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42 U.S.C. § 1320a–3 — Disclosure of ownership and related information; procedure; definitions; scope of requirements

Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 1320a–3 — Disclosure of ownership and related information; procedure; definitions; scope of requirements

Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1320a–3

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Stable record: federal_law:legal_authorities:record_usc_bd30a97e35e610cf78a84905
Source file: Laws/federal/codes/united-states-code/title-42/section-1320a3-disclosure-of-ownership-and-related-information-procedure-definitions-sc--a2f53dff00.md
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Source location: Title 42, Chapter 7, § 1320a–3; chapter-007-social-security.md

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**(a) In general** (1) The Secretary shall by regulation or by contract provision provide that each disclosing entity (as defined in paragraph (2)) shall— (A) as a condition of the disclosing entity’s participation in, or certification or recertification under, any of the programs established by subchapters V, XVIII, and XIX, or (B) as a condition for the approval or renewal of a contract or agreement between the disclosing entity and the Secretary or the appropriate State agency under any of the programs established under subchapters V, XVIII, and XIX, supply the Secretary or the appropriate State agency with full and complete information as to the identity of each person with an ownership or control interest (as defined in paragraph (3)) in the entity or in any subcontractor (as defined by the Secretary in regulations) in which the entity directly or indirectly has a 5 per centum or more ownership interest and supply the Secretary with the 11 So in original. The word “the” probably should not appear. both the employer identification number (assigned pursuant to section 6109 of the Internal Revenue Code of 1986) and social security account number (assigned under [section 405(c)(2)(B) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section405/c/2/B&num=0&edition=prelim)) of the disclosing entity, each person with an ownership or control interest (as defined in subsection (a)(3)), and any subcontractor in which the entity directly or indirectly has a 5 percent or more ownership interest. (2) As used in this section, the term “disclosing entity” means an entity which is— (A) a provider of services (as defined in [section 1395x(u) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395x/u&num=0&edition=prelim), other than a fund), an independent clinical laboratory, a renal disease facility, a managed care entity, as defined in [section 1396u–2(a)(1)(B) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396u–2/a/1/B&num=0&edition=prelim), or a health maintenance organization (as defined in [section 300e(a) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section300e/a&num=0&edition=prelim)); (B) an entity (other than an individual practitioner or group of practitioners) that furnishes, or arranges for the furnishing of, items or services with respect to which payment may be claimed by the entity under any plan or program established pursuant to subchapter V or under a State plan approved under subchapter XIX; or (C) a carrier or other agency or organization that is acting as a fiscal intermediary or agent with respect to one or more providers of services (for purposes of part A or part B of subchapter XVIII, or both, or for purposes of a State plan approved under subchapter XIX) pursuant to (i) an agreement under [section 1395h of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395h&num=0&edition=prelim), (ii) a contract under [section 1395u of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395u&num=0&edition=prelim), or (iii) an agreement with a single State agency administering or supervising the administration of a State plan approved under subchapter XIX. (3) As used in this section, the term “person with an ownership or control interest” means, with respect to an entity, a person who— (A) (i) has directly or indirectly (as determined by the Secretary in regulations) an ownership interest of 5 per centum or more in the entity; or (ii) is the owner of a whole or part interest in any mortgage, deed of trust, note, or other obligation secured (in whole or in part) by the entity or any of the property or assets thereof, which whole or part interest is equal to or exceeds 5 per centum of the total property and assets of the entity; or (B) is an officer or director of the entity, if the entity is organized as a corporation; or (C) is a partner in the entity, if the entity is organized as a partnership. **(b) Other disclosing entities** To the extent determined to be feasible under regulations of the Secretary, a disclosing entity shall also include in the information supplied under subsection (a)(1), with respect to each person with an ownership or control interest in the entity, the name of any other disclosing entity with respect to which the person is a person with an ownership or control interest. **(c) Required disclosure of ownership and additional disclosable parties information** (1) **Disclosure** — A facility shall have the information described in paragraph (2) available— (A) during the period beginning on March 23, 2010, and ending on the date such information is made available to the public under section 6101(b) of the Patient Protection and Affordable Care Act for submission to the Secretary, the Inspector General of the Department of Health and Human Services, the State in which the facility is located, and the State long-term care ombudsman in the case where the Secretary, the Inspector General, the State, or the State long-term care ombudsman requests such