89th Congress Part I (PL 89-4 - PL 89-549)

Unless specified in the statute, legislation is effective upon enactment.

Section 226(a) provides that any individual who has attained the age of 65, and who is entitled to monthly OASDI benefits or is a “qualified railroad retirement beneficiary”, is entitled to hospital insurance benefits after meeting certain conditions.
Section 226(b)(1) provides that entitlement of an individual to hospital insurance benefits consists of entitlement to have payment made for inpatient hospital services, post-hospital extended care services, post-hospital home health services, and outpatient hospital diagnostic services furnished them in the U.S.
Section 226(b)(2) provides that individuals entitled under this section are entitled to hospital insurance benefits for the month in which they die.
Section 226(c) provides that the term “qualified railroad retirement beneficiary” means an individual whose name has been certified by the Railroad Retirement Board.
Section 226(d) contains a cross-reference to Section 103 of the Social Security Act which provides entitlement to hospital insurance benefits for certain individuals not eligible for benefits under this section.

Title XVIII – Health Insurance for the Aged
Section 1801 states that nothing in the new Title XVIII is to be construed to authorize any Federal officer or employee to exercise any supervision or control over the practice of medicine, the manner in which medical services are provided, the personnel policies of providers of health care, or the operation or administration of medical facilities and personnel.
Section 1802 provides that any individual entitled to benefits under Title XVIII may obtain health services from any institution, agency, or person which is qualified to participate under the title and which undertakes to provide service to them.
Section 1803 provides that nothing in Title XVIII is to be construed to preclude any State from providing, or any individual from purchasing or otherwise securing, protection against health costs.
Part A – Hospital Insurance Benefits for the Aged
Section 1811 describes Section 226 of the Social Security Act as an insurance program which provides basic protection against the costs of hospital and related post-hospital services for individuals age 65 or over who are entitled to retirement benefits under Title II of the Social Security Act or under the Railroad Retirement system.
Section 1812(a) provides that the benefits provided under Part A of Title XVIII consist of entitlement to have payment made for inpatient hospital services for up to 120 days during any spell of illness; post-hospital extended care services for up to 100 days during any spell of illness; post-hospital home health services for up to 175 visits after the beginning of one spell of illness and before the beginning of the next; and outpatient hospital diagnostic services.
Section 1812(b) provides that payment may not be made for inpatient hospital services furnished to an individual for more than 120 days; or for post-hospital extended care services for more than 100 days; or for inpatient psychiatric hospital services for more than 210 days during their entire lifetime.
Section 1812(c) provides that if an individual is an inpatient of a psychiatric or a tuberculosis hospital on the first day for which he or she is entitled to benefits under Part A, days spent as an inpatient of such a hospital in the 120-day period immediately before such first day will be included in determining the 120-day limit on inpatient hospital services.
Section 1812(d) provides that payment may be made under Part A for post-hospital home health services furnished an individual only during the 1-year period following the most recent hospital or extended care facility discharge.
Section 1812(e) provides that inpatient hospital services, post-hospital extended care services, and post-hospital home health services will be taken into account for purposes of the limits on duration of coverage.
Section 1812(f) contains a cross reference to the definitions of the terms used in Part A which are found in Section 1861.
Section 1813(a)(1) provides that the amount payable for inpatient hospital services will be reduced by the inpatient hospital deductible or, if less, by the charges imposed for such services or the customary charges for such services, whichever is greater.
Section 1813(a)(2) provides that the amount payable with respect to outpatient hospital diagnostic services shall be reduced by a deduction equal to the sum of one-half the amount of the inpatient hospital deductible and by 20% of the remainder of the amount payable.
Section 1813(a)(3) provides that the amount payable to any provider of services under Part A shall be reduced by an amount equal to the cost of the first three pints of whole blood furnished to an individual during a spell of illness.
Section 1813(a)(4) provides that the amount payable for post-hospital extended care services will be reduced by a deduction equal to ⅛ of the inpatient hospital deductible for each day such services are furnished after the 20 th day but before the 101 st.
Section 1813(b)(1) provides that the inpatient hospital deductible is $40 for any spell of illness and $20 for any diagnostic study beginning before 1969.
Section 1813(b)(2) provides that the HEW Sec. shall, between 7/1/68 – 10/1/68, and of each year thereafter, determine and promulgate the inpatient hospital deductible which is to be applicable in the case of any spell of illness or diagnostic study beginning during the succeeding CY.
Section 1814(a)(1) requires that a written request, signed by the individual who receives the services or by another person when it is impracticable for them to do so, be filed for payment for covered services to providers.
Section 1814(a)(2)(A) requires that a physician certify that in the case of inpatient hospital services, the services were required to be given on an inpatient basis for medical treatment, or inpatient diagnostic study was medically required.
Section 1814(a)(2)(B) requires that a physician certify that in the case of inpatient psychiatric hospital services, the services were required to be given on an inpatient basis, by or under the supervision of a physician, and such treatment could reasonably be expected to improve the condition or inpatient diagnostic study was medically required.
Section 1814(a)(2)(C) requires that a physician certify that in the case of inpatient tuberculosis hospital services, the services were required to be given on an inpatient basis by or under the supervision of a physician for the treatment of tuberculosis, and the treatment can be reasonably expected to improve the condition or render it non-communicable.
Section 1814(a)(2)(D) requires that a physician certify that in the case of post-hospital extended care services, the services were required to be given on an inpatient basis because the individual needed skilled nursing care on a continuing basis for a condition for which he or she was hospitalized prior to transfer to the extended care facility, or which arose while receiving such care for such a condition.
Section 1814(a)(2)(E) requires that a physician certify that in the case of post-hospital home health services, the services were required because the individual was confined to his or her home and needed intermittent skilled nursing care, or physical or speech therapy, or post-hospital extended care services, and the services were furnished while the individual was under the care of a physician and under a plan established and reviewed periodically by a physician.
Section 1814(a)(2)(F) requires that a physician certify that in the case of outpatient hospital diagnostic services, the services were required for diagnostic study.
Section 1814(a)(3) provides that, in the case of inpatient psychiatric hospital services, payment may be made only if the services are those which the records of the hospital indicate were furnished during periods when the individual was receiving intensive treatment services, services necessary for diagnostic study, or similar services.
Section 1814(a)(4) provides that, in the case of inpatient tuberculosis hospital services, payment may be made only if the services are those which hospital records indicate were furnished during periods when the individual was receiving treatment which could reasonably be expected to improve his or her condition or render it non- communicable.
Section 1814(a)(5) provides that payment may not be made for inpatient hospital services furnished an individual after the 20 th day of a continuous stay or for post-hospital extended care services furnished continuously after a finding that the hospital or extended care facility is not making the necessary utilization reviews of long-stay cases.
Section 1814(a)(6) provides that payment may not be made for inpatient hospital services or post-hospital extended care services furnished an individual during a continuous period after a finding by the physician members of the appropriate utilization review committee that further inpatient hospital services or post-hospital extended care services are medically unnecessary.
Section 1814(b) provides that the amount to be paid any provider for services under Part A is the reasonable cost of such services, as determined under Section 1861(v).
Section 1814(c) provides that no payment is to be made to a Federal provider of services, except for emergency services, unless the HEW Sec. determines that the provider is furnishing services to the public generally as a community institution or agency.
Section 1814(d) provides that payment may be made for emergency hospital services, in the absence of an agreement required between the HEW Sec. and the hospital, to the extent that the HEW Sec. would be required to make payment if the hospital had such an agreement in effect and otherwise meets the conditions of payment, and the hospital would have to agree not to charge the patient for the emergency services as a condition of payment under this provision.
Section 1814(e) provides that if a hospital has acted reasonably and in good faith in assuming that an individual was entitled to have payment made for inpatient hospital services under Part A, the hospital can receive payment for such services furnished to the individual, even though they are not entitled to have such payment made, prior to notification from the HEW Sec. that the individual is not so entitled, provided that the individual has used up his or her 120 days of entitlement to inpatient hospital services.
Section 1814(f) provides that the authority relating to payments for emergency hospital services, will be applicable to emergency hospital services furnished by a hospital located outside the U.S. if the individual was present in the U.S. at the time the emergency occurred and the hospital outside the U.S. was closer to the place where the emergency arose.
Section 1815 provides that the HEW Sec. will determine the amounts to be paid to providers of services under Part A from the Federal Hospital Insurance Trust Fund.
Section 1816(a)(1) provides that the HEW Sec. may enter into an agreement with an agency or organization providing for the determination of amounts to be paid under Part A to provide consultative services to enable them to establish and maintain fiscal records and otherwise to qualify as participants in the program.
Section 1816(a)(2) provides that the HEW Sec. may enter into an agreement with an agency or organization providing for the determination of amounts to be paid under Part A to serve as a center for communications between the providers covered under the agreement and the HEW Sec. and make such audits of the records of such providers as may be necessary.
Section 1816(b) provides that the HEW Sec. is not to enter into an agreement with an agency or organization unless it is found that to do so is consistent with effective and efficient administration, the agency or organization is willing and able to assist the providers in the application of safeguards against unnecessary utilization of services, and the agency or organization agrees to furnish to the HEW Sec. such information acquired by it in carrying out its agreement.
Section 1816(c) provides that an agreement with an agency or organization may contain such terms and conditions as the HEW Sec. finds necessary or appropriate and may provide for advances of funds to the agency or organization for making payments to providers of services.
Section 1816(d) provides that if the nomination of an agency or organization is made by a group or association of providers of services, it will not be binding on members of such group or association which notify the HEW Sec. of their election to that effect.
Section 1816(e)(1) provides that an agreement with the HEW Sec. under this section may be terminated by the agency or organization which entered into such agreement at such time and upon such notice to the HEW Sec., to the public, and to the providers as may be provided in regulations.
Section 1816(e)(2) provides that an agreement with the HEW Sec. under this section may be terminated by the HEW Sec. at such time and upon such notice to the agency or organization, to the providers, and to the public after finding that the agency or organization has failed to carry out the agreement, or the continuation of the agreement is inconsistent with the efficient administration of this part.
Section 1816(f) provides that an agreement with any agency or organization may require any of its officers or employees who are participating in carrying out the agreement to give surety bond to the U.S. in such amount as the HEW Sec. may deem appropriate.
Section 1816(g)(1) provides that no individual designated pursuant to such an agreement as a certifying officer will, in the absence of gross negligence or intent to defraud the U.S., be liable for any payments incorrectly certified by them.
Section 1816(g)(2) provides a similar immunity for disbursing officers who make an incorrect payment based upon a voucher signed by a certifying officer designated as provided in paragraph (g)(1).
Section 1816(g)(3) provides that no agency or organization will be liable to the U.S. for any payments referred to in paragraph (g)(1) or (g)(2).
Section 1817(a) creates the Federal Hospital Trust Fund, which will consist of amounts deposited in or appropriated to it as provided in Part A.
Section 1817(a)(1) provides that for the FY ending 6/30/66, and for each FY thereafter, there are appropriated to the Trust Fund amounts equal to the taxes imposed by Sections 3101(b) and 3111(b) of the Internal Revenue Code (IRC) of 1954 on wages reported to the Treasury Sec. after 12/31/65.
Section 1817(a)(2) provides that for the FY ending 6/30/66, and for each FY thereafter, there are appropriated to the Trust Fund amounts equal to the taxes imposed by section 1401(b) of the IRC of 1954 on self-employment income reported to the Treasury Sec. on tax returns.
Section 1817(b) creates the Board of Trustees of the Trust Fund, to be composed of the Treasury Sec., the Labor Sec., and the HEW Sec., with the Treasury Sec. as the Managing Trustee, and the COSS serving as the Secretary of the Board. The Board will meet no less frequently than once each CY and shall hold the Trust Fund; report to Congress not later than the first day of March of each year on the operation and status of the Trust Fund during the preceding FY and on its expected operation and status during the current FY and the next two FYs; report immediately to Congress whenever the Board is of the opinion that the amount of the Trust Fund is unduly small; and review the general policies followed in managing the Trust Fund, and recommend changes in such policies, including necessary changes in the provisions of law which govern the way in which the Trust Fund is to be managed.
Section 1817(c) provides that it is the duty of the Managing Trustee to invest the portion of the Trust Fund which, in his or her judgment, is not required to meet current withdrawals.
Section 1817(d) provides that any obligations acquired by the Trust Fund may be sold by the Managing Trustee at the market price, except public debt obligations issued exclusively to the Trust Fund, which may be redeemed at par plus accrued interest.
Section 1817(e) provides that the interest on and proceeds from the sale of any obligations held in the Trust Fund will be credited to and form a part of the fund.
Section 1817(f)(1) directs the Managing Trustee to pay from time to time from the Trust Fund into the Treasury the amount estimated by them as taxes imposed under Section 3101(b) of the IRC of 1954 which are subject to refund under Section 6413(c) of the Code with respect to wages paid after 12/31/65.
Section 1817(f)(2) provides that repayments under paragraph (f)(1) will not be available for expenditures but will be carried to the surplus fund of the Treasury.
Section 1817(g) provides for the transfer at least once each FY to the Trust Fund, from the OASI Trust Fund and the DI Trust Fund, of amounts equal to the amounts certified as overpayments. It also provides for the transfer at least once each FY to the Trust Fund from the Railroad Retirement account of amounts equal to the amounts certified as overpayments to the Railroad Retirement Board.
Section 1817(h) provides that the Managing Trustee will also pay from time to time from the Trust Fund such amounts as the HEW Sec. certifies are necessary to pay the benefits provided by Part A and certain administrative expenses.
Part B – Supplementary Medical Insurance Benefits for the Aged
Section 1831 establishes a voluntary medical insurance program for individuals aged 65 or over who elect to enroll under such program, to be financed from premium payments by enrollees together with contributions from funds appropriated by the Federal Government.
Section 1832(a)(1) provides that the benefits made available to an individual under the insurance program established by Part B consist of entitlement to have payment made to them or on their behalf for medical and other health services not furnished by a provider of services.
Section 1832(a)(2) provides that the benefits made available to an individual under the insurance program established by Part B consist of entitlement to have payment made on his or her behalf for home health services for up to 100 visits during a CY; and medical and other services furnished by a provider of services.
Section 1832(b) contains a cross reference to the definitions of “spell of illness”, “medical and other health services”, and other terms used in Part B which are found in Section 1861.
Section 1833(a) provides for the amount of payment that will be made from the Federal Supplementary Medical Insurance Trust Fund in the case of each individual covered under the insurance program established by Part B who incurs expenses for services.
Section 1833(a)(1) provides that payment will be made for 80% of the reasonable charges for medical and other health services; except that an organization which provides medical and other health services on a prepayment basis may elect to be paid 80% of the reasonable cost of services for which payment may be made under Part B on behalf of individuals enrolled in such organizations.
Section 1833(a)(2) provides that payment will be made for 80% of the reasonable cost of home health services and medical and other health services.
Section 1833(b) provides that, before any payment is made by the program for covered expenses incurred by an individual during any Calendar Year (CY), the individual must meet a deductible of $50.
Section 1833(c) provides that expenses incurred in any CY for the treatment of mental, psychoneurotic, and personality disorders of an individual who is not an inpatient of a hospital at the time will be considered as incurred expenses only to the extent of $312.50 or 62.5% of the expenses, whichever is smaller.
Section 1833(d) provides that payment may not be made under Part B for services if such individual is entitled to have payment made for those services under Part A.
Section 1833(e) provides that no payment will be made under Part B unless the information necessary to determine the amounts due has been furnished.
Section 1834(a) provides that payment may not be made under Part B for more than 100 home health services visits during any CY.
Section 1834(b) provides that home health services will be taken into account for purposes of the limits on duration of coverage only if payment under Part B is made or would be made if the services had been furnished within such limits and the request and certification requirements had been met for such services.
Section 1835(a) provides that payment for home health services and medical and other health services may be made only to providers of services which have an agreement with the HEW Sec. and only if the requirements with respect to requests and certifications are satisfied.
