
From the U.S. Code Online via GPO Access
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[Laws in effect as of January 23, 2000]
[Document affected by Public Law 106-554 Section 1(a)(6)[413]]
[Document affected by Public Law 106-554 Section 1(a)(6)[437]]
[CITE: 42USC1395ll]

 
                 TITLE 42--THE PUBLIC HEALTH AND WELFARE
 
                       CHAPTER 7--SOCIAL SECURITY
 
        SUBCHAPTER XVIII--HEALTH INSURANCE FOR AGED AND DISABLED
 
                    Part D--Miscellaneous Provisions
 
Sec. 1395ll. Studies and recommendations


(a) Health care of the aged and disabled

    The Secretary shall carry on studies and develop recommendations to 
be submitted from time to time to the Congress relating to health care 
of the aged and the disabled, including studies and recommendations 
concerning (1) the adequacy of existing personnel and facilities for 
health care for purposes of the programs under parts A and B of this 
subchapter; (2) methods for encouraging the further development of 
efficient and economical forms of health care which are a constructive 
alternative to inpatient hospital care; and (3) the effects of the 
deductibles and coinsurance provisions upon beneficiaries, persons who 
provide health services, and the financing of the program.

(b) Operation and administration of insurance programs

    The Secretary shall make a continuing study of the operation and 
administration of the insurance programs under parts A and B of this 
subchapter (including a validation of the accreditation process of the 
Joint Commission on Accreditation of Hospitals, the operation and 
administration of health maintenance organizations authorized by section 
226 of the Social Security Amendments of 1972 [42 U.S.C. 1395mm], the 
experiments and demonstration projects authorized by section 402 of the 
Social Security Amendments of 1967 [42 U.S.C. 1395b-1] and the 
experiments and demonstration projects authorized by section 222(a) of 
the Social Security Amendments of 1972 [42 U.S.C. 1395b-1 note]), and 
shall transmit to the Congress annually a report concerning the 
operation of such programs.

(Aug. 14, 1935, ch. 531, title XVIII, Sec. 1875, as added Pub. L. 89-97, 
title I, Sec. 102(a), July 30, 1965, 79 Stat. 332; amended Pub. L. 90-
248, title IV, Sec. 402(c), Jan. 2, 1968, 81 Stat. 931; Pub. L. 92-603, 
title II, Secs. 201(c)(7), 222(c), 226(d), 244(d), Oct. 30, 1972, 86 
Stat. 1373, 1393, 1404, 1423; Pub. L. 98-369, div. B, title III, 
Sec. 2354(b)(17), July 18, 1984, 98 Stat. 1101; Pub. L. 99-509, title 
IX, Sec. 9316(a), Oct. 21, 1986, 100 Stat. 2006; Pub. L. 100-203, title 
IV, Sec. 4085(i)(20), Dec. 22, 1987, 101 Stat. 1330-133; Pub. L. 100-
647, title VIII, Sec. 8413, Nov. 10, 1988, 102 Stat. 3801; Pub. L. 101-
234, title III, Sec. 301(b)(5), (d)(2), Dec. 13, 1989, 103 Stat. 1985, 
1986; Pub. L. 101-239, title VI, Sec. 6103(b)(3)(A), Dec. 19, 1989, 103 
Stat. 2199.)

                       References in Text

    Parts A and B of this subchapter, referred to in text, are 
classified to sections 1395c et seq. and 1395j et seq., respectively, of 
this title.
    Section 226 of the Social Security Amendments of 1972, referred to 
in subsec. (b), is section 226 of Pub. L. 92-603, which enacted section 
1395mm of this title and provisions set out as notes under that section 
and amended this section and sections 1395f, 1395l, and 1396b of this 
title.
    Section 402 of the Social Security Amendments of 1967, referred to 
in subsec. (b), is section 402 of Pub. L. 90-248, which enacted section 
1395b-1 of this title and amended this section.
    Section 222(a) of the Social Security Amendments of 1972, referred 
to in subsec. (b), is section 222(a) of Pub. L. 92-603, which enacted 
provisions set out as note under section 1395b-1 of this title.


