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1 insurers and health maintenance organizations contracted 2 with for administration of the program. Such report shall be 3 submitted to the Committee on Finance of the Senate and 4 the Committee on Interstate and Foreign Commerce of the 5 House of Representatives no later than six months following 6 the close of the fiscal year."

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REGULATIONS OF THE SECRETARY

SEC. 32. (a) (1) Section 1102 of the Social Security

9 Act is amended—

(A) by inserting "(a)" immediately after "SEC. 1102.", and

(B) by adding at the end the following subsection:

13 "(b) Whenever the Secretary, in compliance with 14 requirements imposed by law, has published in the Federal 15 Register general notice of any proposed rule or regulation 16 to be promulgated by him, that notice shall indicate whether 17 prompt promulgation is urgent. Where the notice indicates 18 that prompt promulgation is urgent, the rule or regulation 19 shall become effective within sixty days after publication of 20 the notice; in any other case, the rule or regulation shall 21 become effective without regard to the provisions of this 22 subsection in the manner prescribed by applicable provisions 23 of law.".

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24 (2) Amendments made by paragraph (1) shall be 25 effective for proposed rules published in the Federal Register

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on and after the first day of the first calendar month which

2 begins more than thirty days after the date of enactment of

3 this Act.

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(b) Except as otherwise specified in this Act or 5 in a provision of law which is enacted or amended by 6 this Act, any regulation of the Secretary of Health, Educa7 tion, and Welfare (hereinafter in this section referred to as 8 the "Secretary"), which is necessary or appropriate to im9 plement any provision of this Act or any other provision of 10 law which is enacted or modified by this Act, shall, subject to paragraph (2), be promulgated so as to become effective not later than the first day of the thirteenth month following the month in which this Act is enacted.

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REPEAL OF SECTION 1867

SEC. 33. Section 1867 of the Social Security Act is 16 hereby repealed.

17 PROCEDURES FOR DETERMINING REASONABLE COST AND

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REASONABLE CHARGE

SEC. 40. (a) (1) In determining the amount of any 20 payment under title XVIII, under a program established 21 under title V, or under a State plan approved under title 22 XIX, when the payment is based upon the reasonable cost 23 or reasonable charge, no element comprising any part of the cost or charge shall be considered to be reasonable if, and 25 to the extent that, that element is

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(A) a commission, finder's fee, or for a similar

arrangement, or

(B) an amount payable for any facility (or part

or activity thereof) under any rental or lease arrange

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6 which is, directly or indirectly, determined, wholly or in 7 part as a percentage, fraction, or portion of the charge or 8 cost attributed to any health service (other than the ele9 ment) or any health service including, but not limited to, 10 the element.

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AMBULANCE SERVICE

SEC. 41. (a) Section 1861 (s) (7) of the Social Security

13 Act is amended by inserting:

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(Including ambulance service to the nearest hos

pital which is: (a) adequately equipped and (b) has medical personnel qualified to deal with, and available for the treatment of, the individual's illness, injury, or condition)" immediately after "ambulance service". (b) The amendment made by subsection (a) shall 20 apply to services furnished on and after the first day of the 21 first calendar month which begins after the date of enact22 ment of this Act.

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23 GRANTS TO REGIONAL PEDIATRIC PULMONARY CENTERS

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SEC. 42. (a) Section 511 of the Social Security Act is 25 amended

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(1) by inserting "(a)" immediately after "SEC.

511.", and

(2) by adding at the end of the section:

"(b) (1) From the sums available under paragraph

(2), the Secretary is authorized to make grants to public 6 or nonprofit private regional pediatric respiratory centers, 7 which are a part of (or are affiliated with) an institution of 8 higher learning, to assist them in carrying out a prograin for 9 the training and instruction (through demonstrations and 10 otherwise) of health care personnel in the prevention, diag11 nosis and treatment of respiratory diseases in children and 12 young adults, and in providing (through such program) 13 needed health care services to children and young adults 14 suffering from such diseases.

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"(2) For the purpose of making grants under this sub16 section, there is authorized to be appropriated, for the fiscal 17 year ending September 30, 1978, and each of the next four 18 succeeding fiscal years, such sums (not in excess of $5,19 000,000 for any fiscal year) as may be necessary. Sums 20 authorized to be appropriated for any fiscal year under this 21 subsection for making grants for the purposes referred to in 22 paragraph (1) shall be in addition to any sums authorized 23 to be appropriated for such fiscal year for similar purposes

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24 under other provisions of this title.".

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(b) Section 502 (2) of such Act is amended by insert26 ing"(a)" immediately after "511".

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WAIVER OF HUMAN EXPERIMENTATION PROVISION

FOR MEDICARE AND MEDICAID

SEC. 43. Any requirements of title II of Public Law

4 93-348 otherwise held applicable are hereby waived with 5 respect to programs established under titles XVIII and XIX 6 of the Social Security Act.

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DISCLOSURE OF AGGREGATE PAYMENTS TO PHYSCIANS

SEC. 44. Section 1106 of the Social Security Act is 9 amended by adding:

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"(f) The Secretary shall not make available, nor shall 11 the State title XIX agency be required to make available 12 to the public information relating to the amounts that have 13 been paid to individual doctors of medicine or osteopathy 14 by or on behalf of beneficiaries of the health programs estab15 lished by titles XVIII or XIX, as the case may be, except 16 as may be necessary to carry out the purposes of those titles or as may be specifically required by the provisions of other 18 Federal law.".

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19 RESOURCES OF MEDICAID APPLICANT TO INCLUDE CERTAIN

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PROPERTY PREVIOUSLY DISPOSED OF TO APPLICANT'S

RELATIVE FOR LESS THAN MARKET VALUE

22 SEC. 45. Section 1904 of the Social Security Act is 23 amended by adding the following sentence: "The Secretary 24 shall not find that a State has failed to comply with the re25 quirements of this title solely because it denies medical as

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