Section 1835(a)(1) requires that a written request be filed for home health services and medical and other health services payments. Section 1835(a)(2)(A) requires that a physician certify that in the case of home health services, the services were required because the individual was confined home and needed intermittent skilled nursing care, or physical or speech therapy, and the services were furnished while the individual is or was under the care of a physician and under a plan established and reviewed periodically by a physician.
Section 1835(a)(2)(B) requires that a physician certify that in the case of medical and other health services, the services were medically required.
Section 1835(b) provides that no payment is to be made under Part B to a Federal provider of services unless the HEW Sec. determines that the provider is furnishing services to the public generally as a community institution or agency.
Section 1836 provides that every individual who has attained the age of 65 and is a resident of the U.S., and is a citizen or is an alien lawfully admitted for permanent residence who has resided in the U.S. continuously during the 5 years immediately preceding the month he or she applies for enrollment, is eligible to enroll in the insurance program established by Part B.
Section 1837(a) provides that an individual may enroll in the insurance program established by Part B only in such manner and form as may be prescribed in regulations, and during an enrollment period described in this section.
Section 1837(b)(1) provides that no individual may enroll for the first time under Part B more than three years after the close of the first enrollment period during which he or she could have enrolled.
Section 1837(b)(2) provides that an individual whose enrollment under Part B has terminated may not enroll for a second time unless he or she does so in a general enrollment period which begins within three years after the effective date of such termination. No individual may enroll under Part B more than twice.
Section 1837(c) provides that the initial general enrollment period is to begin on 4/1/66, and is to end on 9/30/66, and will be open to individuals who meet the eligibility requirements of Section 1836 before 7/1/66.
Section 1837(d) provides that the initial enrollment period for an individual who first meets the eligibility requirements of Section 1836 on or after 01/01/66, is to begin on the first day of the third month before the month in which he or she first meets the eligibility requirements and is to end seven months later.
Section 1837(e) provides that there is to be a general enrollment period from 10/1 to 12/31 of each odd-numbered year beginning with 1967.
Section 1838(a)(1) provides that an individual’s coverage under Part B may begin on 7/1/66 or whichever of the following dates is the latest.
Section 1838(a)(2)(A) provides that an individual’s coverage under Part B may begin, in the case of an individual who enrolls pursuant to Section 1837(d) before the month in which he or she first satisfies the eligibility requirements of Section 1836, the first day of such month.
Section 1838(a)(2)(B) provides that an individual’s coverage under Part B may begin, in the case of an individual who enrolls pursuant to Section 1837(d) in the month in which he or she first satisfies the eligibility requirements of Section 1836, the first day of the month following the month in which he or she so enrolls.
Section 1838(a)(2)(C) provides that an individual’s coverage under Part B may begin, in the case of an individual who enrolls pursuant to Section 1837(d) in the month following the month in which he or she first satisfies the eligibility requirements of Section 1836, the first day of the second month following the month in which he or she so enrolls.
Section 1838(a)(2)(D) provides that an individual’s coverage under Part B may begin, in the case of an individual who enrolls pursuant to Section 1837(d) more than one month following the month in which he or she first satisfies the eligibility requirements of Section 1836, the first day of the third month following the month in which he or she enrolls.
Section 1838(a)(2)(E) provides that an individual’s coverage under Part B may begin, in the case of an individual who enrolls pursuant to Section 1837(e), the 7/1 following the month in which he or she enrolls.
Section 1838(b) provides that an individual’s coverage period will continue until his or her enrollment has been terminated by the filing of notice, during a general enrollment period, that he or she no longer wishes to participate in the program, or for nonpayment of premiums. The filing of such notice will terminate coverage at the close of 12/31 of the year in which the notice is filed. The termination for nonpayment of premiums will take effect on a date determined under regulations, which may provide a grace period of up to 90 days during which overdue premiums may be paid and the coverage period continued.
Section 1838(c) provides that payment may be made under Part B only for expenses incurred by an individual during his or her coverage period.
Section 1839(a) provides that the monthly premium for each individual enrolled under Part B for each month before 1968 is to be $3.
Section 1839(b)(1) provides that for each month after 1967 the amount of the monthly premium of each individual enrolled under Part B will be determined by Section 1839(b)(2).
Section 1839(b)(2) provides that the HEW Sec. shall, between 7/1 and 10/1 of 1967 and of each odd-numbered year thereafter, determine and promulgate the dollar amount which shall be applicable for premiums for months occurring in either of the two succeeding CYs. Such dollar amount will be equal to one-half of the total of the benefits and administrative costs which will be payable from the Federal Supplementary Medical Insurance Trust Fund for such two succeeding CYs.
Section 1839(c) provides that in the case of an individual whose coverage period began pursuant to an enrollment after his or her initial enrollment period, the monthly premium shall be increased by 10% of the monthly premium so determined for each 12 full months in which he or she could have been but was not enrolled. Section 1839(d) provides that if any monthly premium determined under the preceding provisions of this section is not a multiple of 10 cents, it is to be rounded to the nearest multiple of 10 cents.
Section 1840(a)(1) provides that the monthly premium of an individual who is entitled to monthly Social Security benefits is to be collected by deducting the premium from the amount of such benefits.
Section 1840(a)(2) provides that the Treasury Sec. is to transfer periodically from the OASI Trust Fund, and from the DI Trust Fund, to the Federal Supplementary Medical Insurance Trust Fund, the total amount deducted under Section 1840(a)(1).
Section 1840(b)(1) provides that the monthly premium of an individual who is entitled to receive an annuity or pension for a month under the Railroad Retirement Act of 1937 is to be collected by deducting the premium from such annuity or pension.
Section 1840(b)(2) provides that the Treasury Sec. is to transfer periodically from the Railroad Retirement account to the Federal Supplementary Medical Insurance Trust Fund the total amount deducted under Section 1840(b)(1).
Section 1840(c) provides that if an individual is entitled both to monthly Social Security benefits and to an annuity or pension under the Railroad Retirement Act of 1937 at the time he or she enrolls in Part B, or if he or she becomes simultaneously entitled both to such benefits and such annuity or pension after he or she enrolls, Section 1840(a) will apply; except that in the latter case, if the first month for which he or she was entitled to Social Security benefits was later than the first month for which he or she was entitled to a Railroad Retirement annuity or pension, then Section 1840(b) will apply.
Section 1840(d) provides that if an individual estimates that the amount which will be available for deduction under Section 1840(a) or 1840(b) for any premium payment period will be less than the amount of the monthly premiums during that period, he or she may pay such portion of the monthly premiums for such period he or she desires.
Section 1840(e)(1) provides that in the case of an individual receiving an annuity under the Civil Service Retirement Act or under another act administered by the Civil Service Commission, to whom neither Section 1840(a) nor 1840(b) applies, his or her monthly premiums under Part B will be collected by deducting the premium amount from each installment of the annuity.
Section 1840(e)(2) provides that the Treasury Sec. is to transfer periodically but not less often than quarterly from the Civil Service Retirement and Disability Fund, or the account applicable in the case of such other Act administered by the Civil Service Commission, to the Federal Supplementary Medical Insurance Trust Fund the total amount deducted under Section 1840(e)(1).
Section 1840(f) provides that in the case of an individual who participates in the insurance program established by Part B but to whom none of the preceding provisions of Section 1840 applies, except for subsection (d), the premiums are to be at such times and in such manner as may be prescribed by regulations.
Section 1840(g) provides that amounts paid under Section 1840(d) or 1840(f) are to be deposited in the Treasury to the credit of the Federal Supplementary Medical Insurance Trust Fund.
Section 1840(h) provides that the premiums for an individual enrolled under Part B will be payable for the period commencing with the first month of his or her coverage period and ending with the month in which he or she dies or, if earlier, in which his or her coverage period ends.
Section 1841(a) creates the Federal Supplementary Medical Insurance Trust Fund, which will consist of amounts deposited in or appropriated to it as provided in Part B.
Section 1841(b) creates the Board of Trustees of the Trust Fund, which is to meet at least once each CY and will be composed of the Treasury Sec., the Labor Sec., and the HEW Sec, with the Treasury Sec. serving as the Managing Trustee and the COSS serving as the Secretary of the Board. It shall be the duty of the Board to hold the Trust Fund; report to the Congress not later than the first day of March of each year on the operation and status of the Trust Fund during the preceding Fiscal Year (FY) and on its expected operation and status during the current FY and the next two FYs; report immediately to the Congress whenever the Board is of the opinion that the amount of the Trust Fund is unduly small; and review the general policies followed in managing the Trust Fund, and recommend changes in such policies, including necessary changes in the provisions of law which govern the way in which the Trust Fund is to be managed.
Section 1841(c) provides that it is the duty of the Managing Trustee to invest the portion of the Trust Fund which is not required to meet current withdrawals.
Section 1841(d) provides that any obligations acquired by the Trust Fund may be sold by the Managing Trustee at the market price, except public-debt obligations issued exclusively to the Trust Fund, which may be redeemed at par plus accrued interest.
Section 1841(e) provides that the interest on and proceeds from the sale of any obligations held in the Trust Fund will be credited to and form a part of the fund.
Section 1841(f) provides for the transfer at least once each FY to the Trust Fund, from the OASI Trust Fund and the DI Trust Fund, of amounts equal to the amounts certified as overpayments. It also provides for the transfer at least once each FY to the Trust Fund from the Railroad Retirement account of amounts equal to the amounts certified as overpayments.
Section 1841(g) provides that the Managing Trustee will also from the Trust Fund such amounts as the HEW Sec. certifies are necessary to make the payments provided for Part B and the payments for administrative expenses.
Section 1841(h) provides that the Managing Trustee will also pay from the Trust Fund such amounts as the HEW Sec. certifies are necessary to pay the costs incurred by the Civil Service Commission in making deductions.
Section 1842(a) provides that in order to carry out the administration of the voluntary Medical Insurance Program established by Part B with maximum efficiency and convenience for individuals entitled to benefits under Part B and for providers of services and persons furnishing services to such individuals, the HEW Sec. is authorized to enter contracts with carriers which will undertake to perform some or all of the functions listed in this section.
Section 1842(a)(1) provides that the carriers under contract will make determinations of the rates and amounts of payments required pursuant to Part B to be made to providers of services on a reasonable cost basis; receive, disburse, and account for funds in making such payments; and make audits of the records of providers of services necessary to assure that proper payments are made to them under Part B.
Section 1842(a)(2) provides that the carriers will determine compliance with the requirements of Section 1861(k) as to utilization review, and assist providers who furnish services for which payment may be made under Part B.
Section 1842(a)(3) provides that the carriers will serve as a channel of communication of information relating to the administration of the voluntary Medical Insurance Program under Part B.
Section 1842(a)(4) provides that the carriers will assist in discharging other necessary administrative duties, as may be provided in the contract.
Section 1842(b)(1) provides that contracts with carriers may be entered into without regard to Section 3709 of the Railroad Statutes or any other provision of law requiring competitive bidding.
Section 1842(b)(2) provides that the HEW Sec. is not to enter into a contract with a carrier unless he or she finds that the carrier will perform its obligations under the contract efficiently and effectively and will meet such requirements relating to financial responsibility and legal authority.
Section 1842(b)(3)(A) provides that each contract must provide that the carrier will take necessary action to assure that, the cost is reasonable where payment under Part B is on a cost basis.
Section 1842(b)(3)(B) provides that each contract must provide that the carrier will take necessary action to assure that, where payment under Part B for a service is on a charge basis, such charge will be reasonable and not higher than the charge applicable to the policyholders and subscribers of the carrier, and such payment will be made on the basis of a receipted bill.
Section 1842(b)(3)(C) provides that each contract must provide that the carrier will establish and maintain procedures under which an individual enrolled under Part B will be entitled to a fair hearing by the carrier when request for payment is denied or is not acted upon with reasonable promptness or when the amount of payment is in controversy.
Section 1842(b)(3)(D) provides that each contract must provide that the carrier will furnish to the HEW Sec. such timely information and reports as may be necessary for the HEW Sec. to perform his or her functions under Part B.
Section 1842(b)(3)(E) provides that each contract must provide that the carrier will maintain and afford access to whatever records the HEW Sec. finds necessary to assure the correctness and verification of the information and reports furnished to carry out the purposes of Part B.
Section 1842(b)(4) provides that each contract must be for the term of at least one year, and may be made automatically renewable unless either party provides notice of intent to terminate the contract at the end of its current term
Section 1842(c) provides that each contract is to provide for advances of funds to the carrier for the making of payments by it under Part B, and for payment of the necessary and proper administrative costs of the carrier.
Section 1842(d) provides that any contract may require a carrier or any of its officers or employees certifying payments or disbursing funds pursuant to the contract to give surety bond to the U.S. in such amount as the HEW Sec. may deem appropriate.
Section 1842(e)(1) provides that no individual designated pursuant to a contract as a certifying officer will, in the absence of gross negligence or intent to defraud the U.S., be liable for any payments incorrectly certified.
Section 1842(e)(2) provides a similar immunity for disbursing officers who make an incorrect payment based upon a voucher signed by a certifying officer.
Section 1842(e)(3) provides that no carrier will be liable to the U.S. for any payments referred to in Section 1842(e)(1) or 1842(e)(2).
Section 1842(f)(1) provides that, for purposes of Part B, the term “carrier” means with respect to providers of services and other persons, a voluntary association, corporation, or partnership, or other nongovernmental organization which is lawfully engaged in providing, paying for, or reimbursing the cost of health services under group insurance policies or contracts, medical or hospital service agreements, membership or subscription contracts, or similar group arrangements, in consideration of premiums or other periodic charges payable to the carrier, including a health benefits plan duly sponsored or underwritten by an employee organization.
Section 1842(f)(2) provides that, for purposes of Part B, the term “carrier” means with respect to providers of services only, any agency or organization with which an agreement is in effect under Section 1816.
Section 1843(a) provides that the HEW Sec., at the request of a State made before 1/1/68, will enter into an agreement with such State to provide coverage under Part B for all eligible individuals who are in a coverage group elected by the State.
Section 1843(b)(1) provides that the agreement entered into with any State may be applicable to individuals receiving money payments under the plan of such State approved under Title I or Title XVI of the Social Security Act.
Section 1843(b)(2) provides that the agreement entered into with any State may be applicable to individuals receiving money payments under all of the plans of such State approved under Titles I, IV, X, XIV, and XVI of the Social Security Act.
Section 1843(c) provides that an individual shall be treated as an eligible individual only if he or she is eligible on the date an agreement covering him or her is entered into or he or she becomes an eligible individual at any time after such date and before 1/1/68.
Section 1843(d)(1) provides that in the case of any individual enrolled pursuant to this section, the monthly premium to be paid by the State shall be determined by Section 1839.
Section 1843(d)(2) provides that in the case of an individual enrolled pursuant to this section, his or her coverage period shall begin on 7/1/66, the first day of the third month following the month in which the State agreement is entered into, the first day of the first month in which he or she is both an eligible individual and a member of a coverage group specified in the agreement under this section, or such date as may be specified in the agreement, whichever is the latest.
Section 1843(d)(3) provides that in the case of an individual enrolled pursuant to this section, his or her coverage period attributable to the agreement with the State under this section shall end on the last day of the month in which he or she is determined by the State agency to have become ineligible for money payments of a kind specified in the agreement, or the month preceding the first month for which he or she becomes entitled to monthly benefits under Title II of the Social Security Act or to an annuity or pension under the Railroad Retirement Act of 1937, whichever first occurs.
Section 1843(e) provides that any individual whose coverage period attributable to the State agreement is terminated pursuant to Section 1843(d)(3) shall be deemed for purposes of this part to have enrolled under the Section 1837 in the initial general enrollment period provided by Section 1837(c).
Section 1843(f) provides that with respect to eligible individuals receiving money payments under a State approved plan the term “carrier” also includes the State agency, which administers or supervises the administration of the plan of such State.
Section 1844(a) authorizes the appropriation from time to time of a Government contribution, equal to the total premiums payable by individuals who have enrolled under Part B, from the Treasury to the Federal Supplementary Insurance Trust Fund.
Section 1844(b) provides that in order to assure prompt payment of benefits and administrative expenses under Part B during the early months of the program, and to provide a contingency reserve, there is also authorized to be appropriated for repayable advances to the Trust Fund, an amount equal to $18 multiplied by the number of individuals who could be covered in 7/66 by the insurance program established by this part if they had theretofore enrolled under this part.
