Subsec. (j). Pub. L. 93-66 struck out provisions respecting skilled nursing facility services and intermediate care facility services.

1972 Subsec. (a)(1). Pub. L. 92-603, § 207(a) (2), added reference to subecs. (g) and (h) and of this section.

Subsec. (a) (3)-(6). Pub. L. 92-603, §§ 235 (a), 249B, 299E(a), added pars. (3)-(5). Former subsec. (a) (3) redesignated (a) (6).

Subsec. (b) (1). Pub. L. 92-603, § 295, struck out subsec. (b) (1), which related to the amount of quarterly expenditures exceeding the average of total expenditures for each quarter of fiscal year ending June 30, 1965.

Subsec. (b) (3). Pub. L. 92-603, § 221 (c) (6), added par. (3).

Subsec. (e). Pub. L. 92-603, § 230, repealed subsec. (e), which related to furnishing for comprehensive care and services by July 1, 1977.

Subsec. (g). Pub. L. 92-603, §§ 207(a)(1), 278(b) (1), added subsec. (g) and substituted "skilled nursing facility" for "skilled nursing home" and "skilled nursing facilities" for "skilled nursing homes" wherever appearing therein.

Subsec. (h). Pub. L. 92-603, §§ 207(a)(1), 278(b) (1), (5), added subsec. (h) and substituted "skilled nursing facility" for "skilled nursing home" wherever appearing therein.

Subsec. (i). Pub. L. 92-603, §§ 224 (c), 229 (c), 233 (c), 237(a) (1), 278(b) (7), added subsec. (i) and substituted "skilled nursing facility" for "skilled nursing home" wherever appearing therein.

Subsec. (j). Pub. L. 92-603, §§ 225, 278(b) (16), added subsec. (j), relating to skilled nursing facilities services, and substituted "skilled nursing facility for "skilled nursing home" wherever appearing therein.

Subsec. (j). Pub. L. 92-603, § 290, added subsec. (j), relating to orders for suspension of payment.

Subsec. (k). Pub. L. 92-603, § 226 (e), added subsec. (k).

EFFECTIVE DATE OF 1973 AMENDMENT

Amendment by section 13(a) (11), (12) of Pub. L. 93233 effective with respect to payments under this section for calendar quarters commencing after Dec. 31, 1973, see section 13(d) of Pub. L. 93-233, set out as a note under section 1396a of this title.

Amendment of subsec. (b) (2) of this section by section 18(u) of Pub. L. 93-233 effective July 1, 1973, see section 18 (z-3) (4) of Pub. L. 93-233, set out as a note under section 1396a of this title.

Section 234 (b) of Pub. L. 93-66 provided that: "The amendment made by subsection (a) [repealing subsec. (j) of this section] shall be applicable in the case of expenditures for skilled nursing services and for intermediate care facility services furnished in calendar quarters which begin after December 31, 1972."

EFFECTIVE DATE OF 1972 AMENDMENT Section 207(b) of Pub. L. 92-603 provided that: "The amendments made by subsection (a) [amending subsecs. (a) (1), (g) and (h) of this section] shall, except as otherwise provided therein, be effective July 1, 1973."

Section 249B of Pub. L. 92-603 provided in part that the enactment of par. (4) of subsec. (a) and the concurrent redesignation of former par. (4) as par. (5) by section 249B of Pub. L. 92-603, and redesignation of such par. (5) as par. (6) by section 299E (a) of Pub. L. 92-603 shall be effective for the period beginning Oct. 1, 1972, and ending June 30, 1974.

Section 237 (d) (1) of Pub. L. 92-603 provided that: "The amendments made by subsections (a) (1) and (b) [amending subsec. (1) of this section and section 706 (f) of this title shall apply with respect to services furnished in calendar quarters beginning after June 30, 1973."

Section 235(b) of Pub. L. 92-603 provided that: "The amendments made by subsection (a) [amending this section shall apply with respect to expenditures under State plans approved under title XIX of the Social Security Act [this subchapter]. made after June 30, 1971." Amendment of subsec. (1) by section 233 (c) of Pub. L. 92-603 applicable with respect to services furnished by hospitals in accounting periods beginning after Dec. 31, 1972, see section 233 (f) of Pub. L. 92-603, set out as a

note under section 1395f of this title. See, also, section 16 of Pub. L. 93-233, set out as a note under section 1395f of this title.

