42 U.S.C. § 1320a — Uniform reporting systems for health

Page 2598 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 1320 chapter has made a finding (prior to making such expenditure) that (A) such home is so de- fective that continued occupancy is unwar- ranted, (B) unless repairs are made to such home, rental quarters will be necessary for such individual, and (C) the cost of rental quarters to take care of the needs of such indi- vidual (including his spouse living with him in such home and any other individual whose needs were taken into account in determining the need of such individual) would exceed (over such time as the Secretary may specify) the cost of repairs needed to make such home habitable together with other costs attrib- utable to continued occupancy of such home, and (2) no such expenditures were made for re- pairing such home pursuant to any prior find- ing under this section, the amount paid to any such State for any quar- ter under section 303(a), 1203(a), 1353(a), or 1383(a) of this title shall be increased by 50 per centum of such expenditures, except that the ex- cess above $500 expended with respect to any one home shall not be included in determining such expenditures. (Aug. 14, 1935, ch. 531, title XI, § 1119, as added Pub. L. 90–248, title II, § 209(a), Jan. 2, 1968, 81 Stat. 894; amended Pub. L. 104–193, title I, § 108(g)(5), Aug. 22, 1996, 110 Stat. 2168.) Editorial Notes REFERENCES IN TEXT Section 1383(a) of this title, referred to in text, is a reference to section 1383(a) of this title as it existed prior to the general revision of this subchapter by Pub. L. 92–603, title III, § 301, Oct. 30, 1972, 86 Stat. 1465, eff. Jan. 1, 1974. The prior section (which is set out as a note under section 1383 of this title) continues in effect for Puerto Rico, Guam, and the Virgin Islands. AMENDMENTS 1996—Pub. L. 104–193 substituted ‘‘subchapter I, X, XIV, or XVI,’’ for ‘‘subchapter I, X, XIV, or XVI, or part A of subchapter IV’’ in introductory provisions and struck out ‘‘603(a),’’ before ‘‘1203(a),’’ in closing provi- sions. Statutory Notes and Related Subsidiaries EFFECTIVE DATE OF 1996 AMENDMENT Amendment by Pub. L. 104–193 effective July 1, 1997, with transition rules relating to State options to accel- erate such date, rules relating to claims, actions, and proceedings commenced before such date, rules relating to closing out of accounts for terminated or substan- tially modified programs and continuance in office of Assistant Secretary for Family Support, and provisions relating to termination of entitlement under AFDC program, see section 116 of Pub. L. 104–193, as amended, set out as an Effective Date note under section 601 of this title. EFFECTIVE DATE Pub. L. 90–248, title II, § 209(b), Jan. 2, 1968, 81 Stat. 895, provided that: ‘‘The amendment made by sub- section (a) [enacting this section] shall apply with re- spect to expenditures made after December 31, 1967.’’ § 1320. Approval of certain projects No payment shall be made under this chapter with respect to any experimental, pilot, dem- onstration, or other project all or any part of which is wholly financed with Federal funds made available under this chapter (without any State, local, or other non-Federal financial par- ticipation) unless such project shall have been personally approved by the Secretary or Deputy Secretary of Health and Human Services. (Aug. 14, 1935, ch. 531, title XI, § 1120, as added Pub. L. 90–248, title II, § 249, Jan. 2, 1968, 81 Stat. 919; amended Pub. L. 93–608, § 2(5), Jan. 2, 1975, 88 Stat. 1971; Pub. L. 97–375, title I, § 107(a), Dec. 21, 1982, 96 Stat. 1820; Pub. L. 98–369, div. B, title VI, § 2663(j)(2)(D)(v), July 18, 1984, 98 Stat. 1170; Pub. L. 101–509, title V, § 529 [title I, § 112(c)], Nov. 5, 1990, 104 Stat. 1427, 1454.) Editorial Notes AMENDMENTS 1990—Pub. L. 101–509 substituted ‘‘Deputy Secretary of Health and Human Services’’ for ‘‘Under Secretary of Health and Human Services’’. 1984—Pub. L. 98–369 substituted ‘‘Health and Human Services’’ for ‘‘Health, Education, and Welfare’’. 1982—Pub. L. 97–375 struck out subsec. (b) which di- rected the Secretary to submit an annual report to Congress describing each project approved under former subsec. (a) of this section during the preceding year, including the purpose, probable cost, and ex- pected duration of each project, and struck out ‘‘(a)’’ before ‘‘No payment’’. 1975—Subsec. (b). Pub. L. 93–608 substituted provi- sions relating to an annual submission of the required report to the Congress by the Secretary for each ap- proved project, for provisions relating to submission of the report as soon as possible after approval. Statutory Notes and Related Subsidiaries EFFECTIVE DATE OF 1990 AMENDMENT; CONTINUED SERVICE BY INCUMBENTS Amendment by Pub. L. 101–509 effective on the first day of the first pay period that begins on or after Nov. 5, 1990, with continued service by incumbent Under Sec- retary of Health and Human Services, see section 529 [title I, § 112(e)] of Pub. L. 101–509, set out as a note under section 3404 of Title 20, Education. EFFECTIVE DATE OF 1984 AMENDMENT Amendment by Pub. L. 98–369 effective July 18, 1984, but not to be construed as changing or affecting any right, liability, status, or interpretation which existed (under the provisions of law involved) before that date, see section 2664(b) of Pub. L. 98–369, set out as a note under section 401 of this title. § 1320a. Uniform reporting systems for health services facilities and organizations (a) Establishment; criteria for regulations; re- quirements for hospitals For the purposes of reporting the cost of serv- ices provided by, of planning, and of measuring and comparing the efficiency of and effective use of services in, hospitals, skilled nursing fa- cilities, intermediate care facilities, home health agencies, health maintenance organiza- tions, and other types of health services facili- ties and organizations to which payment may be made under this chapter, the Secretary shall es- tablish by regulation, for each such type of health services facility or organization, a uni- form system for the reporting by a facility or organization of that