42 U.S.C. § 300ff–52 — Minimum qualifications of grantees

submitted 82 years ago by Pub. L. 101-381 to r/title-42-THE-PUBLIC-HEALTH-AND-WELFARE · 467 words · no verdicts yet

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Only certain public and nonprofit clinics can receive grants under section 300ff–51. These include community health centers, rural clinics, and hemophilia treatment centers. Grantees must generally already be qualified to bill Medicaid for the services they provide.

(a) Eligible entities — Entities eligible for grants under section 300ff–51 are public and nonprofit private organizations that are: federally-qualified health centers, as defined under Medicaid law; non-State family-planning grantees under section 300; comprehensive hemophilia diagnostic and treatment centers; rural health clinics; health facilities run by or under contract with the Indian Health Service; community-based organizations, clinics, hospitals, or other facilities that provide early intervention services to people infected with HIV/AIDS through intravenous drug use; or nonprofit entities providing comprehensive primary care to populations at risk of HIV/AIDS, including faith-based and community-based organizations. These entities must serve underserved populations, which may include minority and Native American populations, ex-offenders, people with conditions such as hepatitis B or C, mental illness, or substance abuse, low-income populations, inner-city populations, and rural populations. (b) Status as medicaid provider — The Secretary generally cannot give a grant for a Medicaid-covered service in a State unless the applicant itself has a Medicaid participation agreement and can bill Medicaid, or has arranged for another qualified public, nonprofit, or — where no other quality local provider exists — for-profit entity to provide the service under such an agreement. This Medicaid-agreement requirement is waived for an entity that, in providing care, does not charge patients or accept reimbursement from any third-party payor, including insurance or federal or state health benefits programs; whether that entity accepts voluntary public donations has no bearing on this waiver decision.

the actual law source: uscode.house.gov ↗public domain

(a) Eligible entities

(1) In general

The entities referred to in section 300ff–51(a) of this title are public entities and nonprofit private entities that are—

(A)

federally-qualified health centers under section 1905(l)(2)(B) of the Social Security Act [42 U.S.C. 1396d(l)(2)(B)];

(B)

grantees under section 300 of this title (regarding family planning) other than States;

(C)

comprehensive hemophilia diagnostic and treatment centers;

(D)

rural health clinics;

(E)

health facilities operated by or pursuant to a contract with the Indian Health Service;

(F)

community-based organizations, clinics, hospitals and other health facilities that provide early intervention services to those persons infected with HIV/AIDS through intravenous drug use; or

(G)

nonprofit private entities that provide comprehensive primary care services to populations at risk of HIV/AIDS, including faith-based and community-based organizations.

(2) Underserved populations

Entities described in paragraph (1) shall serve underserved populations which may include minority populations and Native American populations, ex-offenders, individuals with comorbidities including hepatitis B or C, mental illness, or substance abuse, low-income populations, inner city populations, and rural populations.

(b) Status as medicaid provider

(1) In general

Subject to paragraph (2), the Secretary may not make a grant under section 300ff–51 of this title for the provision of services described in subsection (b) of such section in a State unless, in the case of any such service that is available pursuant to the State plan approved under title XIX of the Social Security Act [42 U.S.C. 1396 et seq.] for the State—

(A)

the applicant for the grant will provide the service directly, and the applicant has entered into a participation agreement under the State plan and is qualified to receive payments under such plan; or

(B)

the applicant for the grant will enter into an agreement with a public or nonprofit private entity, or a private for-profit entity if such entity is the only available provider of quality HIV care in the area, under which the entity will provide the service, and the entity has entered into such a participation agreement and is qualified to receive such payments.

(2) Waiver regarding certain secondary agreements

(A)

In the case of an entity making an agreement pursuant to paragraph (1)(B) regarding the provision of services, the requirement established in such paragraph regarding a participation agreement shall be waived by the Secretary if the entity does not, in providing health care services, impose a charge or accept reimbursement available from any third-party payor, including reimbursement under any insurance policy or under any Federal or State health benefits program.

(B)

A determination by the Secretary of whether an entity referred to in subparagraph (A) meets the criteria for a waiver under such subparagraph shall be made without regard to whether the entity accepts voluntary donations regarding the provision of services to the public.

Source credit: (July 1, 1944, ch. 373, title XXVI, § 2652, as added Pub. L. 101–381, title III, § 301(a), Aug. 18, 1990, 104 Stat. 607; amended Pub. L. 101–557, title IV, § 401(b)(3), Nov. 15, 1990, 104 Stat. 2771; Pub. L. 104–146, § 3(d)(2), May 20, 1996, 110 Stat. 1357; Pub. L. 107–251, title VI, § 601(a), Oct. 26, 2002, 116 Stat. 1664; Pub. L. 108–163, § 2(m)(3), Dec. 6, 2003, 117 Stat. 2023; Pub. L. 109–415, title III, § 302(a), title VII, § 703, Dec. 19, 2006, 120 Stat. 2806, 2820; Pub. L. 111–87, § 2(a)(1), (3)(A), Oct. 30, 2009, 123 Stat. 2885.)

history & why it existsrecord from the source credit

1944Enacted · Pub. L. 101-381 · 104 Stat. 607
1990Amended · Pub. L. 101-557 · 104 Stat. 2771
1996Amended · Pub. L. 104-146 · 110 Stat. 1357
2002Amended · Pub. L. 107-251 · 116 Stat. 1664
2003Amended · Pub. L. 108-163 · 117 Stat. 2023
2006Amended · Pub. L. 109-415 · 120 Stat. 2806, 2820
2009Amended · Pub. L. 111-87 · 123 Stat. 2885

A history note hasn’t been published yet. The record shows enactment by Pub. L. 101-381 on 1944-07-01.

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