Amendment of subsec. (k) by section 226 (e) 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 a note under section 1395mm of this title. NONDUPLICATION OF PAYMENTS TO STATES; LIMITATION ON INSTITUTIONAL CARE

Section 121(b) of Pub. L. 89-97, as amended by section 249D of Pub. L. 92-603, provided that: "No payment may be made to any State under title I, IV, X, XIV, or XVI of the Social Security Act [subchapter I, IV, X, XIV, or XVI of this chapter] with respect to aid or assistance in the form of medical or any other type of remedial care for any period for which such State receives payments under title XIX of such Act [this subchapter], or for any period after December 31, 1969. After the date of enactment of the Social Security Amendments of 1972 [Oct. 30, 1972], Federal matching shall not be available for any portion of any payment by any State under title I, X, XIV, or XVI, or part A of title IV, of the Social Security Act [subchapter I, X, XIV, or XVI, or part A of subchapter IV of this chapter] for or on account of any medical or any other type of remedial care provided by an institution to any individual as an inpatient thereof, in the case of any State which has a plan approved under title XIX of such Act [this subchapter], if such care is (or could be) provided under a State plan approved under title XIX of such Act [this subchapter] by an institution certified under such title XIX [this subchapter]." COMPREHENSIVE CARE AND SERVICES FOR ELIGIBLE INDIVIDUALS BY JULY 1, 1977; REQUIREMENT INAPPLICABLE FOR ANY PERIOD PRIOR TO JULY 1, 1971; REGULATIONS; ADVICE TO STATES

Section 2(b) of Pub. L. 91-56, which provided that subsection (e) of this section was inapplicable to the period prior to July 1, 1971, and which authorized the Secretary to issue regulations, was repealed by Pub. L. 92-603, title II, § 230, Oct. 30, 1972, 86 Stat. 1410.

§ 1396d. Definitions.

For purposes of this subchapter(a) Medical assistance.

The term "medical assistance" means payment of part or all of the cost of the following care and services (if provided in or after the third month before the month in which the recipient makes application for assistance) for individuals, and, with respect to physicians' or dentists' services, at the option of the State, to individuals (other than individuals with respect to whom there is being paid, or who are eligible, or would be eligible if they were not in a medical institution, to have paid with respect to them a State supplementary payment and are eligible for medical assistance equal in amount, duration, and scope to the medical assistance made available to individuals described in section 1396a (a) (10) (A) of this title) not receiving aid or assistance under any plan of the State approved under subchapter IX, XIV, or XVI, or part A of subchapter IV, and with respect to whom supplemental security income benefits are not being paid under subchapter XVI of this chapter, who are

(iv) blind, with respect to States eligible to participate in the State plan program established under subchapter XVI of this chapter,

(v) 18 years of age or older and permanently and totally disabled, with respect to States eligible to participate in the State plan program established under subchapter XVI of this chapter.

(vi) persons essential (as described in the second sentence of this subsection) to individuals receiving aid or assistance under State plans approved under subchapter I, X, XIV, or XVI of this chapter,

or

(vii) blind or disabled as defined in section 1382c of this title, with respect to States not eligible to participate in the State plan program established under subchapter XVI of this chapter. but whose income and resources are insufficient to meet all of such cost

(4) (A) skilled nursing facility services (other than services in an institution for tuberculosis or mental diseases) for individuals 21 years of age or older (B) effective July 1, 1969, such early and periodic screening and diagnosis of individuals who are eligible under the plan and are under the age of 21 to ascertain their physical or mental defects, and such health care, treatment, and other measures to correct or ameliorate defects and chronic conditions discovered thereby, as may be provided in regulations of the Secretary; and (C) family planning services and supplies furnished (directly or under arrangements with others) to individuals of child-bearing age (including minors who can be considered to be sexually active) who are eligible under the State plan and who desire such services and supplies;

(5) physicians' services furnished by a physician (as defined in section 1395x(r) (1) of this title), whether furnished in the office, the patient's home, a hospital, or a skilled nursing facility, or elsewhere;

