
From the U.S. Code Online via GPO Access
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[Laws in effect as of January 23, 2000]
[Document not affected by Public Laws enacted between
  January 23, 2000 and December 4, 2001]
[CITE: 42USC1395bb]

 
                 TITLE 42--THE PUBLIC HEALTH AND WELFARE
 
                       CHAPTER 7--SOCIAL SECURITY
 
        SUBCHAPTER XVIII--HEALTH INSURANCE FOR AGED AND DISABLED
 
                    Part D--Miscellaneous Provisions
 
Sec. 1395bb. Effect of accreditation


(a) In general

    Except as provided in subsection (b) \1\ of this section and the 
second sentence of section 1395z of this title, if--
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    \1\ See References in Text note below.
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        (1) an institution is accredited as a hospital by the Joint 
    Commission on Accreditation of Hospitals, and
        (2)(A) such institution authorizes the Commission to release to 
    the Secretary upon his request (or such State agency as the 
    Secretary may designate) a copy of the most current accreditation 
    survey of such institution made by such Commission, together with 
    any other information directly related to the survey as the 
    Secretary may require (including corrective action plans),\2\
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    \2\ So in original. Probably should be followed by ``and''.
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        (B) such Commission releases such a copy and any such 
    information to the Secretary,

then, such institution shall be deemed to meet the requirements of the 
numbered paragraphs of section 1395x(e) of this title; except--
        (3) paragraph (6) thereof, and
        (4) any standard, promulgated by the Secretary pursuant to 
    paragraph (9) thereof, which is higher than the requirements 
    prescribed for accreditation by such Commission.

If such Commission, as a condition for accreditation of a hospital, 
requires a utilization review plan (or imposes another requirement which 
serves substantially the same purpose), requires a discharge planning 
process (or imposes another requirement which serves substantially the 
same purpose), or imposes a standard which the Secretary determines is 
at least equivalent to the standard promulgated by the Secretary as 
described in paragraph (4) of this subsection, the Secretary is 
authorized to find that all institutions so accredited by such 
Commission comply also with clause (A) or (B) of section 1395x(e)(6) of 
this title or the standard described in such paragraph (4), as the case 
may be.

(b) Accreditation by American Osteopathic Association or other national 
        accreditation body

    (1) In addition, if the Secretary finds that accreditation of a 
provider entity (as defined in paragraph (4)) by the American 
Osteopathic Association or any other national accreditation body 
demonstrates that all of the applicable conditions or requirements of 
this subchapter (other than the requirements of section 1395m(j) of this 
title or the conditions and requirements under section 1395rr(b) of this 
title) are met or exceeded--
        (A) in the case of a provider entity not described in paragraph 
    (3)(B), the Secretary shall treat such entity as meeting those 
    conditions or requirements with respect to which the Secretary made 
    such finding; or
        (B) in the case of a provider entity described in paragraph 
    (3)(B), the Secretary may treat such entity as meeting those 
    conditions or requirements with respect to which the Secretary made 
    such finding.

    (2) In making such a finding, the Secretary shall consider, among 
other factors with respect to a national accreditation body, its 
requirements for accreditation, its survey procedures, its ability to 
provide adequate resources for conducting required surveys and supplying 
information for use in enforcement activities, its monitoring procedures 
for provider entities found out of compliance with the conditions or 
requirements, and its ability to provide the Secretary with necessary 
data for validation.
    (3)(A) Except as provided in subparagraph (B), not later than 60 
days after the date of receipt of a written request for a finding under 
paragraph (1) (with any documentation necessary to make a determination 
on the request), the Secretary shall publish a notice identifying the 
national accreditation body making the request, describing the nature of 
the request, and providing a period of at least 30 days for the public 
to comment on the request. The Secretary shall approve or deny a request 
for such a finding, and shall publish notice of such approval or denial, 
not later than 210 days after the date of receipt of the request (with 
such documentation). Such an approval shall be effective with respect to 
accreditation determinations made on or after such effective date (which 
may not be later than the date of publication of the approval) as the 
Secretary specifies in the publication notice.
    (B) The 210-day and 60-day deadlines specified in subparagraph (A) 
shall not apply in the case of any request for a finding with respect to 
accreditation of a provider entity to which the conditions and 
requirements of section \3\ 1395i-3 and 1395x(j) of this title apply.
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    \3\ So in original. Probably should be ``sections''.
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    (4) For purposes of this section, the term ``provider entity'' means 
a provider of services, supplier, facility, clinic, agency, or 
laboratory.

