( 17,024) EXAMINATION AND TREATMENT FOR EMERGENCY MEDICAL CONDITIONS AND WOMEN IN LABOR
(42 U.S.C. § 1395dd)
Sec. 1867. (a) MEDICAL SCREENING REQUIREMENT – In the case of a hospital that has a hospital emergency department, if any individual (whether or not eligible for benefits under this title) comes to the emergency department and a request is made on the individual’s behalf for examination or treatment for a medical condition, the hospital must provide for an appropriate medical screening examination within the capability of the hospital’s emergency department, including ancillary services routinely available to the emergency department, to determine whether or not an emergency medical condition (within the meaning of subsection (e)(1)) exists.
(b) NECESSARY STABILIZING TREATMENT FOR EMERGENCY MEDICAL CONDITIONS AND LABOR
1) IN GENERAL – If any individual (whether or not eligible for benefits under this title) comes to a hospital and the hospital determines that the individual has an emergency medical condition, the hospital must provide either –
(A) within the staff and facilities available at the hospital, for such further medical examination and such treatment as may be required to stabilize the medical condition, or
(B) for transfer of the individual to another medical facility in accordance with subsection (c).
(2) REFUSAL TO CONSENT TO TREATMENT – A hospital is deemed to meet the requirement of paragraph (1)(A) with respect to an individual if the hospital offers the individual the further medical examination and treatment described in that paragraph and informs the individual (or a person acting on the individual’s behalf) of the risks and benefits to the individual of such examination and treatment, but the individual (or a person acting on the individual’s behalf) refuses to consent to the examination and treatment. The hospital stall take all reasonable steps to secure the individual’s (or person’s) written informed consent to refuse such examination and treatment.
(3) REFUSAL TO CONSENT TO TRANSFER – A hospital is deemed to meet the requirement of paragraph (1) with respect to an individual if the hospital offers to transfer the individual to another medical facility in accordance with subsection (c) and informs the individual (or a person acting on the individual’s behalf) of the risks and benefits to the individual of such transfer, but the individual (or person acting on the individual’s behalf) refuses to consent o the transfer. The hospital shall take all reasonable steps to secure the individual’s (or person’s) written informed consent to refuse such transfer.
(c) RESTRICTING TRANSFERS UNTIL INDIVIDUAL STABILIZED –
(1) RULE – If an individual at a hospital has an emergency medical condition which has not stabilized (within the meaning of subsection (e)(3)(B)), the hospital may not transfer the individual unless –
(A)(i) the individual (or a legally responsible person acting on the individual’s behalf) after being informed of the hospital’s obligations under this section and of the risk of transfer, in writing requests transfer to another medical facility,
(ii) a physician (within the meaning of section 1861 (r)(1)) has singed a certification that based upon the information available at the time of transfer, the medical benefits reasonably expected from the provision of appropriate medical treatment at another medical facility outweigh the increased risks to the individual and, in the case of labor, to the unborn child from effecting the transfer, or
(iii) if a physician is not physically present in the emergency department at the time an individual is transferred, a qualified medical person (as defined by the Secretary in regulations) has signed a certification described in clause (ii) after a physician (as defined in section 1861 (r)(1)), in consultation with the person, has made the determination described in such clause, and subsequently countersigns the certification; and
(B) the transfer is an appropriate transfer (within the meaning of paragraph (2)) to that facility.
A certification described in clause (ii) or (iii) of subparagraph (A) shall include a summary of the risks and benefits upon which the certification is based.