Part C – Miscellaneous Provisions
Section 1861(a)(1) defines the term “spell of illness” as a period of consecutive days beginning with the first day on which such individual is furnished inpatient hospital services or extended care services, and which occurs in a month for which he or she is entitled to benefits under Part A.
Section 1861(a)(2) defines the term “spell of illness” with respect to any individual as a period of consecutive days ending with the close of the first period of 60 consecutive days thereafter on each of which he or she is neither an inpatient of a hospital nor an inpatient of an extended care facility.
Section 1861(b) defines the term “inpatient hospital services” as bed and board; such nursing services and other related services, such use of hospital facilities, and such medical social services as are ordinarily furnished by the hospital for the care and treatment of inpatients, and such drugs, supplies, appliances, and equipment, for use in the hospital; such other diagnostic or therapeutic items or services, furnished by the hospital; excluding however medical or surgical services provided by a physician, resident, or intern; and the services of a private-duty nurse or other private-duty attendant, provided by the hospital.
Section 1861(c) defines the term “inpatient psychiatric hospital services” to mean inpatient hospital services furnished to an inpatient of a psychiatric hospital.
Section 1861(d) defines the term “inpatient tuberculosis hospital services” to mean inpatient hospital services furnished to an inpatient of a tuberculosis hospital.
Section 1861(e)(1) defines the term “hospital” to mean an institution which is primarily engaged in providing, by or under the supervision of physicians, to inpatients diagnostic services and therapeutic services for medical diagnosis, treatment, and care of injured, disabled, or sick persons, or rehabilitation services for the rehabilitation of injured, disabled, or sick persons.
Section 1861(e)(2) defines the term “hospital” to mean an institution which maintains clinical records on all patients.
Section 1861(e)(3) defines the term “hospital” to mean an institution which has bylaws in effect with respect to its staff of physicians.
Section 1861(e)(4) defines the term “hospital” to mean an institution which has a requirement that every patient must be under the care of a physician.
Section 1861(e)(5) defines the term “hospital” to mean an institution which provides 24-hour nursing service rendered or supervised by a registered professional nurse, and has a licensed practical nurse or registered professional nurse on duty at all times.
Section 1861(e)(6) defines the term “hospital” to mean an institution which has in effect a hospital utilization review plan which meets certain requirements.
Section 1861(e)(7) defines the term “hospital” to mean an institution which in the case of an institution in any State in which State or applicable local law provides for the licensing of hospitals, is licensed pursuant to such law or is approved, by the agency of such State or locality responsible for licensing hospitals, as meeting the standards established for such licensing.
Section 1861(e)(8) defines the term “hospital” to mean an institution which meets such other requirements as the HEW Sec. finds necessary in the interest of the health and safety of individuals who are furnished services in the institution, except that such other requirements may not be higher than the comparable requirements prescribed for the accreditation of hospitals by the Joint Commission on Accreditation of Hospitals.
Section 1861(f)(1) defines the term “psychiatric hospital” to mean an institution which is primarily engaged in providing, by or under the supervision of a physician, psychiatric services for the diagnosis and treatment of mentally ill persons.
Section 1861(f)(2) defines the term “psychiatric hospital” to mean an institution which satisfies the requirements of Sections 1861(e)(3) through 1861(e)(8).
Section 1861(f)(3) defines the term “psychiatric hospital” to mean an institution which maintains clinical records on all patients and maintains such records as the HEW Sec. finds to be necessary to determine the degree and intensity of the treatment provided to individuals entitled to hospital insurance benefits under Part A.
Section 1861(f)(4) defines the term “psychiatric hospital” to mean an institution which meets such staffing requirements as the HEW Sec. finds necessary for the institution to carry out an active program of treatment for individuals who are furnished services in the institution.
Section 1861(f)(5) defines the term “psychiatric hospital” to mean an institution which is accredited by the Joint Commission on Accreditation of Hospitals.
Section 1861(g)(1) defines the term “tuberculosis hospital” to mean an institution which is primarily engaged in providing, by or under the supervision of a phyician, medical services for the diagnosis and treatment of tuberculosis.
Section 1861(g)(2) defines the term “tuberculosis hospital” to mean an institution which satisfies the requirements of Sections 1861(e)(3) through 1861(e)(8).
Section 1861(g)(3) defines the term “tuberculosis hospital” to mean an institution which maintains clinical records on all patients and maintains such records as the HEW Sec. finds to be necessary to determine the degree and intensity of the treatment provided to individuals covered by the insurance program established by Part A.
Section 1861(g)(4) defines the term “tuberculosis hospital” to mean an institution which meets such staffing requirements as the HEW Sec. finds necessary for the institution to carry out an active program of treatment for individuals who are furnished services in the institution.
Section 1861(g)(5) defines the term “tuberculosis hospital” to mean an institution which is accredited by the Joint Commission on Accreditation of Hospitals.
Section 1861(h)(1) defines the term “extended care services” to mean nursing care provided by or under the supervision of a registered professional nurse.
Section 1861(h)(2) defines the term “extended care services” to mean bed and board in connection with the furnishing of such nursing care.
Section 1861(h)(3) defines the term “extended care services” to mean physical, occupational, or speech therapy furnished by the extended care facility or by others under arrangements with them by the facility.
Section 1861(h)(4) defines the term “extended care services” to mean medical social services.
Section 1861(h)(5) defines the term “extended care services” to mean such drugs, supplies, appliances, and equipment, furnished for use in the extended care facility, as are ordinarily furnished by such facility for the care and treatment of inpatients.
Section 1861(h)(6) defines the term “extended care services” to mean medical services provided by an intern or resident-in-training of a hospital with which the facility has in effect a transfer agreement, under a teaching program of such hospital approved as provided in Section 1861(b), and other diagnostic or therapeutic services provided by a hospital with which the facility has such an agreement in effect.
Section 1861(h)(7) defines the term “extended care services” to mean such other services necessary to the health of the patients as are generally provided by extended care facilities.
Section 1861(i) defines the term “post-hospital extended care services” to mean extended care services furnished an individual after transfer from a hospital in which he or she was an inpatient for not less than three consecutive days before his or her discharge from the hospital in connection with such transfer.
Section 1861(j)(1) defines the term “extended care facility” to mean an institution which is primarily engaged in providing to inpatients skilled nursing care and related services for patients who require medical or nursing care, or rehabilitation services for the rehabilitation of injured, disabled, or sick persons.
Section 1861(j)(2) defines the term “extended care facility” to mean an institution which has policies, which are developed with the advice of a group of professional personnel, including one or more physicians and one or more registered professional nurses, to govern the skilled nursing care and related medical or other services it provides.
Section 1861(j)(3) defines the term “extended care facility” to mean an institution which has a physician, a registered professional nurse, or a medical staff responsible for the execution of such policies.
Section 1861(j)(4) defines the term “extended care facility” to mean an institution which has a requirement that the health care of every patient must be under the supervision of a physician, and provides for having a physician available to furnish necessary medical care in case of emergency.
Section 1861(j)(5) defines the term “extended care facility” to mean an institution which maintains clinical records on all patients.
Section 1861(j)(6) defines the term “extended care facility” to mean an institution which provides 24-hour nursing service which is sufficient to meet nursing needs in accordance with the policies developed as provided in Section 1861(j)(2), and has at least one registered professional nurse employed full time.
Section 1861(j)(7) defines the term “extended care facility” to mean an institution which provides appropriate methods and procedures for the dispensing and administering of drugs.
Section 1861(j)(8) defines the term “extended care facility” to mean an institution which has in effect a utilization review plan which meets the requirements of Section 1861(k).
Section 1861(j)(9) defines the term “extended care facility” to mean an institution which in the case of an institution in any State in which State or applicable local law provides for the licensing of institutions of this nature, is licensed pursuant to such law, or is approved, by the agency of such State or locality responsible for licensing institutions of this nature, as meeting the standards established for such licensing.
Section 1861(j)(10) defines the term “extended care facility” to mean an institution which meets such other conditions relating to the health and safety of individuals who are furnished services in such institution or relating to the physical facilities thereof as the HEW Sec. may find necessary.
Section 1861(k)(1) provides that a utilization review plan of a hospital or extended care facility shall be considered sufficient if it provides for the review, on a sample or other basis, of admissions to the institution, the duration of stays therein, and the professional services furnished, with respect to the medical necessity of the services, and for the purpose of promoting the most efficient use of available health facilities and services.
Section 1861(k)(2) provides that a utilization review plan of a hospital or extended care facility shall be considered sufficient if it provides for such review to be made by either a staff committee of the institution composed of two or more physicians, with or without participation of other professional personnel, or a group outside the institution which is similarly composed and which is established by the local medical society and some or all of the hospitals and extended care facilities in the locality.
Section 1861(k)(3) provides that a utilization review plan of a hospital or extended care facility shall be considered sufficient if it provides for such review, in each case of inpatient hospital services or extended care services furnished to such individual during a continuous period of extended duration, as of such days of such period as may be specified in regulations, with such review to be made as promptly as possible, after each day so specified, and in no event later than one week following such day.
Section 1861(k)(4) provides that a utilization review plan of a hospital or extended care facility shall be considered sufficient if it provides for prompt notification to the institution, the individual, and his attending physician of any finding by the physician members of such committee or group that any further stay in the institution is not medically necessary.
Section 1861(l)(1) provides that a hospital and an extended care facility shall be considered to have a transfer agreement in effect if transfer of patients will be effected between the hospital and the extended care facility whenever such transfer is medically appropriate as determined by the attending physician.
Section 1861(l)(2) provides that a hospital and an extended care facility shall be considered to have a transfer agreement in effect if there will be interchange of medical and other information necessary or useful in the care and treatment of individuals transferred between the institutions, or in determining whether such individuals can be adequately cared for otherwise than in either of such institutions.
Section 1861(m)(1) defines the term “home health services” to mean part-time or intermittent nursing care provided by or under the supervision of a registered professional nurse.
Section 1861(m)(2) defines the term “home health services” to mean physical, occupational, or speech therapy.
Section 1861(m)(3) defines the term “home health services” to mean medical social services under the direction of a physician.
Section 1861(m)(4) defines the term “home health services” to mean to the extent permitted in regulations, part-time or intermittent services of a home health aide.
Section 1861(m)(5) defines the term “home health services” to mean medical supplies, and the use of medical appliances, while under such a plan.
Section 1861(m)(6) defines the term “home health services” to mean in the case of a home health agency which is affiliated or under common control with a hospital, medical services provided by an intern or resident-in-training of such hospital, under a teaching program of such hospital.
Section 1861(m)(7)(A) defines the term “home health services” to mean any of the foregoing items and services which are provided on an outpatient basis, under arrangements made by the home health agency, at a hospital or extended care facility, or at a rehabilitation center which meets such standards as may be prescribed in regulations, and the furnishing of which involves the use of equipment of such nature that the items and services cannot readily be made available to the individual in such place of residence.
Section 1861(m)(7)(B) defines the term “home health services” to mean any of the foregoing items and services which are provided on an outpatient basis, under arrangements made by the home health agency, at a hospital or extended care facility, or at a rehabilitation center which meets such standards as may be prescribed in regulations, and which are furnished at such facility while the individual is there to receive any such item or service described in clause (A), but not including transportation of the individual in connection with any such item or service.
Section 1861(n) defines the term “post-hospital home health services” to mean home health services furnished an individual within one year after his or her most recent discharge from a hospital of which he or she was an inpatient for not less than three consecutive days or within one year after his or her most recent discharge from an extended care facility of which he or she was an inpatient entitled to payment under Part A for post-hospital extended care services, but only if the plan covering the home health services is established within 14 days after his or her discharge from such hospital or extended care facility.
Section 1861(o)(1) defines the term “home health agency” to mean a public agency which is primarily engaged in providing skilled nursing services and other therapeutic services.
Section 1861(o)(2) defines the term “home health agency” to mean a public agency which has policies, established by a group of professional personnel, including one or more physicians and one or more registered professional nurses, to govern the services which it provides, and provides for supervision of such services by a physician or registered professional nurse.
Section 1861(o)(3) defines the term “home health agency” to mean a public agency which maintains clinical records on all patients.
Section 1861(o)(4) defines the term “home health agency” to mean a public agency which in the case of an agency or organization in any State in which State or applicable local law provides for the licensing of agencies or organizations of this nature, is licensed pursuant to such law, or is approved, by the agency of such State or locality responsible for licensing agencies or organizations of this nature, as meeting the standards established for such licensing.
Section 1861(o)(5) defines the term “home health agency” to mean a public agency which meets such other conditions of participation as the HEW Sec. may find necessary in the interest of the health and safety of individuals who are furnished services by such agency or organization.
Section 1861(p)(1) defines the term “outpatient hospital diagnostic services” to mean diagnostic services which are furnished to an individual as an outpatient by a hospital or by others under arrangements with them made by a hospital.
Section 1861(p)(2) defines the term “outpatient hospital diagnostic services” to mean diagnostic services which are ordinarily furnished by such hospital to its outpatients for the purpose of diagnostic study.
Section 1861(p)(3) excludes from the definition of “outpatient hospital diagnostic services” any item or service if it would not be included under Section 1861(b) if furnished to an inpatient of a hospital.
Section 1861(p)(4) excludes from the definition of “outpatient hospital diagnostic services” any services furnished under such arrangements unless furnished in the hospital or in other facilities operated by or under the supervision of the hospital or its organized medical staff.
Section 1861(q) defines the term “physicians’ services” to mean professional services performed by physicians, including surgery, consultation, and home, office, and institutional calls.
Section 1861(r) defines the term “physician” to mean a doctor of medicine or osteopathy legally authorized to practice medicine and surgery by the State in which he or she performs such function or action.
Section 1861(s)(1) defines the term “medical and other health services” to mean physicians’ services.
Section 1861(s)(2) defines the term “medical and other health services” to mean services and supplies furnished as incident to a physician’s professional service, of kinds which are commonly furnished in physician’s offices and are commonly either rendered without charge or included in the physician’s bills, and hospital services incident to physician’s services rendered to outpatients.
Section 1861(s)(3) defines the term “medical and other health services” to mean diagnostic X-ray tests, diagnostic laboratory tests, and other diagnostic tests. Section 1861(s)(4) defines the term “medical and other health services” to mean X-ray, radium, and radioactive isotope therapy, including materials and services of technicians.
Section 1861(s)(5) defines the term “medical and other health services” to mean surgical dressings, and splints, casts, and other devices used for reduction of fractures and dislocations.
Section 1861(s)(6) defines the term “medical and other health services” to mean rental of durable medical equipment, including iron lungs, oxygen tents, hospital beds, and wheelchairs used in the patient’s home.
Section 1861(s)(7) defines the term “medical and other health services” to mean ambulance service where the use of other methods of transportation is contraindicated by the individual’s condition.
Section 1861(s)(8) defines the term “medical and other health services” to mean prosthetic devices which replace all or part of an internal body organ, including replacement of such devices.
Section 1861(s)(9) defines the term “medical and other health services” to mean leg, arm, back, and neck braces, and artificial legs, arms, and eyes, including replacements if required because of a change in the patient’s physical condition.
Section 1861(s)(10) provides that no diagnostic tests performed in any laboratory which is independent of a physician’s office or a hospital shall be included in Section 1861(s)(3) unless such laboratory is approved by the agency of a State or locality responsible for licensing establishments of such nature.
Section 1861(s)(11) provides that no diagnostic tests performed in any laboratory which is independent of a physician’s office or a hospital shall be included in Section 1861(s)(3) unless such laboratory meets such other conditions relating to the health and safety of individuals with respect to whom such tests are performed as the HEW Sec. may find necessary.