(c) Disclosure of accreditation survey

    The Secretary may not disclose any accreditation survey (other than 
a survey with respect to a home health agency) made and released to him 
by the Joint Commission on Accreditation of Hospitals, the American 
Osteopathic Association, or any other national accreditation body, of an 
entity accredited by such body, except that the Secretary may disclose 
such a survey and information related to such a survey to the extent 
such survey and information relate to an enforcement action taken by the 
Secretary.

(d) Deficiencies

    Notwithstanding any other provision of this subchapter, if the 
Secretary finds that a provider entity has significant deficiencies (as 
defined in regulations pertaining to health and safety), the entity 
shall, after the date of notice of such finding to the entity and for 
such period as may be prescribed in regulations, be deemed not to meet 
the conditions or requirements the entity has been treated as meeting 
pursuant to subsection (a) or (b)(1) of this section.

(e) State or local accreditation

    For provisions relating to validation surveys of entities that are 
treated as meeting applicable conditions or requirements of this 
subchapter pursuant to subsection (a) or (b)(1) of this section, see 
section 1395aa(c) of this title.

(Aug. 14, 1935, ch. 531, title XVIII, Sec. 1865, as added Pub. L. 89-97, 
title I, Sec. 102(a), July 30, 1965, 79 Stat. 326; amended Pub. L. 92-
603, title II, Secs. 234(h), 244(b), Oct. 30, 1972, 86 Stat. 1413, 1423; 
Pub. L. 97-248, title I, Secs. 122(g)(4), 128(d)(3), Sept. 3, 1982, 96 
Stat. 362, 367; Pub. L. 98-369, div. B, title III, Secs. 2345(a), 
2346(a), July 18, 1984, 98 Stat. 1096; Pub. L. 99-509, title IX, 
Secs. 9305(c)(3), 9320(h)(3), Oct. 21, 1986, 100 Stat. 1990, 2016; Pub. 
L. 100-203, title IV, Secs. 4025(b), 4072(d), Dec. 22, 1987, 101 Stat. 
1330-117, as amended Pub. L. 100-360, title IV, Sec. 411(d)(4)(B)(ii), 
July 1, 1988, 102 Stat. 774; Pub. L. 100-360, title II, Secs. 204(c)(3), 
(d)(3), July 1, 1988, 102 Stat. 728, 729; Pub. L. 100-485, title VI, 
Sec. 608(d)(20)(D), Oct. 13, 1988, 102 Stat. 2420; Pub. L. 101-234, 
title II, Sec. 201(a), Dec. 13, 1989, 103 Stat. 1981; Pub. L. 101-239, 
title VI, Secs. 6003(g)(3)(C)(iv), 6019(a)-(c), 6115(c), Dec. 19, 1989, 
103 Stat. 2153, 2165, 2166, 2219; Pub. L. 101-508, title IV, 
Sec. 4163(c)(3), Nov. 5, 1990, 104 Stat. 1388-100; Pub. L. 103-432, 
title I, Sec. 145(c)(4), Oct. 31, 1994, 108 Stat. 4427; Pub. L. 104-134, 
title I, Sec. 101(d) [title V, Sec. 516(b), (c)(2)], Apr. 26, 1996, 110 
Stat. 1321-211, 1321-246, 1321-247; renumbered title I, Pub. L. 104-140, 
Sec. 1(a), May 2, 1996, 110 Stat. 1327.)

                       References in Text

    Subsection (b) of this section, referred to in subsec. (a), was 
redesignated subsec. (d) and a new subsec. (b) added by Pub. L. 104-134, 
title I, Sec. 101(d) [title V, Sec. 516(b)(1), (3)], Apr. 26, 1996, 110 
Stat. 1321-211, 1321-246; renumbered title I, Pub. L. 104-140, 
Sec. 1(a), May 2, 1996, 110 Stat. 1327.


