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42 U.S.C. § 1395c — Prohibition against any Federal interference
Federal law — U.S. Code and appendices · legal_authorities
Nothing in this subchapter shall be construed to authorize any Federal officer or employee to exercise any supervision or control over the practice of medicine or the manner in which medical services are provided, or over the selection, tenure, or compensation of any officer or employee of any institution, agency, or person providing health services; or to exercise any supervision or control over the administration or operation of any such institution, agency, or person.
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1395c
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Stable record: federal_law:legal_authorities:record_usc_9e6275dff3452aed88ed160e
Source file: Laws/federal/codes/united-states-code/title-42/section-1395c-prohibition-against-any-federal-interference--976c65e8fd.md
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Source location: Title 42, Chapter 7, § 1395c; chapter-007-social-security.md
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Nothing in this subchapter shall be construed to authorize any Federal officer or employee to exercise any supervision or control over the practice of medicine or the manner in which medical services are provided, or over the selection, tenure, or compensation of any officer or employee of any institution, agency, or person providing health services; or to exercise any supervision or control over the administration or operation of any such institution, agency, or person.
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Federal law — U.S. Code and appendices · legal_authorities
**(a) In general** Not later than 90 days after March 23, 2010, the Secretary shall establish a temporary high risk health insurance pool program to provide health insurance coverage for eligible individuals during the period beginning on the date on which such program is established and ending on January 1, 2014.
**(b) Administration**
(1) **In general** — The Secretary may carry out the program under this section directly or through contracts to eligible entities.
(2) **Eligible entities** — To be eligible for a contract under paragraph (1), an entity shall—
(A) be a State or nonprofit private entity;
(B) submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require; and
(C) agree to utilize contract funding to establish and administer a qualified high risk pool for eligible individuals.
(3) **Maintenance of effort** — To be eligible to enter into a contract with the Secretary under this subsection, a State shall agree not to reduce the annual amount the State expended for the operation of one or more State high risk pools during the year preceding the year in which such contract is entered into.
**(c) Qualified high risk pool**
(1) **In general** — Amounts made available under this section shall be used to establish a qualified high risk pool that meets the requirements of paragraph (2).
(2) **Requirements** — A qualified high risk pool meets the requirements of this paragraph if such pool—
(A) provides to all eligible individuals health insurance coverage that does not impose any preexisting condition exclusion with respect to such coverage;
(B) provides health insurance coverage—
(i) in which the issuer’s share of the total allowed costs of benefits provided under such co
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 18001
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Federal law — U.S. Code and appendices · legal_authorities
This chapter may be cited as the “Social Security Act”.
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1305
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Conditions of participation; protection of individual rights; notification of State entities; use of home health aides; medical equipment; individual’s plan of care; compliance with Federal, State, and local laws and regulations** The conditions of participation that a home health agency is required to meet under this subsection are as follows:
(1) The agency protects and promotes the rights of each individual under its care, including each of the following rights:
(A) The right to be fully informed in advance about the care and treatment to be provided by the agency, to be fully informed in advance of any changes in the care or treatment to be provided by the agency that may affect the individual’s well-being, and (except with respect to an individual adjudged incompetent) to participate in planning care and treatment or changes in care or treatment.
(B) The right to voice grievances with respect to treatment or care that is (or fails to be) furnished without discrimination or reprisal for voicing grievances.
(C) The right to confidentiality of the clinical records described in section 1395x(o)(3) of this title.
(D) The right to have one’s property treated with respect.
(E) The right to be fully informed orally and in writing (in advance of coming under the care of the agency) of—
(i) all items and services furnished by (or under arrangements with) the agency for which payment may be made under this subchapter,
(ii) the coverage available for such items and services under this subchapter, subchapter XIX, and any other Federal program of which the agency is reasonably aware,
(iii) any charges for items and services not covered under this subchapter and any charges the individual may have to pay with respect to items and services furn
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1395
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Responsible Officials.—**
(1) Except as otherwise provided in this chapter, the Secretary of Defense shall administer this chapter for the armed forces under his jurisdiction, the Secretary of Homeland Security shall administer this chapter for the Coast Guard when the Coast Guard is not operating as a service in the Navy, and the Secretary of Health and Human Services shall administer this chapter for the National Oceanic and Atmospheric Administration and the Public Health Service. This chapter shall be administered consistent with the Assisted Suicide Funding Restriction Act of 1997 ([42 U.S.C. 14401](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section14401&num=0&edition=prelim) et seq.).