Section 1861(t) defines the term “drugs” to mean only such drugs as are included in the U.S. Pharmacopoeia, the National Formulary, or the U.S. Homeopathic Pharmacopoeia, or in New Drugs or Accepted Dental Remedies, or as are approved by the pharmacy and drug therapeutics committee of the medical staff of the hospital furnishing such drugs for use in such hospital.
Section 1861(u) defines the term “provider of services” to mean a hospital, extended care facility, or home health agency.
Section 1861(v)(1) provides that the reasonable cost of any services shall be determined in accordance with regulations establishing the method or methods to be used, and the items to be included, in determining such costs for various types or classes of institutions, agencies, and services.
Section 1861(v)(2)(A) provides that if the bed and board furnished as part of inpatient hospital services or post-hospital extended care services is in accommodations more expensive than semi-private accommodations, the amount taken into account for purposes of payment under this title with respect to such services may not exceed an amount equal to the reasonable cost of such services if furnished in such semi-private accommodations unless the more expensive accommodations were required for medical reasons.
Section 1861(v)(2(B) provides that where a provider of services furnishes to an individual items or services which are in excess of or more expensive than the items or services with respect to which payment may be made under Part A or Part B, as the case may be, the HEW Sec. shall take into account for purposes of payment to such providers only the equivalent of the reasonable cost of the items or services with respect to which such payment may be made.
Section 1861(v)(3) provides that if the bed and board furnished as part of inpatient hospital services or post-hospital extended care services is not more expensive than semi-private accommodations and was neither at the request of the patient nor for a reason which the HEW Sec. determines is consistent with the purposes of this title, the amount of the payment shall be the reasonable cost of such bed and board furnished in semi-private accommodations minus the difference between the charge customarily made by the hospital or extended care facility for bed and board in semi-private accommodations and the charge customarily made by it for bed and board in the accommodations furnished.
Section 1861(v)(4) defines the term “semi-private accommodations” to mean two-bed, three-bed, or four-bed accommodations.
Section 1861(w) provides that the term “arrangements” is limited to arrangements under which receipt of payment by the hospital, extended care facility, or home health agency, with respect to services for which an individual is entitled to have payment made under this title, discharges the liability of such individual or any other person to pay for the services.
Section 1861(x) provides that the terms “State” and “ U.S.” have the same meaning as when used in Title II of the Social Security Act.
Section 1861(y)(1) provides that the term “extended care facility” also includes a Christian Science sanatorium operated by the First Church of Christ, Scientist, Boston, Massachusetts, but only with respect to items and services ordinarily furnished by such an institution to inpatients.
Section 1861(y)(2)(A) provides that payment under Part A, with respect to Section 1861(y)(1), may not be made for post-hospital extended care services furnished an individual during a spell of illness in an extended care facility after such services have been furnished to him or her for 30 days during such spell, or such services have been furnished to him or her during such spell in an extended care facility to which Section 1861(y)(1) does not apply.
Section 1861(y)(2)(B) provides that payment under Part A, with respect to Section 1861(y)(1), may not be made for post-hospital extended care services furnished an individual during a spell of illness in an extended care facility to which Section 1861(y)(1) does not apply after such services have been furnished to him or her during such spell in an extended care facility to which such section applies.
Section 1861(y)(3) provides that the amount payable under Part A for post-hospital extended care services furnished an individual during any spell of illness in an extended care facility to which Section 1861(y)(1) applies shall be reduced by a coinsurance amount equal to one-eighth of the inpatient hospital deductible for each day before the 31 st day on which he or she is furnished such services in such a facility during such spell.
Section 1861(y)(4) provides that the determination of whether services furnished by or in an institution described in Section 1861(y)(1) constitute post-hospital extended care services shall be made in accordance with and subject to such conditions, limitations, and requirements as may be provided in regulations.
Section 1862(a)(1) provides that no payment may be made under Part A or Part B for any expenses incurred for items or services which are not reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member.
Section 1862(a)(2) provides that no payment may be made under Part A or Part B for any expenses incurred for items or services for which the individual furnished such items or services has no legal obligation to pay, and which no other person has a legal obligation to provide or pay for.
Section 1862(a)(3) provides that no payment may be made under Part A or Part B for any expenses incurred for items or services which are paid for directly or indirectly by a governmental entity, except in such cases as the HEW Sec. may specify.
Section 1862(a)(4) provides that no payment may be made under Part A or Part B for any expenses incurred for items or services which are not provided within the U.S.
Section 1862(a)(5) provides that no payment may be made under Part A or Part B for any expenses incurred for items or services which are required as a result of war, or an act of war, occurring after the effective date of such individual’s current coverage under such part.
Section 1862(a)(6) provides that no payment may be made under Part A or Part B for any expenses incurred for items or services which constitute personal comfort items.
Section 1862(a)(7) provides that no payment may be made under Part A or Part B for any expenses incurred for items or services where such expenses are for routine physical checkups, eyeglasses or eye examinations for the purpose of prescribing, fitting, or changing eyeglasses, hearing aids or examinations therefore, or immunizations.
Section 1862(a)(8) provides that no payment may be made under Part A or Part B for any expenses incurred for items or services where such expenses are for orthopedic shoes or other supportive devices for the feet.
Section 1862(a)(9) provides that no payment may be made under Part A or Part B for any expenses incurred for items or services where such expenses are for custodial care.
Section 1862(a)(10) provides that no payment may be made under Part A or Part B for any expenses incurred for items or services where such expenses are for cosmetic surgery or are incurred in connection therewith, except as required for the prompt repair of accidental injury or for improvement of the functioning of a malformed body member.
Section 1862(a)(11) provides that no payment may be made under Part A or Part B for any expenses incurred for items or services where such expenses constitute charges imposed by immediate relatives of such individual or members of his or her household.
Section 1862(a)(12) provides that no payment may be made under Part A or Part B for any expenses incurred for items or services where such expenses are for services in connection with the care, treatment, filling, removal, or replacement of teeth or structures directly supporting teeth.
Section 1862(b) provides that payment under this title may not be made with respect to any item or service to the extent that payment has been made, or can reasonably be expected to be made, under a workmen’s compensation law or plan of the U.S. or a State. Any payment under this title shall be conditioned on reimbursement to the appropriate Trust Fund established by this title when notice is received that payment for such item or service has been made under such law or plan.
Section 1863 provides that the HEW Sec. is to consult with the Health Insurance Benefits Advisory Council, appropriate State agencies, and national listing and accrediting bodies, and may consult with local agencies, in prescribing such conditions for participation for providers of services as may be necessary for health and safety.
Section 1864(a) provides that the HEW Sec. is to make an agreement with any State which is able and willing to enter into an agreement to utilize the services of the State health agency or other appropriate State agencies for the purpose of determining which institutions and agencies qualify to participate in the programs under Title XVIII.
Section 1864(b) provides that the HEW Sec. is to pay the State for the reasonable costs of the administrative activities performed under its agreement under Section 1864(a), and for the Federal Hospital Insurance Trust Fund’s fair share of costs attributable to planning and other efforts directed toward coordination of activities in carrying out its agreement and other activities related to the provision of services similar to those for which payment may be made under Part A, or related to the facilities and personnel required for the provision of such services, or related to improving the quality of such services.
Section 1865 provides that any hospital accredited by the Joint Commission on Accreditation of Hospitals will be deemed to meet all the requirements in the definition of “hospital” in Section 1861(e) except the utilization review requirement.
Section 1866(a)(1)(A) provides that any provider of services shall be qualified to participate and shall be eligible for payments if it files with the HEW Sec. an agreement not to charge any individual or any other person for items or services for which such individual is entitled to have payment made under this title.
Section 1866(a)(1)(B) provides that any provider of services shall be qualified to participate and shall be eligible for payments if it files with the HEW Sec. an agreement to make adequate provision for return of any moneys incorrectly collected from such individual or other person.
Section 1866(a)(2)(A) provides that a provider of services may charge an individual the amount of any deduction or coinsurance amount imposed pursuant to Section 1813(a)(1), 1813(a)(2), 1813(a)(4), 1833(b), or 1861(y)(3) with respect to such items and services, and an amount equal to 20% of the reasonable charges for such items and services for which payment is made under Part B or, in the case of outpatient hospital diagnostic services, for which payment is made under Part A. Section 1866(a)(2)(B) provides that where a provider of services has furnished, at the request of an individual, items or services which are in excess of or more expensive than the items or services with respect to which payment may be made under this title, such provider may also charge such individual for such more expensive items or services to the extent that the amount customarily charged by it for the items or services furnished at such request exceeds the amount customarily charged by it for the items or services with respect to which payment may be made under this title.
Section 1866(a)(2)(C) provides that a provider of services may also charge any individual for any whole blood furnished to him or her with respect to which a deductible is imposed under Section 1813(a)(3), except that any excess of such charge over the cost to such provider for the blood shall be deducted from any payment to such provider under this title.
Section 1866(b)(1) provides that an agreement with the HEW Sec. may be terminated by the provider of services at such time and upon such notice to the HEW Sec. and the public as may be provided in regulations, except that notice of more than six months shall not be required.
Section 1866(b)(2) provides that an agreement with the HEW Sec. may be terminated by the HEW Sec. at such time and upon such reasonable notice to the provider of services and the public as may be specified in regulations, but only after the HEW Sec. has determined that such provider is not complying with the provisions of such agreement, or that such provider no longer meets the applicable provisions of Section 1861, or that such provider has failed to provide information that the HEW Sec. finds necessary to determine whether payments are or were due and the amounts thereof, or has refused to permit such examination of its fiscal records.
Section 1866(b)(3) provides that any termination shall be applicable in the case of inpatient hospital services or post-hospital extended care services, with respect to such services furnished to any individual who is admitted to the hospital or extended care facility furnishing such services on or after the effective date of such termination.
Section 1866(b)(4) provides that any termination shall be applicable with respect to home health services furnished to an individual under a plan therefore established on or after the effective date of such termination, or if a plan is established before such effective date, with respect to such services furnished to such individual after the CY in which such termination is effective.
Section 1866(b)(5) provides that any termination shall be applicable with respect to any other items and services furnished on or after the effective date of such termination.
Section 1866(c) provides that where an agreement filed under this title by a provider of services has been terminated by the HEW Sec., such provider may not file another agreement under this title unless the HEW Sec. finds that the reason for the termination has been removed and that there is reasonable assurance that it will not recur.
Section 1866(d) provides that if the HEW Sec. finds that there is a substantial failure to make timely review in accordance with Section 1861(k) of long-stay cases in a hospital or extended care facility, he or she may, decide that with respect to any individual admitted to such hospital or facility, after a subsequent date specified, no payment shall be made for inpatient hospital services after the 20 th day of a continuous period of such care as is prescribed in or pursuant to regulations.
Section 1867 provides for the creation of a Health Insurance Benefits Advisory Council, consisting of 16 persons not employed by the Federal Government, to advise the HEW Sec. on general policy in the administration of Title XVIII of the Social Security Act and in the formulation of regulations.
Section 1868(a) provides for the creation of a National Medical Review Committee, which will consist of nine persons not employed by the Federal Government, and appointed by the HEW Sec.
Section 1868(b) provides that the National Medical Review Committee members will be entitled to receive compensation at rates fixed by the HEW Sec.
Section 1868(c) provides that it is the National Medical Review Committee’s function to study the utilization of hospital and other medical care and services for which payment can be made under Part A or Part B with a view to recommending any changes which may seem desirable in the utilization of care and services or the administration of the programs of Title XVIII of the Social Security Act.
Section 1868(d) authorizes the National Medical Review Committee to engage any technical assistance required to carry out its functions.
Section 1869(a) provides that determinations of entitlement to benefits under Part A and Part B, and of the amount of benefits under Part A, are to be made by the HEW Sec. in accordance with regulations.
Section 1869(b) provides that any individual dissatisfied with any determination under Section 869(a) as to entitlement under Part A or Part B, or as to amount of benefits under Part A if the matter in controversy is $1,000 or more, will be entitled to the same hearing and appeal procedures as are now provided in Title II of the Social Security Act.
Section 1869(c) provides that any institution or agency dissatisfied with any determination by the HEW Sec. that is not a provider of services, or with any determination terminating an agreement under Section 1866(b)(2), will be entitled to the same hearing and appeal procedures as are now provided in Title II of the Social Security Act.
Section 1870(a) provides that any payment made under this title to any provider of services or other person with respect to any items or services furnished any individual shall be regarded as a payment to such individual.
Section 1870(b)(1) provides that where more than the correct amount is paid under this title to a provider of services or other person for items or services furnished an individual and the HEW Sec. determines that, within such period as he or she may specify, the excess over the correct amount cannot be recouped from such provider or other person, proper adjustments shall be made under prescribed regulations.
Section 1870(b)(2) provides that where any payment has been made under Section 1814(e) to a provider of services or other person for items or services furnished an individual, proper adjustments shall be made under prescribed regulations.
Section 1870(b)(3) provides that proper adjustments for overpayments on behalf of individuals shall be made under prescribed regulations by the HEW Sec., by decreasing subsequent payments to which such individual is entitled under Title II of the Social Security Act or under the Railroad Retirement Act of 1937.
Section 1870(b)(4) provides that proper adjustments for overpayments on behalf of individuals shall be made under prescribed regulations by the HEW Sec., by decreasing subsequent payments if such individual dies before such adjustment has been completed, to which any other individual is entitled under Title II of the Social Security Act or under the Railroad Retirement Act of 1937, with respect to the wages and self-employment income or the compensation constituting the basis of the benefits of such deceased individual under Title II of the Social Security Act.
Section 1870(c) provides that there will be no adjustment as provided in Section 1870(b) of payments to, or recovery from, any person who is without fault, if such adjustment or recovery would defeat the purposes of Title II of the Social Security Act or the Railroad Retirement Act or would be against equity and good conscience.
Section 1870(d) provides that no certifying or disbursing officer will be liable for overpayments where adjustment or recovery is waived or is not completed prior to the death of all persons against whose benefits the adjustment is authorized.
Section 1871 provides that the HEW Sec. will prescribe the regulations necessary to carry out the administration of the new insurance programs under Title XVIII of the Social Security Act.
Section 1872 provides that Sections 206, 208, 216(j), and 205(a), 205(d), 205(e), 205(f), 205(h), 205(i), 205(j), 205(k), and 205(l) of Title II of the Social Security Act will apply likewise to Title XVIII of the Social Security Act.
Section 1873 provides that any designation made in Title XVIII of the Social Security Act, by name, of any nongovernmental organization or publication will not be affected by a change of the name of such organization or publication and will apply to any successor organization or publication which the HEW Sec. finds serves the purpose for which the designation is made.
Section 1874(a) provides that the programs established by Title XVIII of the Social Security Act are to be administered by the HEW Sec., who may perform any of his or her functions directly or by contract.
Section 1874(b) provides that the HEW Sec. may contract with any person, agency, or institution to secure such special data and actuarial and other information as may be necessary in carrying out his or her functions.
Section 1875(a) provides that the HEW Sec. is to make studies and develop recommendations to be submitted to the Congress relating to the health care of the aged, including studies and recommendations concerning the adequacy of existing personnel and facilities for health care for purposes of the programs under Title XVIII of the Social Security Act; methods for encouraging further development of efficient and economical alternatives to inpatient hospital care; and the effect of the deductibles and coinsurance provisions upon beneficiaries, providers of health services, and the financing of the program.
Section 1875(b) instructs the HEW Sec. to make a continuing study of the operation and administration of the insurance programs under Title XVIII of the Social Security Act and to submit to the Congress annually a report concerning the operation of such programs.

