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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.
(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 implement 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.
REPEAL OF SECTION 1867
SEC. 33. Section 1867 of the Social Security Act is
16 hereby repealed.
17 PROCEDURES FOR DETERMINING REASONABLE COST AND
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 or reasonable charge, no element comprising any part of 24 the cost or charge shall be considered to be reasonable if, and
(A) a commission, finder's fee, or for a similar
(B) an amount payable for any facility (or part
or activity thereof) under any rental or lease arrange
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.
SEC. 41. (a) Section 1861 (s) (7) of the Social Security
13 Act is amended by inserting:
'(Including ambulance service to the nearest hos
pital which is: (a) adequately equipped and (b) has
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.
23 GRANTS TO REGIONAL PEDIATRIC PULMONARY CENTERS
SEC. 42. (a) Section 511 of the Social Security Act is 25 amended
(1) by inserting "(a)" immediately after "SEC.
(2) by adding at the end of the section:
"(b) (1) From the sums available under paragraph
5 (2), the Secretary is authorized to make grants to public
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 program 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.
"(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 24 under other provisions of this title.”.
(b) Section 502 (2) of such Act is amended by insert26 ing"(a)" immediately after "511".
WAIVER OF HUMAN EXPERIMENTATION PROVISION
FOR MEDICARE AND MEDICAID
SEC. 43. Any requirements of title II of Public Law
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.
DISCLOSURE OF AGGREGATE PAYMENTS TO PHYSCIANS
SEC. 44. Section 1106 of the Social Security Act is 9 amended by adding:
"(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 17 or as may be specifically required by the provisions of other 18 Federal law.".
RESOURCES OF MEDICAID APPLICANT TO INCLUDE CERTAIN
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
1 sistance to an individual who would be ineligible for such 2 assistance if, in determining whether he is eligible for bene
fits under title XVI of this Act, there were included in his 4 resources any property owned by him within the preceding 5 twelve months to the extent that he gave or sold that prop6 erty to a relative for less than its fair market value.".
RATE OF RETURN ON NET EQUITY FOR FOR-PROFIT
SEC. 46. (a) Section 1861 (v) (1) (B) of the Social 10 Security Act is amended
(1) in the first sentence thereof, by inserting "hospital or" immediately after "Such regulations in the case of",
(2) in the second sentence thereof, by striking out "one and one-half times" and inserting in lien thereof "the percentages, specified in the next sentence, of" and
(3) by inserting after the last sentence of subparagraph (13) the following sentence: "For hospital and skilled nursing facility fiscal periods beginning before the month following the month of enactment of the Medicare-Medicaid Administrative and Reimbursement Reform Act, the percentage referred to in the previous sentence is 150 per cent and for subsequent fiscal years, the percentage is 200 per cent: Provided, however,