(2) Except as otherwise provided in this chapter, the Secretary of Defense shall have responsibility for administering the TRICARE program and making any decision affecting such program.
**(b) Stability in Program of Benefits.—** The Secretary of Defense shall, to the maximum extent practicable, provide a stable program of benefits under this chapter throughout each fiscal year. To achieve the stability in the case of managed care support contracts entered into under this chapter, the contracts shall be administered so as to implement all changes in benefits and administration on a quarterly basis. However, the Secretary of Defense may implement any such change prior to the next fiscal quarter if the Secretary determines that the change would significantly improve the provision of care to eligible beneficiaries under this chapter.
Source: Supplied U.S. Code snapshot — release unconfirmed · 10 U.S.C. § 1073
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Federal law — U.S. Code and appendices · legal_authorities
**(a)** To assure that medical care is available for dependents, as described in subparagraphs (A), (D), and (I) of [section 1072(2) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title10-section1072/2&num=0&edition=prelim), of members of the uniformed services who are on active duty for a period of more than 30 days, the Secretary of Defense, after consulting with the other administering Secretaries, shall contract, under the authority of this section, for medical care for those persons under such insurance, medical service, or health plans as he considers appropriate. The types of health care authorized under this section shall be the same as those provided under [section 1076 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title10-section1076&num=0&edition=prelim), except as follows:
(1) With respect to dental care—
(A) except as provided in subparagraph (B), only that care required as a necessary adjunct to medical or surgical treatment may be provided; and
(B) in connection with dental treatment for patients with developmental, mental, or physical disabilities or for pediatric patients age 5 or under, only institutional and anesthesia services may be provided.
(2) Consistent with such regulations as the Secretary of Defense may prescribe regarding the content of health promotion and disease prevention visits, the schedule and method of cervical cancer screenings and breast cancer screenings, the schedule and method of colon and prostate cancer screenings, and the types and schedule of immunizations—
(A) for dependents under six years of age, both health promotion and disease prevention visits and immunizations may be provided; and
(B) for dependents six years of age or older, health promotion an
Source: Supplied U.S. Code snapshot — release unconfirmed · 10 U.S.C. § 1079
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Federal law — U.S. Code and appendices · legal_authorities
**(a)** To assure that health benefits are available for the persons covered by subsection (c), the Secretary of Defense, after consulting with the other administering Secretaries, shall contract under the authority of this section for health benefits for those persons under the same insurance, medical service, or health plans he contracts for under [section 1079(a) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title10-section1079/a&num=0&edition=prelim). However, eye examinations and (except as provided in subsection (i)) treatments for eating disorders may not be provided under such plans for persons covered by subsection (c).
**(b)** For persons covered by this section the plans contracted for under [section 1079(a) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title10-section1079/a&num=0&edition=prelim) shall contain the following provisions for payment by the patient:
(1) Except as provided in paragraph (2), the first $150 each calendar year of the charges for all types of care authorized by this section and received while in an outpatient status and 25 percent of all subsequent charges for such care during a calendar year.
(2) A family group of two or more persons covered by this section shall not be required to pay collectively more than the first $300 each calendar year of the charges for all types of care authorized by this section and received while in an outpatient status and 25 percent of the additional charges for such care during a calendar year.
(3) 25 percent of the charges for inpatient care, except that in no case may the charges for inpatient care for a patient exceed $535 per day during the period beginning on April 1, 2006, and ending on September 30, 2011. The Secretary of Defense may
Source: Supplied U.S. Code snapshot — release unconfirmed · 10 U.S.C. § 1086
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Federal law — U.S. Code and appendices · legal_authorities
**(a)** Space for inpatient and outpatient care may be programed in facilities of the uniformed services for persons covered by sections 1074(b) and 1076(b) of this title. The maximum amount of space that may be so programed for a facility is the greater of—
(1) the amount of space that would be so programed for the facility in order to meet the requirements to be placed on the facility for support of the teaching and training of health-care professionals; and
(2) the amount of space that would be so programed for the facility based upon the most cost-effective provision of inpatient and outpatient care to persons covered by sections 1074(b) and 1076(b) of this title.