(2) APPROPRIATE TRANSFER – An appropriate transfer to a medical facility is a transfer –
(A) in which the transferring hospital provides the medical treatment within its capacity which minimizes the risks to the individual’s health and, in the case of a woman in labor, the health of the unborn child;
(B) in which the receiving facility -
(i) has available space and qualified personnel for the treatment of the individual, and
(ii) has agreed to accept transfer of the individual and to provide appropriate medical treatment;
(C) in which the transferring hospital sends to the receiving facility all medical records (or copies thereof), related to the emergency condition for which the individual has presented, available at the time of the transfer, including records related to the individual’s emergency medical condition, observations of signs or symptoms, preliminary diagnosis, treatment, provided, results of any tests and the informed written consent or certification (or copy thereof) provided under paragraph (1)(A), and the name and address of any on-call physician (described in subsection (d)(1)(C) who was refused or failed to appear within a reasonable time to provide necessary stabilizing treatment;
(D) in which the transfer is effected through qualified personnel and transportation equipment, as required including the use of necessary and medically appropriate life support measures during the transfer; and
(E) which meets such other requirements as the Secretary may find necessary in the interest of the health and safety of individuals transferred.
(d) ENFORCEMENT –
(1) CIVIL MONETARY PENALTIES –
(A) A participating hospital that negligently violates a requirement of this section is subject to a civil money penalty of not more than $50,000 (or not more than $25,000 in the case of a hospital with less than 100 beds) for each such violation. The provisions of section 1128A (other than subsections (a) and (b)) shall apply to a civil money penalty under this subparagraph in the same manner as such provisions apply with respect to a penalty or proceeding under section 1128A(a).
(B) Subject to subparagraph (C), any physician who is responsible for the examination, treatment, or transfer of an individual in a participating hospital, including a physician on-call for the care of such an individual, and who negligently violates a requirement of this section, including a physician who –
(i) signs a certification under subsection (c)(1)(A) that the medical benefits reasonably to be expected from a transfer to another facility outweigh the risks associated with the transfer, if the physician knew or should have known that the benefits did not outweigh the risks, or
(ii) misrepresents an individual’s condition or other information, including a hospital’s obligations under this section,
is subject to a civil money penalty of not more than $50,000 for each such violation and, if
the violation is gross and flagrant or is repeated, to exclusion from participation in this title and State health care programs. The provisions of section 1128A (other than the first and second sentences of subsection (a) and subsection (b)) shall apply to a civil money penalty and exclusion under this subparagraph in the same manner as such provisions apply with respect to a penalty, exclusion, or proceeding under section 1128A(a).
(C) If, after an initial examination, a physician determines that the individual requires the services of a physician listed by the hospital on its list of on-call physicians (required to be maintained under section 1866(a)(1)(I)) and notifies the on-call physician and the on-call physician fails or refuses to appear within a reasonable period of time, and the physician orders the transfer of the individual because the physician determines that without the services of the on-call physician the benefits of transfer outweigh the risks of transfer, the physician authorizing the transfer shall not be subject to a penalty under subparagraph (B). However, the previous sentence shall not apply to the hospital or to the on-call physician who failed or refused to appear.
(2) CIVIL ENFORCEMENT –
(A) PERSONAL HARM – Any individual who suffers personal harm as a direct result of a participating hospital’s violation of a requirement of this section may, in a civil action against the participating hospital, obtain those damages available for personal injury under the law of the State in which the hospital is located, and such equitable relief as is appropriate.
(B) FINANCIAL LOSS TO OTHER MEDICAL FACILITY – Any medical facility that suffers a financial loss as a direct result of a participating hospital’s violation of a requirement of this section may, in a civil action against the participating hospital, obtain those damages available for financial loss, under the law of the State in which the hospital is located, and such equitable relief as is appropriate.
(C) LIMITATIONS ON ACTIONS – No action may be brought under this paragraph more than two years after the date of the violation with respect to which the action is brought.
(3) CONSULTATION WITH PEER REVIEW ORGANIZATIONS – In considering allegations of violations of the requirements of this section in imposing sanctions under paragraph (1), the Secretary shall request the appropriate utilization and quality control peer review organization (with a contract under part B of title XI) to assess whether the individual involved had an emergency medical condition which had not been stabilized, and provide a report on its findings. Except in the case in which a delay would jeopardize the health or safety of individuals, the Secretary shall request such a review before effecting a sanction under paragraph (1) and shall provide a period of at least 60 days for such review.
