PUBLIC LAW 95-210—DEC. 13, 1977 ', has appropriate procedures or arrangements for storing, administering, and dispensing any drugs and biologicals; " (I) has appropriate procedures for review of utilization of clinic services to the extent that the Secretary determines to be necessary and feasible; and " (J) meets such other requirements as the Secretary may find necessary in the interest of the health and safety of the individuals who are furnished services by the clinic. For the purposes of this title, such term includes only a facility which (i) is located in an area that is not an urbanized area (as defined by the Bureau of the Census) and that is designated by the Secretary either (I) as an area with a shortage of personal health services under section 1302(7) of the Public Health Service Act or (II) as a health manpower shortage area described in section 332(a)(1)(A) of that Act because of its shortage of primary medical care manpower, (ii) has filed an agreement with the Secretary by which it agrees not to charge any individual or other person for items or services for which such individual is entitled to have payment made under this title, except for the amount of any deductible or coinsurance amount imposed with respect to such items or services (not in excess of the amount customarily charged for such items and services by such clinic), pursuant to subsections (a) and (b) of section 1833, (iii) employs a physician assistant or nurse practitioner, and (iv) is not a rehabilitation agency or a facility which is primarily for the care and treatment of mental diseases. A facility that is in operation and qualifies as a rural health clinic under this title or title X IX and that subsequently fails to satisfy the requirement of clause (i) shall be considered, for purposes of this title and title X IX, as still satisfying the requirement of such clause. "(3) The term 'physician assistant' and the term 'nurse practitioner' mean, for the purposes of paragraphs (1) and (2), a physician assistant or nurse practitioner who performs such services as such individual is legally authorized to perform (in the State in which the individual performs such services) in accordance with State law (or the State regulatory mechanism provided by State law), and who meets such training, education, and experience requirements (or any combination thereof) as the Secretary may prescribe in regulations.". (e) Any private, nonprofit health care clinic that— (1) on July 1, 1977, was operating and located in an area which on that date (A) was not an urbanized area (as defined by the Bureau of the Census) and (B) had a supply of physicians insufficient to meet the needs of the area (as determined by the Secretary), and (2) meets the definition of a rural health clinic under section 1861 (aa)(2) or section 1905(1) of the Social Security Act, except for clause (i) of section 1861 (aa)(2), shall be considered, for the purposes of title X VIII or X IX, respectively, of the Social Security Act, as satisfying the definition of a rural health clinic under such section. (f) Section 1862(a)(3) of such Act is amended by striking out "in such cases" and inserting in lieu thereof "in the case of rural health clinic services, as defined in section 1861(aa)(l), and in such other cases". (g) Section 1861(s)(2) of such Act is amended— (1) by striking out "and" at the end of subparagraph (C) (ii); (2) by inserting "and" at the end of subparagraph (D); and
29-194 0 -
sn
91 STAT. 1^187
42 USC 300e-l. 42 USC 254e.
Ante, p. 1485.
42 USC 1396.
42 USC 1395x note.
Ante, p. 1485. Post, p. 1488. 42 USC 1395. 42 USC 1395y. Ante, p. 1485. 42 USC 1395x.
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