**(b)**
(1) In making determinations for the purposes of clauses (1) and (2) of subsection (a), the Secretary concerned shall take into consideration—
(A) the amount of space that would be so programed for the facility based upon projected inpatient and outpatient workloads at the facility for persons covered by sections 1074(b) and 1076(b) of this title; and
(B) the anticipated capability of the medical and dental staff of the facility, determined in accordance with regulations prescribed by the Secretary of Defense and based upon realistic projections of the number of physicians and other health-care providers that it can reasonably be expected will be assigned to or will otherwise be available to the facility.
(2) In addition, a determination made for the purpose of clause (2) of subsection (a) shall be made in accordance with an economic analysis (including a life-cycle cost analysis) of the facility and consideration of all reasonable and available medical care treatment alternatives (including treatment provided under a contract under [section 1086 of this title](https://uscode.house.gov/v
Source: Supplied U.S. Code snapshot — release unconfirmed · 10 U.S.C. § 1087
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Standard Form.—** The Secretary of Defense, after consultation with the other administering Secretaries, shall prescribe by regulation a standard form for the submission of claims for the payment of health care services provided under this chapter.
**(b) Time for Submission.—** A claim for payment for services provided under this chapter shall be submitted as provided in such regulations as follows:
(1) In the case of services provided outside the United States, the Commonwealth of Puerto Rico, or the possessions of the United States, by not later than three years after the services are provided.
(2) In the case of any other services, by not later than one year after the services are provided.
Source: Supplied U.S. Code snapshot — release unconfirmed · 10 U.S.C. § 1106
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Federal law — U.S. Code and appendices · legal_authorities
**(a) FEHBP Option Demonstration.—** The Secretary of Defense, after consulting with the other administering Secretaries, shall enter into an agreement with the Office of Personnel Management to conduct a demonstration project (in this section referred to as the “demonstration project”) under which eligible beneficiaries described in subsection (b) and residing within one of the areas covered by the demonstration project may enroll in health benefits plans offered through the Federal Employees Health Benefits program under chapter 89 of title 5. The number of eligible beneficiaries and family members of such beneficiaries under subsection (b)(2) who may be enrolled in health benefits plans during the enrollment period under subsection (d)(2) may not exceed 66,000.
**(b) Eligible Beneficiaries; Coverage.—**
(1) An eligible beneficiary under this subsection is—
(A) a member or former member of the uniformed services described in [section 1074(b) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title10-section1074/b&num=0&edition=prelim) who is entitled to hospital insurance benefits under part A of title XVIII of the Social Security Act ([42 U.S.C. 1395c](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395c&num=0&edition=prelim) et seq.);
(B) an individual who is an unremarried former spouse of a member or former member described in section 1072(2)(F) or 1072(2)(G));
(C) an individual who is—
(i) a dependent of a deceased member or former member described in section 1076(b) or 1076(a)(2)(B) of this title or of a member who died while on active duty for a period of more than 30 days; and
(ii) a member of family as defined in [section 8901(5) of title 5](https://uscode.house.gov/view.xhtml?req=gran
Source: Supplied U.S. Code snapshot — release unconfirmed · 10 U.S.C. § 1108
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Federal law — U.S. Code and appendices · legal_authorities
**(a) In General.—**
(1) As soon as practicable, the Secretary of Defense shall notify each individual described in subsection (b)—
(A) that the individual is no longer eligible for health care benefits under the TRICARE program under this chapter; and
(B) of options available for enrollment of the individual in the supplementary medical insurance program under part B of title XVIII of the Social Security Act ([42 U.S.C. 1395j](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395j&num=0&edition=prelim) et seq.).
(2) In carrying out this subsection, the Secretary of Defense shall—
(A) establish procedures for identifying individuals described in subsection (b); and
(B) consult with the Secretary of Health and Human Services to accurately identify and notify such individuals.
**(b) Individuals Described.—** An individual described in this subsection is an individual who is—
(1) a covered beneficiary;
(2) entitled to benefits under part A of title XVIII of the Social Security Act ([42 U.S.C. 1395c](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395c&num=0&edition=prelim)) under section 226(b) or section 226A of such Act ([42 U.S.C. 426(b)](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section426/b&num=0&edition=prelim) and 426–1); and
(3) eligible to enroll in the supplementary medical insurance program under part B of such title ([42 U.S.C. 1395j](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395j&num=0&edition=prelim) et seq.).
Source: Supplied U.S. Code snapshot — release unconfirmed · 10 U.S.C. § 1110a
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