Section 21 provides that for the purposes of Part A of Title XVIII of the Social Security Act, in order to provide hospital insurance benefits for annuitants, pensioners, and certain other aged individuals, the Railroad Retirement Board shall certify the name of any individual who has attained age 65, who is entitled to an annuity or pension under this Act, would be entitled to such an annuity had he or she ceased compensated service and had such spouse’s husband or wife ceased compensated service and applied for such annuity, or bears a relationship to an employee which, has been, or would be, taken into account in calculating the amount of annuity of such employee or survivors.

Section 201(g)(1)(A) provides for payment from any or all of the Trust Funds of the costs to HEW of administering Title II and XVIII of the Social Security Act and for adjustments during, and after the close of, each FY among the Trust Funds so that each fund bears its proportionate share of the costs.
Section 201(g)(1)(B) provides for payments from the Trust Funds to the Treasury to meet the estimated quarterly costs to the Treasury of the administration of Title II and XVIII of the Social Security Act and of Chapter 2 and 21 of the IRC of 1954.

Section 706(a) provides that during 1968 and every fifth year thereafter, the HEW Sec. shall appoint an Advisory Council on Social Security for the purpose of reviewing the status of the Federal OASI Trust Fund, the Federal DI Trust Fund, the Federal Hospital Insurance Trust Fund, and the Federal Supplementary Medical Insurance Trust Fund in relation to the long-term commitments of the OASDI Program and the programs under Part A and Part B of Title XVIII of the Social Security Act, and of reviewing the scope of coverage and the adequacy of benefits under these programs, including their impact on the public assistance programs under the Social Security Act.
Section 706(b) provides that each such Council shall consist of the COSS, as Chairperson, and 12 other persons, appointed by the HEW Sec. without regard to the civil service laws, representing organizations of employers and employees in equal numbers, and self-employed persons and the public.
Section 706(c)(1) provides that any such Council is authorized to engage such technical assistance, including actuarial services, as may be required to carry out its functions, and the HEW Sec. shall make available to such Council such secretarial, clerical, and other assistance and such actuarial data prepared by HEW as it may require to carry out such functions.
Section 706(c)(2) provides that appointed members of any such Council, while serving on business of such Council, shall receive compensation at rates fixed by the HEW Sec., but not exceeding $100 per day 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 5 of the Administrative Expenses Act of 1946 for persons in the Federal Government employed intermittently.
Section 706(d)(1) provides that each such Council shall submit reports of its findings and recommendations to the HEW Sec. not later than 1/1 of the second year after the year in which it is appointed, and shall include a separate report with respect to the OASDI Program under Title II of the Social Security Act and of the taxes imposed under Section 1401(a), 3101(a), and 3111(a) of the IRC of 1954.
Section 706(d)(2) provides that each such Council shall submit reports of its findings and recommendations to the HEW Sec. not later than 1/1 of the second year after the year in which it is appointed, and shall include a separate report with respect to the Hospital Insurance Program under Part A of Title XVIII of the Social Security Act and of the taxes imposed by Section 1401(b), 3101(b), and 3111(b) of the IRC of 1954.
Section 706(d)(3) provides that each such Council shall submit reports of its findings and recommendations to the HEW Sec. not later than 1/1 of the second year after the year in which it is appointed, and shall include a separate report with respect to the Supplementary Medical Insurance Program established by Part B of Title XVIII of the Social Security Act and of the financing thereof.