(e) DEFINITIONS – In this section:
(1) The term “emergency medical condition” means –
(A) a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absences of immediate medical attention could reasonably be expected to result in –
(i) placing the health of the individual (or, with respect to a pregnant woman, the health of the woman or her unborn child) in serious jeopardy,
(ii) serious impairment of bodily functions, or
(iii) serious dysfunction of any bodily organ or part; or
(B) with respect to a pregnant woman who is having contractions –
(i) that there is inadequate time to effect a safe transfer to another hospital before delivery, or
(ii) that transfer may pose a threat to the health or safety of the woman or the unborn child.
(2) The term “participating hospital” means hospital that has entered into a provider agreement under section 1866.
(3)(A) The term “stabilize” means, with respect to an emergency medical condition described in paragraph (1)(A), to provide such medical treatment of the condition as may be necessary to assure, within reasonable medical probability, that no material deterioration of the condition is likely to result from or occur during the transfer of the individual from a facility, or, with respect to an emergency medical condition described in paragraph (1)(B), to deliver (including the placenta).
(B) The term “stabilized” means with respect to an emergency medical condition described in paragraph (1)(A), that no material deterioration of the condition is likely, within reasonable medical probability, to result from or occur during the transfer of the individual from a facility, or, with respect to an emergency medical condition described in paragraph (1)(B), that the woman has delivered (including the placenta).
(4) The term “transfer” means the movement (including the discharge) of an individual outside a hospital’s facilities at the direction of any person employed by (or affiliated or associated directly or indirectly with) the hospital, but does not include such a movement of an individual who (A) has been declared dead, or (B) leaves the facility without the permission of any such person.
(5) The term “hospital” includes a rural primary care hospital (as defined in section 1861(mm)(1)).
(f) PREEMPTION – The provisions of this section do not preempt any State or local law requirement, except to the extent that the requirement directly conflicts with the requirement of this section.
(g) NONDISCRIMINATION – A participating hospital that has specialized capabilities or facilities (such as burn units, shock-trauma units, neonatal intensive care units, or (with respect to rural areas) regional referral centers as identified by the Secretary in regulation) shall not refuse to accept an appropriate transfer of an individual who requires such specialized capabilities or facilities if the hospital has the capacity to treat the individual.
(h) NO DELAY IN EXAMINATION OR TREATMENT – A participating hospital may not delay provision of an appropriate medical screening examination required under subsection (a) or further medical examination and treatment required under subsection (b) in order to inquire about the individual’s method of payment or insurance status.
(i) WHISTLEBLOWER PROTECTIONS – A participating hospital may not penalize or take adverse action against a qualified medical person described in subsection (c)(1)(A)(iii) or a physician because the person or physician refuses to authorize the transfer of an individual with an emergency medical condition that has not been stabilized or against any hospital employee because the employee reports a violation of a requirement of this section.
1990 Amendments:
Section 4008(b)(1) of the “Omnibus Budget Reconciliation Act of 1990,” applicable to actions occurring on or after the first day of the sixth month beginning after November 5, 1990, substituted “negligently” for “knowingly” in subparagraph (d)(2)(A).
Section 4008(b)(2) of the “Omnibus Budget Act of 1990,” applicable to actions occurring on or after the first day of the sixth month beginning after November 5, 1990, added “(or not more than $25,000 in the case of a hospital with less than 100beds)” after $50,000” in subparagraph (d)(2)(A).
(1) AS REQUREMENT OF MEDICARE PROVIDE AGREEMENT – If a hospital knowingly and willfully, or negligently, fails to meet the requirements of this section, such hospital is subject to-
(A) termination of its provider agreement under this title in accordance with section 1866(b), or
Section 4008(b)(3)(A)Ii) of the “Omnibus
Budget Reconciliation Act of 1990,” applicable to actions occurring on or after the first day of the sixth month beginning after November 5, 1990, deleted paragraph (d)(1), which reads as follows:
“(B) at the option of the Secretary, suspension of such agreement for such period of time as the Secretary determines to be appropriate, upon reasonable notice to the hospital and to the public.”
