42 U.S.C. § 300e–6 — Administration of assistance programs

(a) Recordkeeping; audit and examination (1) Every recipient of a loan or loan guarantee under this subchapter must keep records the Secretary requires -- including records fully showing how it used the loan money, the total cost of the project the loan supported, how much of that cost came from other sources, and whatever other records support an effective audit. (2) The Secretary, or the Secretary's authorized representatives, can access -- for audit and examination -- any books, documents, papers, and records of loan or loan-guarantee recipients that relate to that assistance. (b) Report upon expiration of period When the period covered by a loan or loan guarantee ends, the recipient must give the Secretary a full, complete report, in whatever manner the Secretary prescribes by regulation. That report must include -- along with anything else the Secretary requires -- descriptions of the plans, developments, and operations relating to the matters listed in section 300e-5(b)(3). (c) Repealed. (d) Other entities considered health maintenance organizations An entity that provides health services to a defined population on a prepaid basis, and that has members entitled to Medicare (Title XVIII) benefits or Medicaid (Title XIX) assistance, can be treated as an HMO for getting assistance under this subchapter if: (1) for its Medicare- or Medicaid-entitled members, it (A) provides services following section 300e(b) -- except that (i) it doesn't have to give those members basic services it can't get paid for under Medicare or the state Medicaid plan, and (ii) it doesn't have to set those members' payments under a community rating system -- and (B) is organized and operated following section 300e(c), except it doesn't have to take on full financial risk in advance for services it isn't required under Medicare or Medicaid to take that risk for; and (2) for its other members, it provides services following section 300e(b) and is organized and operated following section 300e(c). An entity that provides prepaid health services to a defined population, and has members enrolled under the federal employee health benefits program (5 U.S.C. chapter 89), can also be treated as an HMO for this assistance if, for its other members, it follows section 300e(b) and section 300e(c).