                               Amendments

    1996--Subsec. (a). Pub. L. 104-134, Sec. 101(d) [title V, 
Sec. 516(b)(2), (3)], struck out after second sentence: ``In addition, 
if the Secretary finds that accreditation of an entity by the American 
Osteopathic Association or any other national accreditation body 
provides reasonable assurance that any or all of the conditions of 
section 1395k(a)(2)(F)(i), 1395x(e), 1395x(f), 1395x(j), 1395x(o), 
1395x(p)(4)(A) or (B), paragraphs (15) and (16) of section 1395x(s), 
section 1395x(aa)(2), 1395x(cc)(2), 1395x(dd)(2), or 1395x(mm)(1) of 
this title, as the case may be, are met, he may, to the extent he deems 
it appropriate, treat such entity as meeting the condition or conditions 
with respect to which he made such finding.'' and redesignated fourth 
sentence as subsec. (c).
    Subsec. (b). Pub. L. 104-134, Sec. 101(d) [title V, Sec. 516(b)(3)], 
added subsec. (b). Former subsec. (b) redesignated (d).
    Subsec. (c). Pub. L. 104-134, Sec. 101(d) [title V, Sec. 516(b)(2)], 
redesignated fourth sentence of subsec. (a) as subsec. (c).
    Subsec. (d). Pub. L. 104-134, Sec. 101(d) [title V, Sec. 516(b)(1), 
(c)(2)(A)], redesignated subsec. (b) as (d) and substituted ``a provider 
entity'' for ``a hospital'', ``the entity'' for ``the hospital'' in two 
places, and ``the conditions or requirements the entity has been treated 
as meeting pursuant to subsection (a) or (b)(1) of this section'' for 
``the requirements of the numbered paragraphs of section 1395x(e) of 
this title''.
    Subsec. (e). Pub. L. 104-134, Sec. 101(d) [title V, 
Sec. 516(c)(2)(B)], added subsec. (e).
    1994--Subsec. (a). Pub. L. 103-432 struck out ``1395m(c)(3),'' after 
``conditions of section 1395k(a)(2)(F)(i),'' in closing provisions.
    1990--Subsec. (a). Pub. L. 101-508 inserted ``1395m(c)(3),'' after 
``1395k(a)(2)(F)(i),'' in second sentence.
    1989--Subsec. (a). Pub. L. 101-239, Sec. 6115(c), substituted 
``paragraphs (15) and (16)'' for ``paragraphs (14) and (15)''.
    Pub. L. 101-239, Sec. 6019(b), inserted before period at end ``, 
except that the Secretary may disclose such a survey and information 
related to such a survey to the extent such survey and information 
relate to an enforcement action taken by the Secretary''.
    Pub. L. 101-239, Sec. 6003(g)(3)(C)(iv), substituted ``1395x(dd)(2), 
or 1395x(mm)(1) of this title'' for ``or 1395x(dd)(2) of this title'' in 
third sentence.
    Pub. L. 101-234 repealed Pub. L. 100-360, Sec. 204(c)(3), (d)(3), 
and provided that the provisions of law amended or repealed by such 
section are restored or revived as if such section had not been enacted, 
see 1988 and 1989 Amendment notes.
    Subsec. (a)(2). Pub. L. 101-239, Sec. 6019(a), designated existing 
provisions as subpar. (A), struck out ``(if it is included within a 
survey described in section 1395aa(c) of this title)'' after ``such 
institution'', inserted ``, together with any other information directly 
related to the survey as the Secretary may require (including corrective 