Section 21(a) provides that the Railroad Retirement Board would have the same authority to make determinations as to the rights to hospital insurance benefits of the specified categories of individuals as the HEW Sec. would have under Section 226 of the Social Security Act with respect to individuals whose entitlement to hospital insurance benefits is determined under such section.
Section 21(b) provides that every individual who has attained age 65, and is entitled to an annuity under the Railroad Retirement Act, or would be entitled to such an annuity had he or she ceased compensated service, or had been awarded a pension under Section 6 of the Railroad Retirement Act, or bears a relationship to an employee which, by reason of Section 3(e) of the Railroad Retirement Act, has been, or would be, taken into account in calculating the amount of an annuity of such employee or his or her survivors, shall be certified to the HEW Sec. as a qualified Railroad Retirement beneficiary under Section 226 of the Social Security Act.
Section 21(c) provides that the Railroad Retirement Board and the HEW Sec. shall furnish each other with such information, records, and documents as may be considered necessary to the administration of this section, and Part A of Title XVIII of the Social Security Act.
Section 21(d) provides that for purposes of this section, entitlement to an annuity or pension under the Railroad Retirement Act of 1937 shall be deemed to include entitlement under the Railroad Retirement Act of 1935.
Section 21(e) provides that the rights of individuals described in Section 21(b) of this section to have payment made on their behalf for the services referred to in Section 21(a) of this section but provided in Canada shall be the same as those of individuals to whom Section 226 of the Social Security Act and Part A of Title XVIII of the Social Security Act apply.