(14) inpatient hospital services, skilled nursing facility services, and intermediate care facility services for individuals 65 years of age or over in an institution for tuberculosis or mental diseases;

(15) intermediate care facility services (other than such services in an institution for tuberculosis or mental diseases) for individuals who are determined, in accordance with section 1396a (a) (31) (A) of this title, to be in need of such care; (16) effective January 1, 1973, inpatient psychiatric hospital services for individuals under age 21, as defined in subsection (h) of this section; and

(17) any other medical care, and any other type of remedial care recognized under State law, specified by the Secretary;

except as otherwise provided in paragraph (16), (b) Federal medical assistance percentage; State percentage.

The term "Federal medical assistance percentage" for any State shall be 100 per centum less the State percentage; and the State percentage shall be that percentage which bears the same ratio to 45 per centum as the square of the per capita income of such State bears to the square of the per capita income of the continental United States (including Alaska and Hawaii; except that (1) the Federal medical assistance percentage shall in no case be less than 50 per centum or more than 83 per centum, and (2) the Federal medical assistance percentage

for Puerto Rico, the Virgin Islands, and Guam shall be 50 per centum. The Federal medical assistance percentage for any State shall be determined and promulgated in accordance with the provisions of subparagraph (B) of section 1301 (a) (8) of this

title.

(c) Intermediate care facility.

For purposes of this subchapter the term "intermediate care facility" means an institution which (1) is licensed under State law to provide, on a regular basis, health-related care and services to individuals who do not require the degree of care and treatment which a hospital or skilled nursing facility is designed to provide, but who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, (2) meets such standards prescribed by the Secretary as he finds appropriate for the proper provision of such care, and (3) meets such standards of safety and sanitation as are established under regulation of the Secretary in addition to those applicable to nursing facilities under State law. The term "intermediate care facility" also includes any skilled nursing facility or hospital which meets the requirements of the proceeding sentence. The term "intermediate care facility" also includes a Christian Science sanatorium operated, or listed and certified, by the First Church of Christ, Scientist, Boston, Massachusetts, but only with respect to institutional services deemed appropriate by the State. The term "intermediate care facility" also includes any institution which is located in a State or an Indian reservation and is certified by the Secretary as meeting the requirements of clauses (2) and (3) of this subsection and providing the care and services required under clauses (1). With respect to services furnished to individuals under age 65, the term "intermediate care facility" shall not include, except as provided in subsection (d) of this section, any public institution or distinct part thereof for mental diseases or mental defects.

(d) Intermediate care facility services.

The term "intermediate care facility services" may include services in a public institution (or distinct part thereof) for the mentally retarded or persons with related conditions if

(1) the primary purpose of such institution (or distinct part thereof) is to provide health or rehabilitative services for mentally retarded individuals and which meet such standards as may be prescribed by the Secretary;

(2) the mentally retarded individual with respect to whom a request for payment is made under a plan approved under this subchapter is receiving active treatment under such a program; and

(3) the State or political subdivision responsible for the operation of such institution has agreed that the non-Federal expenditures in any calendar quarter prior to January 1, 1975, with respect to services furnished to patients in such institution (or distinct part thereof) in the State will not, because of payments made under this subchapter, be reduced below the average amount expended

for such services in such institution in the four quarters immediately preceding the quarter in which the State in which such institution is located elected to make such services available under its plan approved under this subchapter.

(e) Physicians' services.

In the case of any State the State plan of which (as approved under this subchapter) —

(1) does not provide for the payment of services (other than services covered under section 1396a (a) (12) of this title) provided by an optometrist; but

(2) at a prior period did provide for the payment of services referred to in paragraph (1); the term "physicians' services" (as used in subsection (a) (5) of this section) shall include services of the type which an optometrist is legally authorized to perform where the State plan specifically provides that the term "physicians' services", as employed in such plan, includes services of the type which an optometrist is legally authorized to perform, and shall be reimbursed whether furnished by a physician or an optometrist.

(f) Skilled nursing facility services.

For purposes of this subchapter, the term "skilled nursing facility services" means services which are or were required to be given an individual who needs or needed on a daily basis skilled nursing care (provided directly by or requiring the supervision of skilled nursing personnel) or other skilled rehabilitation services which as a practical matter can only be provided in a skilled nursing facility on an inpatient basis.