type of the following infor- mation: Page 2599 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 1320a–1 1 See References in Text note below. (1) The aggregate cost of operation and the aggregate volume of services. (2) The costs and volume of services for var- ious functional accounts and subaccounts. (3) Rates, by category of patient and class of purchaser. (4) Capital assets, as defined by the Sec- retary, including (as appropriate) capital funds, debt service, lease agreements used in lieu of capital funds, and the value of land, fa- cilities, and equipment. (5) Discharge and bill data. The uniform reporting system for a type of health services facility or organization shall provide for appropriate variation in the applica- tion of the system to different classes of facili- ties or organizations within that type and shall be established, to the extent practicable, con- sistent with the cooperative system for pro- ducing comparable and uniform health informa- tion and statistics described in section 242k(e)(1) of this title. In reporting under such a system, hospitals shall employ such chart of accounts, definitions, principles, and statistics as the Sec- retary may prescribe in order to reach a uniform reconciliation of financial and statistical data for specified uniform reports to be provided to the Secretary. (b) Monitoring, etc., of systems by Secretary The Secretary shall— (1) monitor the operation of the systems es- tablished under subsection (a); (2) assist with and support demonstrations and evaluations of the effectiveness and cost of the operation of such systems and encour- age State adoption of such systems; and (3) periodically revise such systems to im- prove their effectiveness and diminish their cost. (c) Availability of information to appropriate agencies and organizations The Secretary shall provide information ob- tained through use of the uniform reporting sys- tems described in subsection (a) in a useful man- ner and format to appropriate agencies and or- ganizations, including health systems agencies (designated under section 300l–4 1 of this title) and State health planning and development agencies (designated under section 300m 1 of this title), as may be necessary to carry out such agencies’ and organizations’ functions. (Aug. 14, 1935, ch. 531, title XI, § 1121, as added Pub. L. 95–142, § 19(a), Oct. 25, 1977, 91 Stat. 1203.) Editorial Notes REFERENCES IN TEXT Section 300l–4 of this title, referred to in subsec. (c), was repealed effective Jan. 1, 1987, by Pub. L. 99–660, title VII, § 701(a), Nov. 14, 1986, 100 Stat. 3799. Section 300m of this title, referred to in subsec. (c), was in the original a reference to section 1521 of act July 1, 1944, which was repealed effective Jan. 1, 1987, by Pub. L. 99–660, title VII, § 701(a), Nov. 14, 1986, 100 Stat. 3799. Pub. L. 101–354, § 2, Aug. 10, 1990, 104 Stat. 410, enacted section 1503 of act July 1, 1944, which is classi- fied to section 300m of this title. PRIOR PROVISIONS A prior section 1320a, act Aug. 14, 1935, ch. 531, title XI, § 1121, as added Jan. 2, 1968, Pub. L. 90–248, title II, § 250(a), 81 Stat. 920, provided for assistance in the form of institutional services in intermediate care facilities, the subsecs. providing as follows: subsec. (a), modifica- tion of certain plans to include such benefit; subsec. (b), eligible individuals; subsec. (c), payments and Fed- eral medical assistance percentage; subsec. (d), condi- tions, limitations, rights, and obligations applicable to modified plans; and subsec. (e), definition of ‘‘inter- mediate care facility’’, which is covered in section 1396d(c) of this title, prior to repeal by Pub. L. 92–223, § 4(c), Dec. 28, 1971, 85 Stat. 810. Section was additionally amended by Pub. L. 92–603, title II, § 278(a)(24), Oct. 30, 1972, 86 Stat. 1453, without reference to the earlier repeal of this section by Pub. L. 92–223. Statutory Notes and Related Subsidiaries TIME PERIODS FOR ESTABLISHMENT OF UNIFORM RE- PORTING SYSTEMS; CONSULTATIONS WITH INTERESTED PARTIES Pub. L. 95–142, § 19(c)(1), Oct. 25, 1977, 91 Stat. 1205, di- rected Secretary of Health, Education, and Welfare to establish the systems described in subsec. (a) of this section only after consultation with interested parties and for hospitals, skilled nursing facilities, and inter- mediate care facilities, not later than the end of the one year period beginning on Oct. 25, 1977, and for other types of health services facilities and organizations, not later than the end of the two-year period beginning on Oct. 25, 1977. § 1320a–1. Limitation on use of Federal funds for capital expenditures (a) Use of reimbursement for planning activities for health services and facilities The purpose of this section is to assure that Federal funds appropriated under subchapters XVIII and XIX are not used to support unneces- sary capital expenditures made by or on behalf of health care facilities which are reimbursed under any of such subchapters and that, to the extent possible, reimbursement under such sub- chapters shall support planning activities with respect to health services and facilities in the various States. (b) Agreement between Secretary and State for submission of proposed capital expenditures related to health care facilities and proce- dures for appeal from recommendations The Secretary, after consultation with the Governor (or other chief executive officer) and with appropriate local public officials, shall make an agreement with any State which is able and willing to do so under which a des- ignated planning agency (which shall be an agency described in clause (ii) of subsection (d)(1)(B) that has a governing body or advisory board at least half of whose members represent consumer interests) will— (1) make, and submit to the Secretary to- gether with such supporting materials as he may find necessary, findings and recommenda- tions with respect to capital expenditures pro- posed by or on behalf of any health care facil- ity in such State within the field of its respon- sibilities, (2) receive from other agencies described in clause (ii) of subsection (d)(1)(B), and submit to the Secretary together with such sup-