Page:United States Statutes at Large Volume 87.djvu/950

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[87 STAT. 918]
PUBLIC LAW 93-000—MMMM. DD, 1973
[87 STAT. 918]

918

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PUBLIC LAW 93-222-DEC. 29, 1973

[87 STAT.

" (B) vision care not included as a basic health service under paragraph (1)(A) or (1)(H); " (C) dental services not included as a basic health service under paragraph (1)(A) or (1)(H); " (D) mental health services not included as a basic health service under paragraph (1)(D); " (E) long-term physical medicine and rehabilitative services (including physical the r a p y); and " (F) the provision of prescription drugs prescribed in the course of the provision by the health maintenance organization of a basic health service or a service described in the preceding subparagraphs of this paragraph. If a service of a physician described in the preceding sentence may also be provided under applicable State law by a dentist, optometrist, or podiatrist, a health maintenance organization may provide such service through an optometrist, dentist, or podiatrist (as the case may be) licensed to provide such service. A health maintenance organization is authorized, in connection with the prescription or provision of prescription drugs, to maintain, review, and evaluate (in accordance with regulations of the Secretary) a drug use profile of its members receiving such services, evaluate patterns of drug utilization to assure optimum drug therapy, and provide for instruction of its members and of health professionals in the use of prescription and non-prescription drugs. "(3) The term 'member when used in connection with a health maintenance organization means an individual who has entered into a contractual arrangement, or on Avhose behalf a contractual arrangement has been entered into, with the organization under which the organization assumes the responsibility for the provision to such individual of basic health services and of such supplemental health services as may be contracted for. "(4) The term 'medical group' means a partnership, association, or other group— " (A) which is composed of health professionals licensed to practice medicine or osteopathy and of such other licensed health professionals (including dentists, optometrists, and podiatrists) as are necessary for the provision of health services for which the group is responsible; " (B) a majority of the members of which are licensed to practice medicine or osteopathy; and " (C) the members of which (i) as their principal professional activity and as a group responsibility engage in the coordinated practice of their profession for a health maintenance organization; (ii) pool their income from practice as members of the group and distribute it among themselves according to a prearranged salary or drawing account or other plan; (iii) share medical and other records and substantial portions of major equipment and of professional, technical, and administrative staff; (iv) utilize such additional professional personnel, allied health professions personnel, and other health personnel (as specified in regulations of the Secretary) as are available and appropriate for the effective and efficient delivery of the services of the members of the group; and (v) arrange for and encourage continuing education in the field of clinical medicine and related areas for the mrembers of the group. " (5) The term 'individual practice association' means a partnership, corporation, association, or other legal entity which has entered into a services arrangement (or arrangements) with persons who are licensed to practice medicine, osteopathy, dentistry, podiatry, optome-