(g) Chiropractors' services.

If the State plan includes provision of chiropractors' services, such services include only

(1) services provided by a chiropractor (A) who is licensed as such by the State and (B) who meets uniform minimum standards promulgated by the Secretary under section 1395x (r) (5) of this title; and

(2) services which consist of treatment by means of manual manipulation of the spine which the chiropractor is legally authorized to perform by the State.

(h) Inpatient psychiatric hospital services for individuals under age 21.

(1) For purposes of paragraph (16) of subsection (a) of this section, the term "inpatient psychiatric hospital services for individuals under age 21" includes only

(A) inpatient services which are provided in an institution which is accredited as a psychiatric hospital by the Joint Commission on Accreditation of Hospitals;

(B) inpatient services which, in the case of any individual (i) involve active treatment which meets such standards as may be prescribed in regulations by the Secretary, and (ii) a team, consisting of physicians and other personnel qualified to make determinations with respect to mental health conditions and the treatment thereof, has determined are necessary on an inpatient basis and can reasonably be expected to improve the

condition, by reason of which such services are necessary, to the extent that eventually such services will no longer be necessary; and

(C) inpatient services which, in the case of any individual, are provided prior to (A) the date such individual attains age 21, or (B) in the case of an individual who was receiving such services in the period immediately preceding the date on which he attained age 21, (i) the date such individual no longer requires such services, or (ii) if earlier, the date such individual attains age 22;

(2) Such term does not include services provided during any calendar quarter under the State plan of any State if the total amount of the funds expended, during such quarter, by the State (and the political subdivisions thereof) from non-Federal funds for inpatient services included under paragraph (1), and for active psychiatric care and treatment provided on an outpatient basis for eligible mentally ill children, is less than the average quarterly amount of the funds expended, during the 4quarter period ending December 31, 1971, by the State (and the political subdivisions thereof) from non-Federal funds for such services.

(i) Skilled nursing facility.

For purposes of this subchapter, the term "skilled nursing facility" also includes any institution which is located in a State on an Indian reservation and is certified by the Secretary as being a qualified skilled nursing facility by meeting the requirements of section 1395x(j) of this title.

(j) State supplementary payment.

The term "State supplementary payment" means any cash payment made by a State on a regular basis to an individual who is receiving supplemental security income benefits under subchapter XVI of this chapter or who would but for his income be eligible to receive such benefits, as assistance based on need in supplementation of such benefits (as determined by the Secretary), but only to the extent that such payments are made with respect to an individual with respect to whom supplemental security income benefits are payable under subchapter XVI of this chapter, or would but for his income be payable under that subchapter.

(k) Supplemental security income benefits.

Increased supplemental security income benefits payable pursuant to section 211 of Public Law 9366 shall not be considered supplemental security income benefits payable under subchapter XVI of this chapter. (As amended Dec. 28, 1971, Pub. L. 92– 223, § 4(a), 85 Stat. 809; Oct. 30, 1972, Pub. L. 92603, title II, §§ 212(a), 247(b), 275 (a), 278(a) (21) – (23), 280, 297(a), 299, 299B, 299E(b), 299L, 86 Stat. 1384, 1425, 1452-1454, 1459-1462, 1464; Dec. 31, 1973; Pub. L. 93-233, §§ 13 (a) (13)–(48), 18(w), (x) (7) (10), (y) (2), 87 Stat. 963, 964, 972, 973.)

REFERENCES IN TEXT

Section 211 of Pub. L. 93-66, referred to in subsec. (k), is set out as a note under section 1382 of this title entitled in part "Federal Program of Supplemental Security Income".

AMENDMENTS

1973-Subsec. (a). Pub. L. 93-233, § 13 (a) (13), substituted in introductory text "individuals (other than individuals with respect to whom there is being paid, or

who are eligible or would be eligible if they were not in a medical institution, to have paid with respect to them a State supplementary payment and are eligible for medical assistance equal in amount, duration, and scope to the medical assistance made available to individuals described in section 1396a (a) (10) (A) of this title) not receiving aid or assistance under any plan of the State approved under subchapter I, X, XIV, or XVI, or part A of subchapter IV of this chapter, and with respect to whom supplemental security income benefits are not being paid under subchapter XVI of this chapter" for "individuals not receiving aid or assistance under the State's plan approved under subchapter I, X, XIV, or XVI, or part A of subchapter IV of this chapter".