                               Amendments

    1989--Subsec. (c). Pub. L. 101-239 struck out subsec. (c) which 
related to patient outcome assessment research program.
    Subsec. (c)(7). Pub. L. 101-234, Sec. 301(b)(5), (d)(2), amended 
par. (7) identically, substituting ``date of the enactment of this 
section'' for ``date of the enactment of this Act''.
    1988--Subsec. (c)(3). Pub. L. 100-647 amended par. (3) generally. 
Prior to amendment, par. (3) read as follows: ``For purposes of carrying 
out the research program, there are authorized to be appropriated--
        ``(A) from the Federal Hospital Insurance Trust Fund $4,000,000 
    for fiscal year 1987 and $5,000,000 for each of fiscal years 1988 
    and 1989, and
        ``(B) from the Federal Supplementary Medical Insurance Trust 
    Fund $2,000,000 for fiscal year 1987 and $2,500,000 for each of 
    fiscal years 1988 and 1989.''
    1987--Subsec. (c)(3)(B). Pub. L. 100-203 substituted ``fiscal year 
1987'' for ``fiscal years 1987''.
    1986--Subsec. (c). Pub. L. 99-509 added subsec. (c).
    1984--Subsec. (b). Pub. L. 98-369 struck out ``the'' after ``Joint 
Commission on''.
    1972--Subsec. (a). Pub. L. 92-603, Sec. 201(c)(7), inserted ``and 
the disabled'' after ``aged''.
    Subsec. (b). Pub. L. 92-603, Secs. 222(c), 226(d)(1), 244(d), 
substituted ``(including a validation of the accreditation process of 
the Joint Commission on the Accreditation of Hospitals, the operation 
and administration of health maintenance organizations authorized by 
section 226 of the Social Security Amendments of 1972, the experiments 
and demonstration projects authorized by section 402 of the Social 
Security Amendments of 1967 and the experiments and demonstration 
projects authorized by section 222(a) of the Social Security Amendments 
of 1972)'' for ``(including the experimentation authorized by section 
402 of the Social Security Amendments of 1967)''. Pub. L. 92-603, 
Sec. 226(d)(2), which directed the substitution of ``1972'' for 
``1971'', could not be executed because ``1971'' did not appear.
    1968--Subsec. (b). Pub. L. 90-248 inserted ``(including the 
experimentation authorized by section 402 of the Social Security 
Amendments of 1967'' after ``under parts A and B of this subchapter''.


                    Effective Date of 1989 Amendment

    Section 6103(b)(3)(A) of Pub. L. 101-239 provided that the amendment 
made by that section is effective for fiscal years beginning after 
fiscal year 1990.


                    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 2354(e)(1) of Pub. L. 98-369, set out as a 
note under section 1320a-1 of this title.


                    Effective Date of 1972 Amendment

    Amendment by section 226(d) of Pub. L. 92-603 effective with respect 
to services provided on or after July 1, 1973, see section 226(f) of 
Pub. L. 92-603, set out as an Effective Date note under section 1395mm 
of this title.


   Study and Report Regarding Utilization of Physicians' Services by 
                         Medicare Beneficiaries

    Pub. L. 106-113, div. B, Sec. 1000(a)(6) [title II, Sec. 211(c)], 
Nov. 29, 1999, 113 Stat. 1536, 1501A-349, provided that:
    ``(1) Study by secretary.--The Secretary of Health and Human 
Services, acting through the Administrator of the Agency for Health Care 
Policy and Research, shall conduct a study of the issues specified in 
paragraph (2).
    ``(2) Issues to be studied.--The issues specified in this paragraph 
are the following:
        ``(A) The various methods for accurately estimating the economic 
    impact on expenditures for physicians' services under the original 
    medicare fee-for-service program under parts A and B of title XVIII 
    of the Social Security Act (42 U.S.C. 1395 et seq.) [parts A and B 
    of this subchapter] resulting from--
            ``(i) improvements in medical capabilities;
            ``(ii) advancements in scientific technology;
            ``(iii) demographic changes in the types of medicare 
        beneficiaries that receive benefits under such program; and
            ``(iv) geographic changes in locations where medicare 
        beneficiaries receive benefits under such program.
        ``(B) The rate of usage of physicians' services under the 
    original medicare fee-for-service program under parts A and B of 
    title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) 
    among beneficiaries between ages 65 and 74, 75 and 84, 85 and over, 
    and disabled beneficiaries under age 65.
        ``(C) Other factors that may be reliable predictors of 
    beneficiary utilization of physicians' services under the original 
    medicare fee-for-service program under parts A and B of title XVIII 
    of the Social Security Act (42 U.S.C. 1395 et seq.).
    ``(3) Report to congress.--Not later than 3 years after the date of 
the enactment of this Act [Nov. 29, 1999], the Secretary of Health and 
Human Services shall submit a report to Congress setting forth the 
results of the study conducted pursuant to paragraph (1), together with 
any recommendations the Secretary determines are appropriate.
    ``(4) Medpac report to congress.--Not later than 180 days after the 
date of submission of the report under paragraph (3), the Medicare 
Payment Advisory Commission shall submit a report to Congress that 
includes--
        ``(A) an analysis and evaluation of the report submitted under 
    paragraph (3); and
        ``(B) such recommendations as it determines are appropriate.''