Section 4008(b)(3)(A)(ii) of the “Omnibus Budget Reconciliation Act of 1990” applicable to actions occurring on or after the first day of the sixth month beginning after November 5, 1990, redesignated paragraphs (d)(2) and (d)(3) as paragraphs (d)(1) and (d)(2) respectively.
Section 4008(b)(3)(A)(iii) of the “Omnibus Budget Reconciliation Act of 1990,” applicable to actions occurring on or after the first day of the sixth month beginning after November 5, 1990, substituted “(d)(1)(C)” for (d)(2)(C)” in subparagraph (c)(2)(C).
Section 4207(a)(1)(A) of the “Omnibus Budget Reconciliation Act of 1990,” applicable to actions occurring on or after the first day of the sixth month beginning after November 6, 1990,” applicable to actions occurring on or after the first day of the sixth month beginning after November 5, 1990, added paragraph
d)(3).
Section 4207 (a)(2) of the “Omnibus Budget Reconciliation Act of 1990,” applicable to actions occurring on or after the first day of the sixth month beginning after November 5, 1990, substituted “negligently” for “knowingly” in subparagraph (d)(2)(B) prior to redesignation by section 4008(b)(3)(A)(ii) of that Act.
Section 4207 (a)(3) of the “Omnibus Budget Reconciliation Act of 1990,” applicable to actions occurring on or after the first day of the sixth month beginning after November 5, 1990, substituted “gross and flagrant or is repeated” for “knowing and willful or negligent” in subparagraph (d)(2)(B) prior to redesignation by section 4008(b)(3)(A)(ii) of that Act.
Prior to amendment by section 4207(k)(3) of the “Omnibus Budget Reconciliation Act of 1990,” effective November 5, 1990, subsection 1867(i) reads as follows:
“(i) WHISTLEBLOWER PROTECTION – A participating hospital may not penalize or take adverse action against a physician because the physician refuses to authorize the transfer of the individual with an emergency medical condition that has not been stabilized.”
1989 Amendments:
Section 6003(g)(3)(D)(xiv) of the “Omnibus Budget Reconciliation Act of 1989” effective December 19, 1989, added a new paragraph (e)(6) (which was redesignated as paragraph (e)(5) see below).
Section 6211 of the “Omnibus Budget Reconciliation Act of 1989,” effective on the first
day of the first month that begins more than 180 days after December 19, 1989, without regard to whether regulations to carry out these amendments have been promulgated by that date, made the following changes of section 1867:
Substituted “department, including ancillary services routinely available to the emergency department,” for “department: the third place it appeared in subsection (a).
Added “and informs the individual (or a person acting on the individual’s behalf) of the risks and benefits to the individual of such examination and treatment,” after “in that paragraph” in paragraph (b)(2).
Substituted “and treatment” for “or treatment”
Added the following sentence at the end of paragraph (b)(2): “The hospital shall take all reasonable steps to secure the individual’s (or person’s) written informed consent to refuse such examination and treatment.”
Added “and informs the individual (or a person acting on the individual’s behalf) of the risks and benefits to the individual of such transfer,” after “with subsection (c)” in paragraph (b)(3).
Added the following sentence at the end of paragraph (b)(3): “The hospital shall take all reasonable steps to secure the individual’s (or person’s) written informed consent to refuse such transfer.”
Substituted “after being informed of the hospital’s obligations under this section and of the risk of transfer, in writing requests transfer to another medical facility” for “requests that the transfer be effected” in clause (c)(1)(A)(i).
Deleted “or” at the end of clause (c)(1)(A)(i).
Deleted “, or other qualified medical personnel when a physician is not readily available in the emergency department,” after “section 1861(r)(1),” added “of transfer” after “information available at the time,” and substituted “, or” for “, and” in clause (c)(1)(A)(ii).