Subsec. (a) (iv). Pub. L. 93-233, § 13(a) (14), inserted "with respect to States eligible to participate in the State plan program established under subchapter XVI of this chapter," following "blind,”.

Subsec. (a) (v). Pub. L. 93–233, § 13 (a) (15), substituted "with respect to States eligible to participate in the State plan program established under subchapter XVI of this chapter," for "or".

Subsec. (a) (vi). Pub. L. 93-233, § 13(a) (16), inserted "or" at end of text.

Subsec. (a) (vii). Pub. L. 93-233, § 13(a) (17), added cl. (vii).

Subsec. (a) (16). Pub. L. 93-233, § 18(x) (7), substituted "under age 21, as defined in subsection (h) of this section; and" for "under 21, as defined in subsection (e) of this section;".

Subsec. (b). Pub. L. 93-233, § 18 (y) (2), struck out "; except that the Secretary shall promulgate such percentage as soon as possible after July 30, 1965, which promulgation shall be conclusive for each of the six quarters In the period beginning January 1, 1966, and ending with the close of June 30, 1966" after "section 1301(a) (8) of this title".

Subsec. (c). Pub. L. 93-233, § 18(x) (8), substituted "skilled nursing facility" for "skilled nursing home" wherever appearing.

Subsec. (h) (1) (B). Pub. L. 93-233, § 18(w), substituted "(1) involve active treatment" for ", involves active treatment (1)"; struck out "pursuant to subchapter XVIII of this chapter" following "may be prescribed"; and substituted "(ii)" for "(ii) which", respectively.

Subsec. (h) (2). Pub. L. 93-233, § 18(x) (10), substituted "paragraph (1)" for "paragraph (e) (1)".

Subsec. (1). Pub. L. 93-233, § 18(x) (9), redesignated subsec. (h) as added by Pub. L. 92-603, § 299L (b), as subsec. (1).

Subsecs. (1), (k). Pub. L. 93-233, § 13(a) (18), added subsecs. (j) and (k).

1972 Subsec. (a). Pub. L. 92-603, § 299B (c), in material following redesignated subsec. (a) (17) substituted "as otherwise provided in paragraph (16)," for "that".

Subsec. (a) (4). Pub. L. 92-603, §§ 278 (a) (21), 299E(b), substituted "skilled nursing facility" for "skilled nursing home" and added cl. (C).

Subsec. (a) (5). Pub. L. 92-603, §§ 278(a) (22), 280, substituted "skilled nursing facility" for "skilled nursing home" and inserted "furnished by a physician (as defined in section 1395x (r) (1) of this title) after "physicians' services".

Subsec. (a) (14). Pub. L. 92-603, §§ 278 (a) (23), 297(a), substituted "skilled nursing facility" for "skilled nursing home" and added reference to intermediate care facility services.

Subsec. (a) (15)-(17). Pub. L. 92-603, § 299B (a), redesignated subsecs. (a) (15) as (a) (17) and (a) (16) as (a) (15), and added subsec. (a) (16).

Subsec. (c). Pub. L. 92-603, § 299L (a), added provision defining the term "intermediate care facility" with respect to any institution located in a State on an Indian reservation.

Subsec. (d) (3). Pub. L. 92-603, § 299, added provisions relating to the reduction of non-Federal expenditures in any calendar quarter prior to January 1, 1975.

Subsec. (e). Pub. L. 92-603, § 212(a), added subsec. (e). Subsec. (f). Pub. L. 92-603, § 247(b), added subsec. (f). Subsec. (g). Pub. L. 92-603, § 275 (a), added subsec. (g). Subsec. (h). Pub. L. 92-603, § 299B (b), added subsec. (h).

Subsec. (1). Pub. L. 92–603, § 299L(b), added subsec. (1), 1971-Subsec. (a) (16). Pub. L. 92-223, § 4(a) (1) (C), added cl. (16).