                    Study of Adult Day Care Services

    Pub. L. 100-360, title II, Sec. 208, July 1, 1988, 102 Stat. 732, as 
amended by Pub. L. 100-485, title VI, Sec. 608(d)(8), Oct. 13, 1988, 102 
Stat. 2415, directed Secretary of Health and Human Services to conduct a 
survey of adult day care services in United States and to report to 
Congress, by not later than 1 year after July 1, 1988, on the 
information collected in the survey, prior to repeal by Pub. L. 101-234, 
title II, Sec. 201(a), Dec. 13, 1989, 103 Stat. 1981.


      Study To Develop a Strategy for Quality Review and Assurance

    Section 9313(d) of Pub. L. 99-509, as amended by Pub. L. 100-203, 
title IV, Sec. 4085(i)(21)(A), Dec. 22, 1987, 101 Stat. 1330-133, 
directed Secretary of Health and Human Services to arrange, with the 
National Academy of Sciences or other appropriate nonprofit private 
entity, for a study to design a strategy for reviewing and assuring the 
quality of care for which payment may be made under this subchapter, 
specified items to be included in the study, and directed Secretary to 
submit to Congress, not later than Jan. 1, 1990, a report on the study 
with recommendations with respect to strengthening quality assurancees 
and review activities for services furnished under the medicare program.


            Special Treatment of States Formerly Under Waiver

    For treatment of hospitals in States which have had a waiver 
approved under this section, upon termination of waiver, see section 
9202(j) of Pub. L. 99-272, as amended, set out as a note under section 
1395ww of this title.


      Drug Detoxification Medicare Coverage and Facility Incentives

    Pub. L. 96-499, title IX, Sec. 931(f), Dec. 5, 1980, 94 Stat. 2634, 
which related to a study of medicare coverage of certain additional 
detoxification-related services, was repealed by Pub. L. 97-35, title 
XXI, Sec. 2121(h), Aug. 13, 1981, 95 Stat. 796.


 Legislative Recommendations Regarding Reimbursement for Optometrists' 
                                Services

    Pub. L. 96-499, title IX, Sec. 937(b), Dec. 5, 1980, 94 Stat. 2640, 
provided that the Secretary of Health and Human Services submit to the 
Congress by Jan. 1, 1982, legislative recommendations with respect to 
reimbursement under title XVIII of the Social Security Act [this 
subchapter] for services furnished by optometrists in connection with 
cataracts and such other services which they are legally authorized to 
perform.