Added a new clause (c)(1)(A)(iii).
Deleted “, based upon the reasonable risks and benefits to the patient, and” after “signed a certification that”, and substituted “individual and, in the case of labor, to the unborn child” for “individual’s medical condition” in clause (c)(1)(A)(ii).
Added the following sentence at the end of paragraph (c)(1): “ certification described in clause (ii) or (iii) of subparagraph (A) shall include a summary of the risks and benefits upon which the certification is based."
Redesignated subparagraph (c)(2)(A), (B), (C), and (D) as subparagraphs (c)(2)(B), (C), (D) and (E), respectively, and added a new subparagraph (c)(2)(A).
Revised subparagraph (c)(2)(B) (redesignated as (c)(2)(C); see above), which, prior to amendment, read as follows
(B) in which the transferring hospital provides the receiving facility with appropriate medical records (or copies thereof) of the examination and treatment effected at the transferring hospital;”
Revised subparagraphs (d)(2)(B) and (C), which, prior to amendment, read as follows:
(B) The responsible physician in a participating hospital with respect to the hospital’s violation of a requirement of this subsection is subject to the sanctions described in section 1842(j)(2), except that, for purposes of this subparagraph, the civil money penalty with respect to each violation may not exceed $50,000 rather than $2,000.
(C) As used in this paragraph, the term ‘responsible physician’ means, with respect to a hospital’s violation of a requirement of this section, a physician who –
(i) is employed by, or under contract with, the participating hospital, and
“(ii) acting as such an employee or under such a contract, has professional responsibility for the provision of examinations or treatments for the individual, or transfers of the individual, with respect to which the violation occurred.”
Added new subsections (g), (h), and (i).
Substituted “INDIVIDUAL” for “PATIENT” in the heading of subsection (c).
Substituted “an individual”, “the individual”, “individual’s, and “individuals” for “a patient”, “the patient”, “patient’s”, and “patients”, respectively, each place each appears in subsection (c).
Substituted “an individual” for “a patient” both places it appears in paragraph (e)(5) (redesignated as (e)(4); see below).
Revised paragraph (e)(1), which, prior to amendment, reads as follows:
(1) The term ‘emergency medical condition’ means a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in –
(A) placing the patient’s health in serious jeopardy,
(B) serious impairment to bodily functions, or
(C) serious dysfunctions of any bodily organ or part.”
Deleted paragraph (e)(2), which read as follows:
(2) The term ‘active labor’ means labor at a time at which –
"(A) delivery is imminent,
(B) there is inadequate time to effect safe transfer to another hospital prior to delivery, or
(C) a transfer may pose a threat of the health and safety of the patient or the unborn child.”
Added “described in paragraph (1)(A)” after “emergency medical condition” in suparagraphs (e)(4)(A) and (e)(4)(B) (redesignated as subparagraphs (e)(3)(A) and (B), respectively; see below).
Added “or occur during” after “likely to results from” in subparagraphs (e)(4)(A) and (e)(4)(B) (redesignated as subparagraphs (e)(3)(A) and (B), respectively; see below).
Added “, or, with respect to an emergency medical condition described in paragraph (1)(B), to deliver (including the placenta)” after “individual from a facility” and before the period at the end of subparagraph (e)(4)(A) (redesignated as subparagraph (e)(3)(A); see below).
Added “, or, with respect to an emergency medical condition described in paragraph (1)(B), that the woman has delivered (including the placenta)” after “individual from a facility” and before the period at the end of the subparagraph (e)(4)(B) (redesignated as subparagraph (e)(3)(B); see below).
Redesignated paragraphs (e)(3), (4), (5) and (6) as paragraphs (e)(2), (3), (4), and (5), respectively.
Delete “ACTIVE” after “AND WOMEN IN” in the heading of section 1867.