Subsecs. (c), (d). Pub. L. 92-223, § 4(a) (2), added subsecs. (c) and (d).

EFFECTIVE DATE OF 1973 AMENDMENT Amendment by section 13(a)(13)–(18) of Pub. L. 93233 effective with respect to payments under section 1396b of this title for calendar quarters commencing after Dec. 31, 1973, see section 13(d) of Pub. L. 93-233, set out as a note under section 1396a of this title.

EFFECTIVE DATE OF 1972 AMENDMENT

Section 297(b) of Pub. L. 92-603 provided that: "The amendment made by this section [amending subsec. (a) (14) of this section] shall apply with respect to services furnished after December 31, 1972."

Section 212 (b) of Pub. L. 92-603 provided that: "The provisions of subsection (e) of section 1905 of the Social Security Act [subsec. (e) of this section] (as added by subsection (a) of this section) shall be applicable in the case of services performed on or after the date of enactment of this Act [Oct. 30, 1972]."

Enactment of subsec. (f) by Section 247 (ee) of Pub. L. 92-603 effective with respect to services furnished after Dec. 31, 1972, see section 247(c) of Pub. L. 92-603, set out as a note under section 1395f of this title.

Section 275(b) of Pub. L. 92-603 provided that: "The amendment made by this section [enacting subsec. (g) of this section] shall be effective with respect to services furnished after June 30, 1973."

EFFECTIVE DATE OF 1971 AMENDMENT

Enactment of subsecs. (a) (16), (c), and (d) of this section by Pub. L. 92-223 effective Jan. 1, 1972, see section 4(d) of Pub. L. 92-223, set out as a note under section 1396a of this title.

§ 1396e. Repealed. Pub. L. 92-603, title II, § 287(a), Oct. 30, 1972, 86 Stat. 1457.

Section, act Aug. 14, 1935, ch. 531, title XIX, § 1906, as added Jan. 2, 1968, Pub. L. 90-248, title II, § 226, 81 Stat. 903, created the Advisory Council on Medical Assistance, set forth the composition of the Council, term of membership of the members, and the purposes of the Council, and provided for the compensation of the members.

EFFECTIVE DATE OF REPEAL

Section 287(b) of Pub. L. 92-603 provided that: "The provisions of subsection (a) [which repealed this section] shall become effective on the first day of the third calendar month following the month in which this Act is enacted [Oct. 30, 1972]."

§ 1396g. State programs for licensing of administrators of nursing homes.

(d) Waiver of standards other than good character or suitability standards.

No State shall be considered to have failed to comply with the provisions of section 1396a (a) (29) of this title because the agency or board of such State (established pursuant to subsection (b) of this section) shall have granted any waiver, with respect to any individual who, during all of the three calendar years immediately preceding the calendar year in which the requirements prescribed in section 1396a (a) (29) of this title are first met by the State, has served as a nursing home administrator, of any of the standards developed, imposed, and enforced by such agency or board pursuant to subsection (c) of this section.

under State law, or, if State law does not employ the term nursing home, the equivalent term or terms as determined by the Secretary, but does not include a Christian Science sanatorium operated, or listed and certified, by the First Church of Christ, Scientist, Boston, Massachusetts; and

(2) "nursing home administrator" means any individual who is charged with the general administration of a nursing home whether or not such individual has an ownership interest in such home and whether or not his functions and duties are shared with one or more other individuals.

(As amended Oct. 30, 1972, Pub. L. 92-603, title II, §§ 268(b), 269, 274(b), 86 Stat. 1451, 1452; Dec. 31, 1973, Pub. L. 93-233, § 18(y) (3), 87 Stat. 973.)

AMENDMENTS

1973-Subsec. (d). Pub. L. 93-233 struck out second sentence reading substantially the same as the first sentence but containing the following additional text reading "other than such standards as relate to good character or suitability if

"(1) such waiver is for a period which ends after being in effect for two years or on June 30, 1972, whichever is earlier, and

"(2) there is provided in the State (during all of the period for which waiver is in effect), a program of training and instruction designed to enable all individuals with respect to whom any such waiver is granted, to attain the qualifications necessary in order to meet such standards" and also "calendar year" instead of "three calendar years" and reference to "subsection (c) (1) of this section" instead of "subsection (c) of this section".

