(1) Section 1301(c) is amended by striking out paragraphs (4), (9), and (10), by redesignating paragraphs (5) through (8) as paragraphs (4) through (7), by redesignating paragraph (11) as paragraph (9), and by adding after paragraph (7) (as so redesignated) the following new paragraph: "(8) adopt at least one of the following arrangements to protect its members from incurring liability for payment of any fees which are the legal obligation of such organization— "(A) a contractual arrangement with any hospital that is regularly used by the members of such organization prohibiting such hospital from holding any such member liable for payment of any fees which are the legal obligation of such organization; (B) insolvency insurance, acceptable to the Secretary; "(C) adequate financial reserve, acceptable to the Secretary; and . (D) other arrangements, acceptable to the Secretary, to protect members, except that the requirements of this paragraph shall not apply to a health maintenance organization if applicable State law provides the members of such organization with protection from liability for payment of any fees which are the legal obligation of such organization; and". (2) Subsection (d) of section 1301 is repealed. (e) Section 1301(c)(2) (42 U.S.C. 300e(c)(2)) is amended— (1) by striking out "obtain insurance or make other arrangements", (2) by inserting "obtain insurance or make other arrangements'^^after "(A)^, "(B)", and "(C)", (3) by striking out "and (C)" and inserting in lieu thereof "(C)", and (4) by inserting before the semicolon a comma and the following: "and (D) make arrangements with physicians or other health professionals, health care institutions, or any combination of such individuals or institutions to assume all or part of the financial risk on a prospective basis for the provision of basic health services by the physicians or other health professionals or through the institutions". (f) The last sentence of section 1302(1) (42 U.S.C. 300e-l(l)) is repealed. (g)(1) The first sentence of section 1302(2) (42 U.S.C. 300e-l(2)) is amended to read as follows: "The term 'supplemental health services' means any health service which is not included as a basic health service under paragraph (1) of this section.". (2) The second sentence of such section is amended by striking out "If a service of a physician described in the preceding sentence' and inserting in lieu thereof "If a health service provided by a physician". (3) The last sentence of such section is repealed. (h) Section 1302(4)(C) is amended by inserting before the semicolon at the end of clause (i) the following:, except that this clause does not apply before the end of the forty-eight month period beginning after the month in which the health maintenance oranization becomes a qualified health maintenance organization as defined in section 1310(d), or as authorized by the Secretary in accordance with regulations that take into consideration the unusual circumstances of the group". (i) Section 1302(5)(B) is amended by striking out "feasible (1)" and inserting in lieu thereof "feasible," and by striking out "administra-