action plans)'' after ``by such Commission'', and added subpar. (B).
    Subsec. (b). Pub. L. 101-239, Sec. 6019(c), struck out ``following a 
survey made pursuant to section 1395aa(c) of this title'' after ``if the 
Secretary finds''.
    1988--Subsec. (a). Pub. L. 100-360, Sec. 411(d)(4)(B)(ii), as 
amended by Pub. L. 100-485, Sec. 608(d)(20)(D), added Pub. L. 100-203, 
Sec. 4025(b), see 1987 Amendment note below.
    Pub. L. 100-360, Sec. 204(d)(3), substituted ``paragraphs (14) and 
(15)'' for ``paragraphs (13) and (14)'' in third sentence.
    Pub. L. 100-360, Sec. 204(c)(3), inserted ``1395m(e)(3),'' after 
``1395k(a)(2)(F)(i),'' in third sentence.
    1987--Subsec. (a). Pub. L. 100-203, Sec. 4072(d), substituted 
``paragraphs (13) and (14)'' for ``paragraphs (12) and (13)'' in 
penultimate sentence.
    Pub. L. 100-203, Sec. 4025(b), as added by Pub. L. 100-360, 
Sec. 411(d)(4)(B)(ii), as amended by Pub. L. 100-485, 
Sec. 608(d)(20)(D), inserted ``(other than a survey with respect to a 
home health agency)'' after ``survey'' in last sentence.
    1986--Subsec. (a). Pub. L. 99-509, Sec. 9305(c)(3), inserted ``, 
requires a discharge planning process (or imposes another requirement 
which serves substantially the same purpose)'' after ``the same 
purpose)'', and ``clause (A) or (B) of'' after ``comply also with'' in 
second sentence.
    Pub. L. 99-509, Sec. 9320(h)(3), substituted ``paragraphs (12) and 
(13)'' for ``paragraphs (11) and (12)'' in third sentence.
    1984--Subsec. (a). Pub. L. 98-369, Sec. 2346(a), in provisions 
following par. (4), substituted ``section 1395k(a)(2)(F)(i), 1395x(e), 
1395x(f), 1395x(j), 1395x(o), 1395x(p)(4)(A) or (B), paragraphs (11) and 
(12) of section 1395x(s), section 1395x(aa)(2), 1395x(cc)(2), or 
1395x(dd)(2) of this title'' for ``section 1395x(e), (j), (o), or (dd) 
of this title'', and substituted ``entity'' for ``institution or 
agency'' in two places.
    Pub. L. 98-369, Sec. 2345(a), struck out ``(on a confidential 
basis)'' after ``release to the Secretary'' in par. (2), and inserted 
provision that the Secretary may not disclose any accreditation survey 
made and released to him by the Joint Commission on Accreditation of 
Hospitals, the American Osteopathic Association, or any other national 
accreditation body, of an entity accredited by such body, in provisions 
following par. (4).
    1982--Subsec. (a). Pub. L. 97-248, Sec. 122(g)(4), substituted 
``(o), or (dd)'' for ``or (o)''.
    Subsec. (b). Pub. L. 97-248, Sec. 128(d)(3), substituted ``a 
hospital'' for ``an institution'' and ``the hospital'' for ``such 
institution''.
    1972--Pub. L. 92-603 designated existing provisions as subsec. (a), 
inserted reference to subsec. (b) of this section in opening provisions, 
redesignated existing provisions as pars. (1) and (3) and added pars. 
(2) and (4) and in provisions following par. (4) inserted provisions for 
the imposition of a standard which the Secretary determines is at least 
equivalent to the standard promulgated by the Secretary as described in 
par. (4), and added subsec. (b).


