Sec. 1106. Disclosure of Information in Possession of Department-- Page 1 306 308 308 308 308 308 310 Sec. 1108. Limitation on Payments to Puerto Rico, the Virgin Islands, and Guam__. 311 Sec. 1109. Amounts Disregarded Not To Be Taken Into Account in 312 Sec. 1110. Cooperative Research or Demonstration Projects- 312 313 Sec. 1112. Medical Care Guides and Reports for Public Assistance and 313 Sec. 1113. Assistance for United States Citizens Returned From Foreign Sec. 1116. Administrative and Judicial Review of Certain Administrative 317 SEC. 1117. [Repealed.] Sec. 1118. Alternative Federal Payment With Respect to Public Assistance Expenditures__ 318 Sec. 1119. Federal Participation in Payments for Repairs to Home Owned by Recipient of Aid or Assistance_. 318 Sec. 1120. Approval of Certain Projects----. 319 Sec. 1192. Limitation on Federal Participation for Capital Expenditures__ 319 323 Sec. 1130. [Repealed] Sec. 1131. Notification of Social Security Claimant With Respect to Deferred Vested Benefits_ 324 324 PART B-PROFESSIONAL STANDARDS REVIEW Sec. 1151. Declaration of Purpose.. Sec. 1152. Designation of Professional Standards Review Organizations__ Organizations Sec. 1154. Trial Period for Professional Standards Review Organizations_ Sec. 1156. Norms of Health Care Services for Various Illnesses or Health Sec. 1157. Submission of Reports by Professional Standards Review Or- Sec. 1158. Requirement of Review Approval as Condition of Payment of 1 This table of contents does not appear in the law. 325 326 329 329 330 Ꭷ 335 335 Sec. 1159. Hearings and Review by Secretary. Page1 336 Sec. 1160. Obligations of Health Care Practitioners and Providers of Health Care Services; Sanctions and Penalties; Hearings and Review____ 337 Sec. 1161. Notice to Practitioner or Provider__. 339 Sec. 1162. Statewide Professional Standards Review Councils; Advisory 339 Sec. 1163. National Professional Standards Review Council___ 341 Sec. 1165. Correlation of Functions Between Professional Standards Re- 342 343 343 343 Sec. 1168. Authorization for Use of Certain Funds to Administer the 344 345 Sec. 1169. Technical Assistance to Organizations Desiring to be Designated Part A-General Provisions Definitions Sec. 1101. (a) When used in this Act 345 (1) The term "State", except where otherwise provided, includes the District of Columbia and the Commonwealth of Puerto Rico, and when used in titles IV, V, VII, XI, and XIX includes the Virgin Islands and Guam. Such term when used in title V also includes American Samoa and the Trust Territory of the Pacific Islands. Such term when used in titles III, IX, and XII also includes the Virgin Islands. In the case of Puerto Rico, the Virgin Islands, and Guam, title I, X, and XIV, and title XVI, (as in effect without regard to the amendment made by section 301 of the Social Security Amendments of 1972) shall continue to apply, and the term "States" when used in such titles (but not in title XVI as in effect pursuant to such amendment after December 31, 1973) includes Puerto Rico, the Virgin Islands, and Guam.2 (2) The term "United States" when used in a geographical sense means, except when otherwise provided, the States. (3) The term "person" means an individual, a trust or estate, a partnerhip, or a corporation. (4) The term "corporation" includes associations, joint-stock companies, and insurance companies. (5) The term "shareholder" includes a member in an association, joint-stock company, or insurance company. (6) The term "Secretary", except when the context otherwise requires, means the Secretary of Health, Education, and Welfare. 1 This table does not appear in the law. 'Paragraph (1) was amended by section 116(a) of P.L. 94-566. (7) The terms "physician" and "medical care" and "hospitalization" include osteopathic practitioners or the services of osteopathic practioners and hospitals within the scope of their practice as defined by State law. (8) (A) The "Federal percentage" for any State (other than Puerto Rico, the Virgin Islands, and Guam) shall be 100 per centum less the State percentage; and the State percentage shall be that percentage which bears the same ratio to 50 per centum as the square of the per capita income of such State bears to the square of the per capita income of the United States; except that the Federal percentage shall in no case be less than 50 per centum or more than 65 per centum. (B) The Federal percentage for each State (other than Puerto Rico, the Virgin Islands, and Guam) shall be promulgated by the Secretary between October 1 and November 30 of each even-numbered year, on the basis of the average per capita income of each State and of the United States for the three most recent calendar years for which satisfactory data are available from the Department of Commerce. Such promulgation shall be conclusive for each of the eight quarters in the period beginning October 1 next succeeding such promulgation: Provided, That the Secretary shall promulgate such percentage as soon as possible after the enactment of the Social Security Amendments of 1958, which promulgation shall be conclusive for each of the eleven quarters in the period beginning October 1, 1958, and ending with the close of June 30, 1961.1 (C) The term "United States" means (but only for purposes of subparagraphs (A) and (B) of this paragraph) the fifty States and the District of Columbia. (D) Promulgations made before satisfactory data are available from the Department of Commerce for a full year on the per capita income of Alaska shall prescribe a Federal percentage for Alaska of 50 per centum and, for purposes of such promulgations, Alaska shall not be included as part of the "United States." Promulgations made thereafter but before per capita income data for