Page:United States Statutes at Large Volume 95.djvu/599

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PUBLIC LAW 97-000—MMMM. DD, 1981

PUBLIC LAW 97-35—AUG. 13, 1981

95 STAT. 573

the loan fund for fiscal years 1982, 1983, and 1984, such sums as may be necessary to assure such balance and meet such obligations.'. (c) Section 1304(j) (42 U.S.C. 300e-3(j)) is amended by striking out "1981" and inserting in lieu thereof "1984". REVISION OF REQUIREMENTS FOR HEALTH MAINTENANCE ORGANIZATIONS

SEC. 942. (a)(1) Section 1301(b)(3) is amended (A) by striking out 42 USC 300e. subparagraph (C), and (B) by redesignating subparagraphs (D) and (E) as subparagraphs (C) and (D), respectively. (2) Section 1301(b)(3)(A)(iv) is amended by striking out "subject to subparagraph (C),". (3)(A) Section 1310(b)(1) (42 U.S.C. 300e-9(b)(l)) is amended by striking out "provides basic health services" and inserting in lieu thereof "provides more than one-half of its basic health services which are provided by physicians". (B) Section 1310(b)(2) is amended by striking out "basic health services" and inserting in lieu thereof "its basic health services which are provided by physicians". (4) Section 1310(b)(2) (42 U.S.C. 300e-9(b)(2)) is amended by striking out "or (B)" and inserting in lieu thereof "(B) individual physicians and other health professionals under contract with the organization, or(C)". (5) The amendment made by paragraph (3)(A) shall apply with ^^ use 300e-9 respect to the offering of a health maintenance organization in note. accordance with section 13100t>Xl) of the Public Health Service Act after four years after the date the organization becomes a qualified health maintenance organization for purposes of section 1310 of such Act if the health maintenance organization provides assurances satisfactory to the Secretary that upon the expiration of such four years it will provide more than one half of its basic health services which are provided by physicians through physicians or other health professionals who are members of the staff of the organization or a medical group (or groups). (b)(1) Section 1301(b)(3)(B) is amended by striking out "(i)", by striking out clause (ii), and by redesignating subclauses (I) and (II) as clauses (i) and (ii), respectively. (2) Subparagraph (D) of section 1301(b)(3) is amended to read as follows: "(D) Contracts between a health maintenance organization and health professionals for the provision of basic and supplemental health services shall include such provisions as the Secretary may require, but only to the extent that such requirements are designed to insure the delivery of quality health care services and sound fiscal management.". (c)(1) The first sentence of section 1301(b)(4) (42 U.S.C. 300e(b)(4)) is amended by inserting before the period a comma and the following: "except that a health maintenance organization which has a service area located wholly in a nonmetropolitan area may make a basic health service avauable outside its service area if that basic health service is not a primary care or emergency health care service and if there is an insufficient number of providers of that basic health service within the service area who will provide such service to members of the health maintenance organization". (2) The first sentence of section 1301(b)(4) is amended by striking out "promptly as appropriate" and inserting in lieu thereof "with reasonable promptness".