information; and (B) beginning on the effective date of the final regulations promulgated under paragraph (3)(A), for reporting such information in accordance with such final regulations. Nothing in subparagraph (A) shall be construed as authorizing a facility to dispose of or delete information described in such subparagraph after the effective date of the final regulations promulgated under paragraph (3)(A). (2) **Information described** (A) *In general* — The following information is described in this paragraph: (i) The information described in subsections (a) and (b), subject to subparagraph (C). (ii) The identity of and information on— (I) each member of the governing body of the facility, including the name, title, and period of service of each such member; (II) each person or entity who is an officer, director, member, partner, trustee, or managing employee of the facility, including the name, title, and period of service of each such person or entity; and (III) each person or entity who is an additional disclosable party of the facility. (iii) The organizational structure of each additional disclosable party of the facility and a description of the relationship of each such additional disclosable party to the facility and to one another. (B) *Special rule where information is already reported or submitted* — To the extent that information reported by a facility to the Internal Revenue Service on Form 990, information submitted by a facility to the Securities and Exchange Commission, or information otherwise submitted to the Secretary or any other Federal agency contains the information described in clauses (i), (ii), or (iii) of subparagraph (A), the facility may provide such Form or such information submitted to meet the requirements of paragraph (1). (C) *Special rule* — In applying subparagraph (A)(i)— (i) with respect to subsections (a) and (b), “ownership or control interest” shall include direct or indirect interests, including such interests in intermediate entities; and (ii) subsection (a)(3)(A)(ii) shall include the owner of a whole or part interest in any mortgage, deed of trust, note, or other obligation secured, in whole or in part, by the entity or any of the property or assets thereof, if the interest is equal to or exceeds 5 percent of the total property or assets of the entirety. (3) **Reporting** (A) *In general* — Not later than the date that is 2 years after March 23, 2010, the Secretary shall promulgate final regulations requiring, effective on the date that is 90 days after the date on which such final regulations are published in the Federal Register, a facility to report the information described in paragraph (2) to the Secretary in a standardized format, and such other regulations as are necessary to carry out this subsection. Such final regulations shall ensure that the facility certifies, as a condition of participation and payment under the program under subchapter XVIII or XIX, that the information reported by the facility in accordance with such final regulations is, to the best of the facility’s knowledge, accurate and current. (B) *Guidance* — The Secretary shall provide guidance and technical assistance to States on how to adopt the standardized format under subparagraph (A). (4) **No effect on existing reporting requirements** — Nothing in this subsection shall reduce, diminish, or alter any reporting requirement for a facility that is in effect as of March 23, 2010. (5) **Definitions** — In this subsection: (A) *Additional disclosable party* — The term “additional disclosable party” means, with respect to a facility, any person or entity who— (i) exercises operational, financial, or managerial control over the facility or a part thereof, or provides policies or procedures for any of the operations of the facility, or provides financial or cash management services to the facility; (ii) leases or subleases real property to the facility, or owns a whole or part interest equal to or exceeding 5 percent of the total value of such real property; or (iii) provides management or administrative services, management or clinical consulting services, or accounting or financial services to the facility. (B) *Facility* — The term “facility” means a disclosing entity which is— (i) a skilled nursing facility (as defined in [section 1395i–3(a) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395i–3/a&num=0&edition=prelim)); or (ii) a nursing facility (as defined in [section 1396r(a) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396r/a&num=0&edition=prelim)). (C) *Managing employee* — The term “managing employee” means, with respect to a facility, an individual (including a general manager, business manager, administrator, director, or consultant) who directly or indirectly manages, advises, or supervises any element of the practices, finances, or operations of the facility. (D) *Organizational structure* — The term “organizational structure” means, in the case of— (i) a corporation, the officers, directors, and shareholders of the corporation who have an ownership interest in the corporation which is equal to or exceeds 5 percent; (ii) a limited liability company, the members and managers of the limited liability company (including, as applicable, what percentage each member and manager has of the ownership interest in the limited liability company); (iii) a general partnership, the partners of the general partnership; (iv) a limited partnership, the general partners and any limited partners of the limited partnership who have an ownership interest in the limited partnership which is equal to or exceeds 10 percent; (v) a trust, the trustees of the trust; (vi) an individual, contact information for the individual; and (vii) any other person or entity, such information as the Secretary determines appropriate.