   Demonstration Projects, Studies, and Reports: Nutritional Therapy, 
Second Opinion Cost-Sharing, Services of Registered Dietitians, Services 
   of Clinical Social Workers, Orthopedic Shoes, Respiratory Therapy 
    Services, and Foot Conditions; Grants, Payments, and Expenditures

    Pub. L. 96-499, title IX, Sec. 958, Dec. 5, 1980, 94 Stat. 2648, 
directed Secretary of Health and Human Services to carry out certain 
demonstration projects and conduct certain studies as follows: (a) a 
demonstration project to determine extent to which nutritional therapy 
in early renal failure could retard the disease with resultant 
substantive deferment of dialysis, and aspects of making such therapy 
available under this subchapter, report to Congress to be submitted 
within twenty-four months of Dec. 5, 1980; (b) demonstration projects 
with respect to waiving the applicable cost sharing amounts which 
beneficiaries under this subchapter had to pay for obtaining a second 
opinion on having surgery, report to be submitted within one year after 
Dec. 5, 1980; (c) a study of conditions under which services of 
registered dietitians could be covered as a home health benefit under 
this subchapter, report to be submitted within twenty-four months of 
Dec. 5, 1980; (d) demonstration projects to determine aspects of making 
services of clinical social workers more generally available under this 
subchapter, report to be submitted within twenty-four months of Dec. 5, 
1980; (e) a study of methods for providing coverage under part B of this 
subchapter for orthopedic shoes for individuals with disabling or 
deforming conditions requiring special fitting considerations, or 
requiring special shoes in conjunction with the use of an orthosis or 
foot support, report to be submitted no later than July 1, 1981; (f) a 
study of conditions under which services with respect to respiratory 
therapy could be covered as a home health benefit under this subchapter, 
report to be submitted within twenty-four months of Dec. 5, 1980; and 
(g) a study analyzing cost effects of alternative approaches to 
improving coverage under this subchapter for treatment of various types 
of foot conditions, report to be submitted within twenty-four months of 
Dec. 5, 1980. Payments and expenditures for such studies and projects 
were to be made in appropriate part from the Federal Hospital Insurance 
Trust Fund established by section 1395i of this title, and the Federal 
Supplemental Medical Insurance Trust Fund established by section 1395t 
of this title.


          Demonstration Project Relating to the Terminally Ill

    Pub. L. 96-265, title V, Sec. 506, June 9, 1980, 94 Stat. 475, 
authorized Secretary of Health and Human Services to provide for 
participation, by Social Security Administration, in a demonstration 
project relating to the terminally ill then being conducted within the 
Department of Health and Human Services, the purpose of such 
participation to be to study impact on terminally ill of provisions of 
disability programs administered by Social Security Administration and 
to determine how best to provide services needed by persons who were 
terminally ill through programs over which the Social Security 
Administration had administrative responsibility, and authorized to be 
appropriated necessary sums not in excess of $2,000,000 for any fiscal 
year.


 Report to Congress With Respect to Urban or Rural Comprehensive Mental 
 Health Centers and Centers for Treatment of Alcoholism and Drug Abuse; 
                 Submission No Later Than June 13, 1978

    Pub. L. 95-210, Sec. 4, Dec. 13, 1977, 91 Stat. 1490, directed 
Secretary of Health, Education, and Welfare to submit to Congress, no 
later than six months after Dec. 13, 1977, a report on the advantages 
and disadvantages of extending coverage under this subchapter to urban 
or rural comprehensive mental health centers and to centers for 
treatment of alcoholism and drug abuse.


Study and Review by Comptroller General of Administrative Structure for 
             Processing Medicare Claims; Report to Congress

    Pub. L. 95-142, Sec. 12, Oct. 25, 1977, 91 Stat. 1197, directed 
Comptroller General to conduct a comprehensive study and review of 
administrative structure established for processing of claims under this 
subchapter for purpose of determining whether and to what extent more 
efficient claims administration under this subchapter could be achieved 
and directed Comptroller General to submit to Congress no later than 
July 1, 1979, a complete report with respect to such study and review.


  Report by Secretary of Health, Education, and Welfare on Delivery of 
     Home Health and Other In-Home Services; Contents; Consultation 
                  Requirements; Submission to Congress

    Pub. L. 95-142, Sec. 18, Oct. 25, 1977, 91 Stat. 1202, directed 
Secretary of Health, Education, and Welfare, not later than one year 
after Oct. 25, 1977, to submit to appropriate committees of Congress a 
report analyzing, evaluating, and making recommendations with respect to 
all aspects of delivery of home health and other in-home services 
authorized to be provided under subchapters XVIII, XIX, and XX of this 
chapter.

                  Section Referred to in Other Sections

    This section is referred to in title 45 section 231f.