                    Effective Date of 1994 Amendment

    Amendment by Pub. L. 103-432 applicable to mammography furnished by 
a facility on and after the first date that the certificate requirements 
of section 263b(b) of this title apply to such mammography conducted by 
such facility, see section 145(d) of Pub. L. 103-432, set out as a note 
under section 1395m of this title.


                    Effective Date of 1990 Amendment

    Amendment by Pub. L. 101-508 applicable to screening mammography 
performed on or after Jan. 1, 1991, see section 4163(e) of Pub. L. 101-
508, set out as a note under section 1395l of this title.


                    Effective Date of 1989 Amendments

    Section 6019(d) of Pub. L. 101-239 provided that:
    ``(1) Except as provided in paragraph (2), the amendments made by 
this section [amending this section] shall take effect on the date of 
the enactment of this Act [Dec. 19, 1989].
    ``(2) The amendments made by subsection (a) [amending this section] 
shall take effect 6 months after the date of the enactment of this 
Act.''
    Amendment by section 6115(c) of Pub. L. 101-239 applicable to 
screening pap smears performed on or after July 1, 1990, see section 
6115(d) of Pub. L. 101-239, set out as a note under section 1395x of 
this title.
    Amendment by Pub. L. 101-234 effective Jan. 1, 1990, see section 
201(c) of Pub. L. 101-234, set out as a note under section 1320a-7a of 
this title.


                    Effective Date of 1988 Amendments

    Amendment by Pub. L. 100-485 effective as if included in the 
enactment of the Medicare Catastrophic Coverage Act of 1988, Pub. L. 
100-360, see section 608(g)(1) of Pub. L. 100-485, set out as a note 
under section 704 of this title.
    Amendment by section 204(c)(3), (d)(3) of Pub. L. 100-360 applicable 
to screening mammography performed on or after Jan. 1, 1990, see section 
204(e) of Pub. L. 100-360, set out as a note under section 1395m of this 
title.
    Except as specifically provided in section 411 of Pub. L. 100-360, 
amendment by section 411(d)(4)(B)(ii) of Pub. L. 100-360, as it relates 
to a provision in the Omnibus Budget Reconciliation Act of 1987, Pub. L. 
100-203, effective as if included in the enactment of that provision in 
Pub. L. 100-203, see section 411(a) of Pub. L. 100-360, set out as a 
Reference to OBRA; Effective Date note under section 106 of Title 1, 
General Provisions.


                    Effective Date of 1987 Amendment

    Amendment by section 4025(b) of Pub. L. 100-203 applicable with 
respect to agreements entered into or renewed on or after Dec. 22, 1987, 
see section 4025(c) of Pub. L. 100-203, as amended, set out as a note 
under section 1395aa of this title.
    For effective date of amendment by section 4072(d) of Pub. L. 100-
203, see section 4072(e) of Pub. L. 100-203, set out as a note under 
section 1395x of this title.


                    Effective Date of 1986 Amendment

    Amendment by section 9305(c)(3) of Pub. L. 99-509 applicable to 
hospitals as of one year after Oct. 21, 1986, see section 9305(c)(4) of 
Pub. L. 99-509, set out as a note under section 1395x of this title.
    Amendment by section 9320(h)(3) of Pub. L. 99-509 applicable to 
services furnished on or after Jan. 1, 1989, with exceptions for 
hospitals located in rural areas which meet certain requirements related 
to certified registered nurse anesthetists, see section 9320(i), (k) of 
Pub. L. 99-509, as amended, set out as notes under section 1395k of this 
title.


                    Effective Date of 1984 Amendment

    Section 2345(b) of Pub. L. 98-369 provided that: ``The amendments 
made by this section [amending this section] shall become effective on 
the date of the enactment of this Act [July 18, 1984], and shall apply 
with respect to surveys released to the Secretary on, before, or after 
such date.''
    Section 2346(b) of Pub. L. 98-369 provided that: ``The amendments 
made by this section [amending this section] shall become effective on 
the date of the enactment of this Act [July 18, 1984].''


                    Effective Date of 1982 Amendment

    Amendment by section 122(g)(4) of Pub. L. 97-248 applicable to 
hospice care provided on or after Nov. 1, 1983, see section 122(h)(1) of 
Pub. L. 97-248, as amended, set out as a note under section 1395c of 
this title.
    Amendment by section 128(d)(3) of Pub. L. 97-248 effective Sept. 3, 
1982, see section 128(e)(3) of Pub. L. 97-248, set out as a note under 
section 1395x of this title.


                    Effective Date of 1972 Amendment

    Amendment by section 234(h) of Pub. L. 92-603 applicable with 
respect to providers of services for fiscal years beginning after the 
fifth month following October 1972, see section 234(i) of Pub. L. 92-
603, set out as a note under section 1395x of this title.

                  Section Referred to in Other Sections

    This section is referred to in sections 1320c-9, 1395w-22, 1395x, 
1395aa of this title.