Section 202(k)(4) provides that any individual who, under this section and Section 223 of the Social Security Act, is entitled for any month to both an OASI benefit and a DI benefit shall be entitled to only the larger of such benefits for such month, except that, if such individual so elects, he or she shall instead be entitled to only the smaller of such benefits for such month.

Section 202(q)(2) provides that if an individual is entitled to a DI benefit for a month after a month for which such individual was entitled to an OASI benefit, such DI benefit for each month shall be reduced by the amount such OASI benefit would be reduced had such individual attained age 65 in the first month for which he or she most recently became entitled to a DI benefit.

Section 202(q)(3)(F) sets forth the method for reducing the DI benefit of a woman who becomes entitled to that benefit at or after attainment of age 62 and who is entitled for the same month to a reduced widow’s benefit. The amount of the reduction to such benefit is the amount by which such benefit had been reduced because of prior entitlement to a reduced old-age benefit at age 62 or later; or a sum equal to the amount by which the widow’s benefit which the woman was getting at age 62 was reduced plus the amount by which the DI benefit would be reduced if such benefit were equal to the excess of the unreduced disability benefit over the unreduced widow’s insurance benefit, whichever is larger.

Section 202(q)(3)(G) sets forth the method for reducing the DI benefit of a woman who becomes entitled to the disability benefit before attainment of age 62 and after entitlement to a reduced widow’s benefit. Her DI benefit will be reduced by the amount by which her widow’s benefit would have been reduced if she had attained age 62 in the first month for which she became entitled to the DI benefit.

Section 202(q)(7)(F) provides that, in determining the “adjusted reduction period” applicable to a reduced old-age insurance benefit, any month for which a DI benefit was payable will be excluded.

Section 202(d)(7) permits a child whose benefits are terminated after he or she attains age 18 to become re-entitled to child’s insurance benefits, on filing a new application, if he or she becomes a full-time student before age 22 or becomes disabled before that age.
Section 202(d)(8) defines the term “full-time student” to mean an individual who is in full-time attendance at an educational institution, excluding an individual who is paid by his or her employer while attending school at the request of such employer; and defines the term “educational institution” to mean all public schools, colleges, and universities, and all private schools, colleges, and universities which are accredited by a State recognized or nationally recognized accrediting association.

Section 202(s)(1) prevents a wife, widow, or surviving divorced mother from getting benefits if the only child in her care is getting benefits solely because he or she is a student.
Section 202(s)(2) amends the provisions of law which permit a person with a childhood disability to continue to get benefits when he or she marries another beneficiary, and which permit such a beneficiary to continue to get benefits when he or she marries a person with a childhood disability, so that benefits will not be terminated if the child was under a disability which began before he or she attained age 22, instead of age 18 as under present law, or had been under such a disability in the third month before the month in which such marriage occurred.
Section 202(s)(3) provides that the exemption in present law from the dependency requirements for husband’s and widower’s benefits shall apply to a person receiving child’s benefits if the person is under a disability that began before he or she attained age 22.

Section 202(q)(3)(E) provides a method for reducing the old-age insurance benefit of a widow who is entitled to reduced widow’s benefits. The amount of the reduction in the old-age benefit shall be the reduction which would have been made in the old-age benefit if no widow’s benefit had been payable; or the dollar amount of the reduction in the widow’s benefit plus the amount resulting from applying to the amount by which the unreduced old-age benefit exceeds the unreduced widow’s benefit the reduction factor which would have been applied to the unreduced old-age benefit if the woman had not been eligible for a reduced widow’s benefit, whichever is larger.

Section 202(q)(5)(D) provides that regardless of the provisions for reducing the benefits of widows who claim them before age 62, in no case will a widow who had in her care a child entitled to child’s benefits get less in benefits for months in which she had the child in her care than the amount of the mother’s insurance benefit.

Section 216(d)(1) defines the term “divorced wife” to mean a woman divorced from an individual, but only if she had been married to such individual for a period of 20 years immediately before the date the divorce became effective.
Section 216(d)(2) defines the term “surviving divorced wife” to mean a woman divorced from an individual who has died, but only if she had been married to the individual for a period of 20 years immediately before the date the divorce became effective.
Section 216(d)(3) defines the term “surviving divorced mother” to mean a woman divorced from an individual who has died, but only if she is the mother of his son or daughter, she legally adopted his son or daughter while she was married to him and while such son or daughter was under the age of 18, he legally adopted her son or daughter while she was married to him and while such son or daughter was under the age of 18, or she was married to him at the time both of them legally adopted a child under the age of 18.
Section 216(d)(4) provides that the terms “divorce” and “divorced” refer to a divorce a vinculo matrimonii.