Deleted “or to determine if the individual is in active labor (within the meaning of section (e)(2))” after “subsection (e)(1)) exists” and before the period at the end of subsection (a).
Deleted “ACTIVE” after “MEDICAL CONDITIONS AND” in the heading of subsection (b).
Deleted “or is in active labor” after “emergency medical condition” in paragraph (b)(1).
Deleted “or to provide for treatment of the labor” after “stabilize the medical condition” in subparagraph (b)(1)(A).
Substituted “(e)(3)(B))” for (e)(4)(B)) or is in active labor” in paragraph (c)(1).
1987 Amendments:
Prior to amendment by section 4009(a) of the “Omnibus Budget Reconciliation Act of 1987,” as corrected by section 411(b)(8)(A) of the “OBRA Technical Corrections” subtitle of the “Medicare Catastrophic Coverage Act of 1988” and section 608(d)(18)(E) (technical corrections section) of the “Family Support Act of 1988,” effective for actions occurring on or after December 22, 1987, paragraph (d)(2) read as follows:
(2) CIVIL MONETARY PENALTIES- In addition to the other grounds of imposition of a civil money penalty under section 1128A(a), a participating hospital that knowingly violates a requirement of this section and the responsible physician in the hospital with respect to such a violation are each subject, under that section, to a civil money penalty of not more than $50,000 for each such violation. As used in the previous sentence, the term “responsible physician” means, with respect to a hospital’s violation of a requirement of this section, a physician who –
(A) is employed by, or under contract with, the participating hospital, and
"(B) acting as such an employee or under such a contract, has professional responsibility for the provision of examinations or treatments for the individual, or transfers of the individual, with respect to which the violation occurred.”
1986 Amendments:
Section 1867 was added by section 9121(b) of the Consolidated Omnibus Budget Reconciliation Act of 1985,” effective on the first day of the first month that begins at least 90 days after April 7, 1986.
Section 9307(c)(4) of the “Omnibus Budget Reconciliation Act of 1986,” effective October 21, 1986, deleted “legally responsible” after “individual (or a” in paragraphs (b)(2) and (b)(3).
Section 1895(b)(4) of the “Tax Reform Act of 1986,” effective as if included in the enactment of the “Consolidated Omnibus Budget Reconciliation Act of 1985,” deleted “and has, under the agreement, obligated itself to comply with the requirements of this section”, which appeared after “section 1866” in paragraph (e)(3).
History:
Sec. 9121(b) of the “Consolidated Omnibus Budget Reconciliation Act of 1985” (P.L. 99-272); as amended by sec. 9307(c)(4) of the “Omnibus Budget Reconciliation Act of 1986”
(P.L. 99-509), sec. 1895(b)(4) of the “Tax Reform Act of 1986” (P.L. 99-514), sec. 4009(a) of the “Omnibus Budget Reconciliation Act of 1987” (P..L. 100-203), sec. 411(b)(8)(A) of the “Medicare Catastrophic Coverage Act of 1988” (P.L. 100-360), sec. 608(d)(18)(E) of the �mily Support Act of 1988” (P.L. 100-485), secs. 6003(g)(3)(D)(xiv) and 6211 of the “Omnibus Budget Reconciliation Act of 1989” (P.L. 101-239), sec. 4008(b)(1), (b)(2), and (b)(3)(A), and 4207(a)(1)(A), (a)(2), (a)(3) and (k)(3) of the “Omnibus Budget Reconciliation Act of 1990” (P.O. 101-508).
(17,032) (Sec. 1867. Repealed.)
