42 U.S.C. § 1320c–10 — Annual reports
submitted 91 years ago by Pub. L. 97-248 to r/title-42-THE-PUBLIC-HEALTH-AND-WELFARE · 201 words · no verdicts yet
The Secretary must send Congress a complete annual report about the program during the previous fiscal year. The report must cover participating organizations, services subject to review, payment methods, sanctions, costs, and decision criteria.
(1) By April 1 each year, the Secretary* must send Congress a full and complete report about how the program operated during the previous fiscal year, its effects, and its cost. The report must include the number, status, and service areas of all quality improvement organizations taking part in the program. (2) It must include the number of health care institutions and practitioners whose services are subject to review by those organizations, and the number of beneficiaries and recipients who received services subject to that review during the year. (3) It must describe the different payment methods used in contracts under this part and the relative efficiency of each method. (4) It must describe penalties and sanctions imposed under this title for breaking the law or failing to meet the obligations imposed by this part. (5) It must state* the total costs incurred under subchapters XVIII and XIX of this chapter to carry out and operate all procedures required by those subchapters for reviewing services to determine their medical necessity, appropriate use, and quality. (6) It must describe the criteria used to make decisions, including how the criteria were selected and the relative weight given to each one.
The Secretary* shall submit to the Congress not later than April 1 of each year, a full and complete report on the administration*, impact, and cost of the program under this part during the preceding fiscal year, including data and information on—
the number, status, and service areas of all quality improvement organizations participating in the program;
the number of health care institutions and practitioners whose services are subject to review by such organizations, and the number of beneficiaries and recipients who received services subject to such review during such year;
the various methods of reimbursement utilized in contracts under this part, and the relative efficiency of each such method of reimbursement;
the imposition of penalties and sanctions under this title for violations of law and for failure to comply with the obligations imposed by this part;
the total costs incurred under subchapters XVIII and XIX of this chapter in the implementation and operation of all procedures required by such subchapters for the review of services to determine their medical necessity, appropriateness of use, and quality; and
descriptions of the criteria upon which decisions are made, and the selection and relative weights of such criteria.
Source credit: (Aug. 14, 1935, ch. 531, title XI, § 1161, as added Pub. L. 97–248, title I, § 143, Sept. 3, 1982, 96 Stat. 392; amended Pub. L. 112–40, title II, § 261(a)(2)(C), Oct. 21, 2011, 125 Stat. 423.)
- 1935Enacted · Pub. L. 97-248 · 96 Stat. 392
- 2011Amended · Pub. L. 112-40 · 125 Stat. 423
A history note hasn’t been published yet. The record shows enactment by Pub. L. 97-248 on 1935-08-14.
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