Alaska for a full three-year period are available from the Department of Commerce shall be based on satisfactory data available there from for Alaska for such one full year or, when such data are available for a two-year period, for such two years. (b) The terms "includes" and "including" when used in a definition contained in this Act shall not be deemed to exclude other things otherwise within the meaning of the term defined. (c) Whenever under this Act or any Act of Congress, or under the law of any State, an employer is required or permitted to deduct any amount from the remuneration of an employee and to pay the amount 1 Paragraph (B) was amended by section 22 of P.L. 94-273. deducted to the United States, a State, or any political subdivision thereof, then for the purposes of this Act the amount so deducted shall be considered to have been paid to the employee at the time of such deduction. (d) Nothing in this Act shall be construed as authorizing any Federal official, agent, or representative, in carrying out any of the provisions of this Act, to take charge of any child over the objections of either of the parents of such child, or of the person standing in loco parentis to such child. Rules and Regulations Sec. 1102. The Secretary of the Treasury, the Secretary of Labor, and the Secretary of Health, Education, and Welfare, respectively, shall make and publish such rules and regulations, not inconsistent with this Act, as may be necessary to the efficient administration of the functions with which each is charged under this Act. Separability Sec. 1103. If any provision of this Act, or the application thereof to any person or circumstance, is held invalid, the remainder of the Act and the application of such provision to other persons or circumstances shall not be affected thereby. Reservation of Power Sec. 1104. The right to alter, amend, or repeal any provision of this Act is hereby reserved to the Congress. Short Title Sec. 1105. This Act may be cited as the "Social Security Act." Disclosure of Information in Possession of Department Sec. 1106. (a) No disclosure of any return or portion of a return (including information returns and other written statements) filed with the Commissioner of Internal Revenue under title VIII of the Social Security Act or under subchapter E of chapter 1 or subchapter A of chapter 9 of the Internal Revenue Code of 1939, or under chapter 2 or 21 or, pursuant thereto, under subtitle F of the Internal Revenue Code of 1954, or under regulations made under authority thereof, which has been transmitted to the Secretary of Health, Education, and Welfare by the Commissioner of Internal Revenue, or of any file, record, report, or other paper, or any information, obtained at any time by the Secretary or by any officer or employee of the Department of Health, Education, and Welfare in the course of discharging the duties of the Secretary under this Act, and no disclosure of any such file, record, report, or other paper, or information, obtained at any time by any person from the Secretary or from any officer or employee of the Department of Health, Education, and Welfare, shall be made except as the Secretary may by regulations prescribe and except as provided in part D of title IV of this Act. Any person who shall violate any provision of this section shall be deemed guilty of a misde. meanor and, upon conviction thereof, shall be punished by a fine not exceeding $1,000, or by imprisonment not exceeding one year, or both. (b) Requests for information, disclosure of which is authorized by regulations prescribed pursuant to subsection (a) of this section, and requests for services, may, subject to such limitations as may be prescribed by the Secretary to avoid undue interference with his functions under this Act, be complied with if the agency, person, or organization making the request agrees to pay for the information or services requested in such amount, if any (not exceeding the cost of furnishing the information or services), as may be determined by the Secretary. Payments for information or services furnished pursuant to this section shall be made in advance or by way of reimbursement, as may be requested by the Secretary, and shall be deposited in the Treasury as a special deposit to be used to reimburse the appropriations (including authorizations to make expenditures from the Federal Old-Age and Survivors Insurance Trust Fund, the Federal Disability Insurance Trust Fund, the Federal Hospital Insurance Trust Fund, and the Federal Supplementary Medical Insurance Trust Fund) for the unit or units of the Department of Health, Education, and Welfare which furnished the information or services. Notwithstanding the preceding provisions of this subsection, requests for information made pursuant to the provisions of part D of title IV of this Act for the purpose of using Federal records for locating parents shall be complied with and the cost incurred in providing such information shall be paid for as provided in such part D of title IV. (c) [Repealed.] (d) Notwithstanding any other provision of this section the Secretary shall make available to each State agency operating a program under title XIX and shall, subject to the limitations contained in subsection (e), make available for public inspection in readily accessible form and fashion, the following official reports (not including, however, references to any internal tolerance rules and practices that may be contained therein, internal working papers or other informal memoranda) dealing with the operation of the health programs established by titles XVIII and XIX (1) individual contractor performance reviews and other formal evaluations of the performance of carriers, intermediaries, |