1984 Amendments:
Prior to repeal by section 2349(a) of the “Medicare and Medicaid Budget Reconciliation Amendments of 1984, “effective July 18, 1984, section 1867 reads as follows:
HEALTH INSURANCE BENEFITS
ADVISORY COUNCIL”
Sec. 1867. (a) There is hereby created a Health Insurance Benefits Advisory Council which shall consist of 19 persons, not otherwise in the employ of the United States, appointed by the Secretary without regard to the provisions of title 5, United Sates Code, governing appointments in the competitive services. The Secretary shall from time to time appoint one of the members to serve as Chairman. The members shall include persons who are out-standing in fields related to hospital, medical, and other health activities, persons who are representatives or organizations and associations of professional personnel in the field of medicine, and at least one person who is representative of the general public. Each member shall hold office for a term of four years, except that any member appointed to fill a vacancy occurring prior to the expiration of the term for which his predecessor was appointed shall be appointed for the remainder of such term. A member shall not be eligible to serve continuously for more than two terms. Member of the Advisory Council, while attending meetings or conferences thereof or otherwise serving on business of the Advisory Council, shall be entitled to receive compensation at rates fixed by the Secretary, but not exceeding $100 per day, including travel time, and while so serving away from their homes or regular places of business they may be allowed travel expenses, including per diem in lieu of subsistence, as authorized by section 5703 of title 5, United States Code, for persons in the Government service employed intermittently, The Advisory Council shall meet as the Secretary deemed necessary, but not less than annually.
((b) It shall be the function of the Advisory Council to provide advice and recommendations
Social Security Act
for the consideration of the Secretary on Matters of general policy with respect to this title and title XIX.”
1972 Amendments:
Prior to amendment by sections 228(a), (b) and (c) of the SS Amendments of 1972, effective October 30, 1972, Sec. 1867 read as follows:
Sec. 1867. (a) There is hereby created a Health Insurance Benefits Advisory Council which shall consists of 19 persons not otherwise in the employ of the United States, appointed by the Secretary without regard to the provisions of title 5, United States Code, governing appointments in the competitive service. The Secretary shall from time to time appoint one of the members to serve as Chairman. The members shall include persons who are outstanding in fields related to hospital, medical, and other health activities, persons who are representative of organizations and associates of professional personnel in the field of medicine, and at least one person who is representative of the general public. Each member shall hold office for a term of 4 years, except that any member appointed to fill vacancy occurring prior to the expiration of the term for which his predecessor was appointed shall be appointed for the remainder of such term. A member shall not be eligible to serve continuously for more than 2 terms. The Secretary may, at the request of the Advisory Council or otherwise, appoint such special advisory professional or technical committees as may be useful in carrying out this title. Members of the Advisory Council and members of any such advisory or technical committee, while attending meetings or conferences thereof or otherwise serving on business of the Advisory Council or of such committee, shall be entitled to receive compensation at rates fixed by the Secretary, but not exceeding $100 per day, including travel time, and while so serving away from their homes or regular places of business they may be allowed travel expenses, including per diem in lieu of subsistence, as authorized by section 4703 of title 5, United Sates Code, for persons in the Government service employed intermittently. The Advisory Council shall meet as frequently as the Secretary deems necessary. Upon request of 5 or more members, it shall be the duty of the Secretary to call a meeting of the Advisory Council.
(b) It is the function of the Advisory Council (1) to advise the Secretary on matters of general policy in the administration of this title and in the formulation of regulations under this title, and (2) to study the utilization of hospital and other medical care and services for which payment may be made its effectiveness shall terminate when the Secretary finds that the reason therefore has been removed and that there is reasonable assurance that it will not recur. The Secretary shall not make any such decision except after reasonable notice and opportunity for hearing to the institution or agency affected thereby.
“(c) For purposes of this section, the term ‘provider of services’ shall include a clinic, rehabilitation agency, or public health agency if, in the case of a clinic or rehabilitation agency, such clinic or agency meets the requirements of section 1861(p)(4)(A) or if, in the case of a public health agency, such agency meets the requirements of section 1861(p)(4)(B), but only with respect to the furnishing of outpatient physical therapy services (as therein defined).”
1967 Amendments:
Prior to amendment by section 164(a) of the SS amendments of 1967, effective as provided in section 164(b) of these amendments, ( 18,916), section 1867 read as follows: