Page:United States Statutes at Large Volume 91.djvu/1225

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PUBLIC LAW 95-000—MMMM. DD, 1977

PUBLIC LAW 95-142—OCT. 25, 1977

91 STAT. 1191

cedures required by such titles for the review of services to determine their medical necessity, appropriateness of use, and quality; " (5) changes in utilization rates and patterns, and changes in medical procedures and practices, attributable to the activities of Professional Standard s Review Organizations; " (6) the results of program evaluation activities, including the operation of data collection systems and the status of Professional Standard s Review Organization data policy and implementation; " (7) the extent to which Professional Standard s Review Organizations are performing reviews of services for other governmental or private health insurance program s; and " (8) recommendations for legislative changes.". (1)(1) Title X I of such Act (as amended by subsections (d)(2)(D) ^«««. P- 1190. and (k) of this section) is further amended by adding after section 1172 the following new section: ' M E D I C A L OFFICERS I N AMERICAN SAMOA, THE NORTHERN MARIANA ISLANDS, AND THE TRUST TERRITORY OF THE PACIFIC ISLANDS TO BE INCLUDED I N THE PROFESSIONAL STANDARDS REVIEW PROGRAM

" SEC. 1173. For purposes of applying this part (except sections 1155(c) and 1163) to American Samoa, the Northern Mariana Islands, and the T r u s t T e r r i to r y of the Pacific Islands, individuals licensed to practice medicine in those places shall be considered to be physicians and doctors of medicine.". (2) The second sentence of section 1101(a)(1) of such Act is amended by inserting " and in part B of this title" after "title V". (m) Section 1861(w)(2) of such Act is amended by inserting " part B of this title or under " immediately after "entitled to have payment made for such services under". (n) Section 1167 of such Act is amended— (1) by inserting "or to any Statewide Professional Standard s Review Council" in subsection (a) after "Professional Standard s Review Organization"; (2) by inserting "or such Council" in subsection (a) after "such Organization"; (3) by inserting "or of any Statewide Professional Standard s Review Council" in subsection (b)(1) after "Professional Standards Review Organization"; (4) by inserting "or council" in subsection (b)(1) after "organization"; (5) by inserting "or of Statewide Professional Standard s Review Councils" in subsection (b)(1) after "Review Organizations"; and

42 USC

1320C-22. 42 USC 1320C-4, 1320C-12. 42 USC 1301. 42 USC 1395x.

42 USC 1320C-16.

(6) by inserting "AND STATEWIDE PROFESSIONAL STANDARDS REVIEW

COUNCILS" in the heading of the section after "PROFESSIONAL STANDARDS REVIEW ORGANIZATIONS".

(o)(1) Section 1152(b)(1)(A) of such Act is amended by striking 42 USC 1320C-1. out "subsection (c)(i) " and inserting in lieu thereof "subsection (c)(1)". (2) Section 1 1 5 5 (a)(1) of such Act is amended by striking out 42 USC 13200-1. "(subject to the provisions of subsection (g)) " in the matter preceding subparagraph (A). (3) Section 1160(b)(1) of such Act is amended by inserting " o r " Ante, p. 1189. after "permanently" in the matter following subparagraph (B).