
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: 42USC300e-6]

 
                 TITLE 42--THE PUBLIC HEALTH AND WELFARE
 
                    CHAPTER 6A--PUBLIC HEALTH SERVICE
 
             SUBCHAPTER XI--HEALTH MAINTENANCE ORGANIZATIONS
 
Sec. 300e-6. Administration of assistance programs


(a) Recordkeeping; audit and examination

    (1) Each recipient of a loan or loan guarantee under this subchapter 
shall keep such records as the Secretary shall prescribe, including 
records which fully disclose the amount and disposition by such 
recipient of the proceeds of the loan (directly made or guaranteed), the 
total cost of the undertaking in connection with which the loan was 
given or used, the amount of that portion of the cost of the undertaking 
supplied by other sources, and such other records as will facilitate an 
effective audit.
    (2) The Secretary, or any of his duly authorized representatives, 
shall have access for the purpose of audit and examination to any books, 
documents, papers, and records of the recipients of a loan or loan 
guarantee under this subchapter which relate to such assistance.

(b) Report upon expiration of period

    Upon expiration of the period for which a loan or loan guarantee was 
provided an entity under this subchapter, such entity shall make a full 
and complete report to the Secretary in such manner as he may by 
regulation prescribe. Each such report shall contain, among such other 
matters as the Secretary may by regulation require, descriptions of 
plans, developments, and operations relating to the matters referred to 
in section 300e-5(b)(3) of this title.

(c) Repealed. Pub. L. 99-660, title VIII, Sec. 803(a), Nov. 14, 1986, 
        100 Stat. 3799

(d) Other entities considered health maintenance organizations

    An entity which provides health services to a defined population on 
a prepaid basis and which has members who are entitled to insurance 
benefits under title XVIII of the Social Security Act [42 U.S.C. 1395 et 
seq.] or to medical assistance under a State plan approved under title 
XIX of such Act [42 U.S.C. 1396 et seq.] may be considered as a health 
maintenance organization for purposes of receiving assistance under this 
subchapter if--
        (1) with respect to its members who are entitled to such 
    insurance benefits or to such medical assistance it (A) provides 
    health services in accordance with section 300e(b) of this title, 
    except that (i) it does not furnish to those members the health 
    services (within the basic health services) for which it may not be 
    compensated under such title XVIII [42 U.S.C. 1395 et seq.] or such 
    State plan, and (ii) it does not fix the basic or supplemental 
    health services payment for such members under a community rating 
    system, and (B) is organized and operated in the manner prescribed 
    by section 300e(c) of this title, except that it does not assume 
    full financial risk on a prospective basis for the provision to such 
    members of basic or supplemental health services with respect to 
    which it is not required under such title XVIII or such State plan 
    to assume such financial risk; and
        (2) with respect to its other members it provides health 
    services in accordance with section 300e(b) of this title and is 
    organized and operated in the manner prescribed by section 300e(c) 
    of this title.

An entity which provides health services to a defined population on a 
prepaid basis and which has members who are enrolled under the health 
benefits program authorized by chapter 89 of title 5, may be considered 
as a health maintenance organization for purposes of receiving 
assistance under this subchapter if with respect to its other members it 
provides health services in accordance with section 300e(b) of this 
title and is organized and operated in the manner prescribed by section 
300e(c) of this title.

(July 1, 1944, ch. 373, title XIII, Sec. 1307, as added Pub. L. 93-222, 
Sec. 2, Dec. 29, 1973, 87 Stat. 926; amended Pub. L. 94-460, title I, 
Secs. 109(b)(1), 112, Oct. 8, 1976, 90 Stat. 1950, 1953; Pub. L. 97-35, 
title IX, Sec. 943(d), Aug. 13, 1981, 95 Stat. 576; Pub. L. 99-660, 
title VIII, Sec. 803(a), (b)(2), Nov. 14, 1986, 100 Stat. 3799, 3800.)

                       References in Text

    The Social Security Act, referred to in subsec. (d), is act Aug. 14, 
1935, ch. 531, 49 Stat. 620, as amended. Titles XVIII and XIX of the 
Social Security Act are classified generally to subchapters XVIII 
(Sec. 1395 et seq.) and XIX (Sec. 1396 et seq.), respectively, of 
chapter 7 of this title. For complete classification of this Act to the 
Code, see section 1305 of this title and Tables.


                               Amendments

    1986--Subsec. (a)(1). Pub. L. 99-660, Sec. 803(b)(2), substituted 
``loan or loan guarantee'' for ``grant, contract, loan, or loan 
guarantee'', ``proceeds of the loan'' for ``proceeds of the grant, 
contract, or loan'', and ``with which the loan was given'' for ``with 
which such assistance was given''.
    Subsecs. (a)(2), (b). Pub. L. 99-660, Sec. 803(b)(2)(A), substituted 
``loan or loan guarantee'' for ``grant, contract, loan, or loan 
guarantee''.
    Subsec. (c). Pub. L. 99-660, Sec. 803(a), struck out subsec. (c) 
which read as follows: ``If in any fiscal year the funds appropriated 
under section 300e-8 of this title are insufficient to fund all 
applications approved under this subchapter for that fiscal year, the 
Secretary shall, after applying the applicable priorities under sections 
300e-2 and 300e-3 of this title, give priority to the funding of 
applications for projects which the Secretary determines are the most 
likely to be economically viable.''
    1981--Subsec. (e). Pub. L. 97-35 struck out subsec. (e) which 
related to limitation on cumulative total of loan guarantees in any 
fiscal year.
    1976--Subsec. (d). Pub. L. 94-460, Sec. 112, inserted sentence at 
end setting conditions upon which an entity providing health services to 
a defined population on a prepaid basis may be considered as a health 
maintenance organization for purposes of receiving assistance under this 
subchapter.
    Subsec. (e). Pub. L. 94-460, Sec. 109(b)(1), inserted ``for a 
private health maintenance organization (other than a private nonprofit 
health maintenance organization)'' after ``may be made'', and ``for 
private health maintenance organizations (other than private nonprofit 
health maintenance organizations)'' after ``guaranteed''.


                    Effective Date of 1986 Amendment

    Amendment by Pub. L. 99-660 not applicable to any grant made or 
contract entered into under this subchapter before Oct. 1, 1985, see 
section 803(c) of Pub. L. 99-660, set out as a note under section 300e-5 
of this title.
    Amendment by Pub. L. 99-660 effective Oct. 1, 1985, see section 
815(a) of Pub. L. 99-660, set out as an Effective and Termination Dates 
of 1986 Amendment note under section 300e-1 of this title.


                    Effective Date of 1976 Amendment

    Amendment by Pub. L. 94-460 effective Oct. 8, 1976, see section 118 
of Pub. L. 94-460, set out as a note under section 300e of this title.