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 701 — Authorization of appropriations; purposes; definitions

**(a)** To improve the health of all mothers and children consistent with the applicable health status goals and national health objectives established by the Secretary under the Public Health Service Act [[42 U.S.C. 201](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section201&num=0&edition=prelim) et seq.] for the year 2000, there are authorized to be appropriated $850,000,000 for fiscal year 2001 and each fiscal year thereafter— (1) for the purpose of enabling each State— (A) to provide and to assure mothers and children (in particular those with low income or with limited availability of health services) access to quality maternal and child health services; (B) to reduce infant mortality and the incidence of preventable diseases and handicapping conditions among children, to reduce the incidence of stillbirth, to reduce the need for inpatient and long-term care services, to increase the number of children (especially preschool children) appropriately immunized against disease and the number of low income children receiving health assessments and follow-up diagnostic and treatment services, and otherwise to promote the health of mothers and infants by providing prenatal, delivery, and postpartum care for low income, at-risk pregnant women, and to promote the health of children by providing preventive and primary care services for low income children; (C) to provide rehabilitation services for blind and disabled individuals under the age of 16 receiving benefits under subchapter XVI, to the extent medical assistance for such services is not provided under subchapter XIX; and (D) to provide and to promote family-centered, community-based, coordinated care (including care coordination services, as defined in subsection (b)(3)) for chi

Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 701

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 1395h — Health insurance advisory service for medicare beneficiaries

**(a) In general** The Secretary of Health and Human Services shall establish a health insurance advisory service program (in this section referred to as the “beneficiary assistance program”) to assist medicare-eligible individuals with the receipt of services under the medicare and medicaid programs and other health insurance programs. **(b) Outreach elements** The beneficiary assistance program shall provide assistance— (1) through operation using local Federal offices that provide information on the medicare program, (2) using community outreach programs, and (3) using a toll-free telephone information service. **(c) Assistance provided** The beneficiary assistance program shall provide for information, counseling, and assistance for medicare-eligible individuals with respect to at least the following: (1) With respect to the medicare program— (A) eligibility, (B) benefits (both covered and not covered), (C) the process of payment for services, (D) rights and process for appeals of determinations, (E) other medicare-related entities (such as peer review organizations, fiscal intermediaries, and carriers), and (F) recent legislative and administrative changes in the medicare program. (2) With respect to the medicaid program— (A) eligibility, benefits, and the application process, (B) linkages between the medicaid and medicare programs, and (C) referral to appropriate State and local agencies involved in the medicaid program. (3) With respect to medicare supplemental policies— (A) the program under [section 1395ss of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395ss&num=0&edition=prelim) and standards required under such program, (B) how to make informed decisions on whether to purcha

Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1395h

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 1395u — Establishment of supplementary medical insurance program for aged and disabled

There is hereby established a voluntary insurance program to provide medical insurance benefits in accordance with the provisions of this part for aged and disabled individuals who elect to enroll under such program, to be financed from premium payments by enrollees together with contributions from funds appropriated by the Federal Government.

Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1395u

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 1397 — Purposes of division; authorization of appropriations

For the purposes of consolidating Federal assistance to States for social services into a single grant, increasing State flexibility in using social service grants, and encouraging each State, as far as practicable under the conditions in that State, to furnish services directed at the goals of— (1) achieving or maintaining economic self-support to prevent, reduce, or eliminate dependency; (2) achieving or maintaining self-sufficiency, including reduction or prevention of dependency; (3) preventing or remedying neglect, abuse, or exploitation of children and adults unable to protect their own interests, or preserving, rehabilitating or reuniting families; (4) preventing or reducing inappropriate institutional care by providing for community-based care, home-based care, or other forms of less intensive care; and (5) securing referral or admission for institutional care when other forms of care are not appropriate, or providing services to individuals in institutions, there are authorized to be appropriated for each fiscal year such sums as may be necessary to carry out the purposes of this division.

Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1397

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 1396b — Payment to States

**(a) Computation of amount** From the sums appropriated therefor, the Secretary (except as otherwise provided in this section) shall pay to each State which has a plan approved under this subchapter, for each quarter, beginning with the quarter commencing January 1, 1966— (1) an amount equal to the Federal medical assistance percentage (as defined in [section 1396d(b) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396d/b&num=0&edition=prelim), subject to subsections (g) and (j) of this section and [section 1396r–4(f) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396r–4/f&num=0&edition=prelim)) of the total amount expended during such quarter as medical assistance under the State plan; plus (2) (A) an amount equal to 75 per centum of so much of the sums expended during such quarter (as found necessary by the Secretary for the proper and efficient administration of the State plan) as are attributable to compensation or training of skilled professional medical personnel, and staff directly supporting such personnel, of the State agency or any other public agency; plus (B) notwithstanding paragraph (1) or subparagraph (A), with respect to amounts expended for nursing aide training and competency evaluation programs, and competency evaluation programs, described in [section 1396r(e)(1) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396r/e/1&num=0&edition=prelim) (including the costs for nurse aides to complete such competency evaluation programs), regardless of whether the programs are provided in or outside nursing facilities or of the skill of the personnel involved in such programs, an amount equal to 50 percent (or, for calendar

Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1396b

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