Subsec. (e). Pub. L. 93-233 redesignated former subsec. (g) as (e) and repealed prior subsec. (e) relating to authorization of appropriations for fiscal years 1968 through 1972 and to limitation of grants.

Subsec. (f). Pub. L. 93-233 repealed subsec. (f) providing for creation of National Advisory Council on Nursing Home Administration and for its composition, appointment of members, the Chairman, representation of interests, functions and duties, compensation and travel expenses, technical assistance, availability of assistance and data, and termination date of Dec. 31, 1971.

Subsec. (g). Pub. L. 93-233, redesignated former subsec. (g) as (e).

1972-Subsec. (d). Pub. L. 92-603, §§ 269, 274 (b), inserted references to the grant of waivers to individuals who, during all of the three calendar years immediately preceding the calendar year in which the requirements prescribed in section 1396a (a)(29) of this title are first met by the State, have served as nursing home administrators and substituted "subsection (c) (1)" for "subsection (b) (1)".

Subsec. (g) (1). Pub. L. 92-603, § 268 (b), added ", but does not include a Christian Science sanatorium operated, or listed and certified, by the First Church of Christ, Scientist, Boston, Massachusetts" after "Secretary".

EFFECTIVE DATE OF 1972 AMENDMENT Amendment of subsec. (g) (1) of this section by section 268(b) of Pub. L. 92-603 effective on Oct. 30, 1972, see section 268 (c) of Pub. L. 92-603, set out as a note under section 1396a of this title.

(3) having knowledge of the occurrence of any event affecting (A) his initial or continued right to any such benefit or payment, or (B) the initial or continued right to any such benefit or payment of any other individual in whose behalf he has applied for or is receiving such benefit or payment, conceals or fails to disclose such event with an intent fraudulently to secure such benefit or payment either in a greater amount or quantity than is due or when no such benefit or payment is authorized, or

(4) having made application to receive any such benefit or payment for the use and benefit of another and having received it, knowingly and willfully converts such benefit or payment or any part thereof to a use other than for the use and benefit of such other person,

shall be guilty of a misdemeanor and upon conviction thereof shall be fined not more than $10,000 or imprisoned for not more than one year, or both.

(b) Whoever furnishes items or services to an individual for which payment is or may be made in whole or in part out of Federal funds under a State plan approved under this subchapter and who solicits, offers, or receives any

(1) kickback or bribe in connection with the furnishing of such items or services or the making or receipt of such payment, or

(2) rebate of any fee or charge for referring any such individual to another person for the furnishing of such items or services

shall be guilty of a misdemeanor and upon conviction thereof shall be fined not more than $10,000 or imprisoned for not more than one year, or both.

(c) Whoever knowingly and willfully makes or causes to be made, or induces or seeks to induce the making of, any false statement or representation of a material fact with respect to the conditions or operation of any institution or facility in order that such institution or facility may qualify (either upon initial certification or upon recertification) as a hospital, skilled nursing facility, intermediate care facility, or home health agency (as those terms are employed in this subchapter) shall be guilty of a misdemeanor and upon conviction thereof shall be fined not more than $2,000 or imprisoned for not more than 6 months, or both. (Aug. 14, 1935, ch. 531, title XIX, § 1909, as added and amended Oct. 30, 1972, Pub. L. 92-603, title II, §§ 242 (c), 278(b) (9), 86 Stat. 1419, 1454.)

AMENDMENTS

1972 Subsec. (c). Pub. L. 92-603, § 278(b) (9), substituted "skilled nursing facility" for "skilled nursing home".

EFFECTIVE DATE

Section not applicable to any acts, statements, or representations made or committed prior to Oct. 30, 1972, see section 242 (d) of Pub. L. 92-603, set out as a note under section 1395nn of this title.

§ 13961. Certification and approval of skilled nursing facilities.

(a) Whenever the Secretary certifies an institution in a State to be qualified as a skilled nursing facility under subchapter XVIII of this chapter, such institution shall be deemed to meet the standards for certification as a skilled nursing facility for purposes of section 1396a (a) (28) of this title.