Section 227(a) provides that for anyone who attains age 72 before 1969 and does not meet the existing insured-status requirements of Section 214(a) of the Social Security Act, the minimum 6 quarters of coverage requirement shall, instead be 3 quarters of coverage for purposes of determining entitlement.
Section 227(b) provides benefits for a widow who reaches age 72 before 1969 and whose husband died before 1957 or reached age 65 before 1957 and died before the transitional provisions go into effect.
Section 227(c) provides that a widow whose husband dies after the transitional provisions go into effect can become entitled to widow’s benefits of $35 a month if she reaches age 72 before 1969, if her husband reached age 65 before 1957, and if he was entitled to benefits under the transitional provisions.

Section 3121(k)(1)(H) provides that an organization which files a certificate pursuant to Section 3121(k)(1) of the IRC of 1954 before 1966 may amend such certificate during 1965 or 1966 to make the certificate effective with the first day of any calendar quarter preceding the quarter for which such certificate originally became effective, except that such date may not be earlier than the 20 th calendar quarter preceding the quarter in which such certificate is so amended.

Section 3125(c) provides that the return and payment of the employee and employer taxes imposed under Chapter 21 of the IRC of 1954 with respect to services performed as employees of the District of Columbia may be made by the Commissioners of the District of Columbia or by such agents as they may designate.

Section 6205(a)(4) provides that the Commissioners of the District of Columbia and each agent designated by them, pursuant to Section 3125 of the IRC of 1954, shall make returns of the employee and employer taxes imposed under the FICA, will be deemed to be a separate employer, relating to adjustments of underpayments of such taxes.

Section 6413(a)(4) provides that the Commissioners of the District of Columbia and each agent designated by them, pursuant to Section 3125 of the IRC of 1954, shall make returns of the employee and employer taxes imposed under the FICA, will be deemed to be a separate employer, relating to adjustments of overpayments of such taxes.

Section 6413(c)(2)(F) provides that for purposes of the special credit or refund provisions contained in Section 6413(c)(1) of the IRC of 1954, the Commissioners of the District of Columbia and each agent designated by them to make returns of the employee and employer taxes imposed under the FICA will be deemed to be a separate employer, thus permitting a claim for special credit or refund, rather than a general claim for refund, in any case where an employee receives more than the maximum creditable wages in a CY by reason of having performed services for two or more reporting units of the District of Columbia.

Section 102(k)(2) permits the coverage agreement with the State of California to be modified to apply to certain additional services performed for any hospital affected by any modification executed pursuant to this section.

Section 1402(c)(6) provides an exception from the term “trade or business” the performance of service by individuals who are members of certain religious faiths during the period for which an exemption is effective with respect to them, thus exempting such individuals from the self-employment tax.

Section 211(c)(6) provides an exception from the term “trade or business” the performance of service by individuals who are members of certain religious faiths during the period for which an exemption is effective with respect to them, thus removing such self-employed individuals from Socials Security coverage.

Section 1402(h)(1) provides that any individual may file an application for an exemption from the tax imposed on self-employment income if he or she is a member of a recognized religious sect or division thereof and is an adherent of established tenets or teachings of such sect or division by reason of which he or she is conscientiously opposed to the acceptance of the benefits of any private or public insurance making payments in the event of death, disability, old-age, or retirement or making payments toward the cost of, or providing services for, medical care.
Section 1402(h)(1)(A) provides that such individual’s application for exemption must contain, or be accompanied by, such evidence of such individual’s membership in, and adherence to the tenets or teachings of, the religious sect or division thereof for the purposes of determining such individual’s compliance with the requirements of Section 1402(h)(1) of the IRC of 1954.
Section 1402(h)(1)(B) provides that such application must be accompanied by the individual’s waiver of all benefits and other payments under Title II and Title XVIII of the Social Security Act on the basis of his or her wages and self-employment income as well as all such benefits and other payments to him or her on the basis of the wages and self-employment income of any other person.
Section 1402(h)(1)(C) provides that an exemption may be granted only if the HEW Sec. finds that the religious sect or division thereof has the established tenets or teachings by reason of which the individual applicant is conscientiously opposed to the benefits of certain types of insurance.
Section 1402(h)(1)(D) provides that an exemption may be granted only if the HEW Sec. finds that it is the practice, and has been for a period of time, for members of such sect or division thereof to make provision for their dependent members which, in the judgment of the HEW Sec., is reasonable in view of the general level of living of the members of the sect or division thereof.
Section 1402(h)(1)(E) provides that an exemption may be granted only if the HEW Sec. finds that the sect or division thereof has been in existence continuously since 12/31/50.
Section 1402(h)(2)(A) provides that an individual who has self-employment income for any taxable year ending before 12/31/65, must file his or her application for exemption on or before 4/15/66. <> Section 1402(h)(2)(B) provides that in any other case, besides that of Section 1402(h)(2)(A) of the IRC of 1954, an individual must file his or her application for exemption on or before the due date of the return for the first taxable year ending on or after 12/31/65, in which he or she has self-employment income.
Section 1402(h)(3) provides that an exemption granted to an individual pursuant to this section will apply with respect to all taxable years beginning after 12/31/50.
Section 1402(h)(3)(A) provides that such exemption will not apply for any taxable year which begins before the taxable year in which the individual who files an application for exemption first became a member of a recognized religious sect or division thereof and was an adherent of established tenets or teachings of such sect or division by reason of which he or she was conscientiously opposed to the acceptance of the benefits of certain types of insurance.
Section 1402(h)(3)(B) provides that an exemption granted pursuant to this section will cease to be effective for any taxable year ending after the time the individual who files an application for exemption ceases to meet the requirements of this section.
Section 1402(h)(4) provides that in any case where an individual who has self-employment income dies before the expiration of the time prescribed in this section for filing an application for exemption pursuant to this section, such an application may be filed with respect to such deceased individual within the time prescribed in this section with respect to him or her by a fiduciary acting for such individual’s estate or by such individual’s survivor.

Section 202(v) provides that if an individual is granted a tax exemption under Section 1402(h) of the IRC of 1954, no benefits or other payments are to be payable to him or her under Title II of the Social Security Act, no payments are to be made on his or her behalf under Part A of Title XVIII of the Social Security Act, and no benefits or other payments are to be payable to him or her on the basis of the wages and self-employment income of any other person, after the filing of his or her waiver of benefits pursuant to Section 1402(h) of the IRC of 1954.

Section 217(g)(1) provides that in 9/65, and in every fifth September thereafter up to and including 9/10, the HEW Sec. shall determine the amount which, if paid in equal installments at the beginning of each FY in the period beginning with 7/1/65, in the case of the first such determination, and with the 7/1 following the determination in the case of all other such determinations, and ending with the close of 6/30/15, would accumulate, with interest compounded annually, to an amount equal to the amount needed to place each of the Trust Funds and the Federal Hospital Insurance Trust Fund in the same position at the close of 6/30/15, as he or she estimates they would otherwise be in at the close of that date if Section 210 of the Social Security Act as in effect prior to the Social Security Act Amendments of 1950, and this section, had not been enacted.
Section 217(g)(2) authorizes there to be appropriated to the Trust Funds and the Federal Hospital Insurance Trust Fund for the FY ending 6/30/66, an amount equal to the amount determined under Section 217(g)(1) of the Social Security Act in 9/65, and for each FY in the period beginning with 7/1/66, and ending with the close of 6/30/15, an amount equal to the annual installment for such FY under the most recent determination under Section 217(g)(1) of the Social Security Act which precedes such FY.
Section 217(g)(3) authorizes for each FY ending 6/30/16, there to be appropriated to the Trust Funds and the Federal Hospital Insurance Trust Fund such sums as the HEW Sec. determines would place the Trust Funds and the Federal Hospital Insurance Trust Fund in the same position in which they would have been at the close of 6/30/15, if Section 210 of the Social Security Act as in effect prior to the Social Security Act Amendments of 1950, and this section, had not been enacted.
Section 217(g)(4) authorizes there to be appropriated to the Trust Funds and the Federal Hospital Insurance Trust Fund annually, as benefits under Title II of the Social Security Act and Part A of Title XVIII of the Social Security Act are paid after 6/3015, such sums as the HEW Sec. determines to be necessary to meet the additional costs of such benefits.

Section 202(d)(9) retains the existing provisions relating to adoptions by disabled workers and makes such provisions applicable in the case where the worker is entitled to old-age insurance benefits and was entitled to DI benefits for the month preceding the first month for which he or she was entitled to old-age insurance benefits.
Section 202(d)(10) restricts the payment of child’s insurance benefits when a child is adopted by a worker after the worker became entitled to old-age insurance benefits by adding that the child must have been living with the worker at the time the worker became entitled to old-age insurance benefits or adoption proceedings had begun at or before that time; the child must have been receiving at least one-half of his or her support from the worker for the entire year before the worker became entitled to old-age insurance benefits or before a period of disability began which continued until he or she became entitled to old-age insurance benefits; and the adoption must have been completed within two years after the worker became entitled to old-age insurance benefits.

Section 203(f)(5)(D) provides that, in determining the net earnings from self-employment of a beneficiary who has attained age 65, there is to be excluded in computing his or her gross income from a trade or business any royalties received in or after the year in which he or she attained age 65 if he or she shows that the royalties are attributable to a copyright or patent which was obtained before the taxable year in which he or she attained age 65 and that the property to which the copyright or patent relates was created by his or her own personal efforts. Effective after 1964.

Section 204(d) provides that if an individual dies before any payment due him or her under Title II of the Social Security Act is completed, and the total amount due at the time of his or her death does not exceed the amount of the monthly insurance benefit to which he or she was entitled for the month preceding the month in which he or she died, payment of the amount due shall be made to the person determined by the HEW Sec. to be the surviving spouse of the deceased individual and to have been living in the same household with the deceased at the time of his or her death, or if there is no such person, or if such person dies before receiving payment, to the legal representative of the estate of such deceased individual.

Section 1402(e)(5) provides that any individual who has filed a certificate under this section by 4/15/66, and who has filed a timely return reporting earnings derived from him or her in any taxable year ending after 1954 from the performance of service as a minister, a member of a religious order, or a Christian Science practitioner, but who does not have self-employment coverage for the first year for which such a return was filed because a certificate under this section is not in effect with respect to such year, may have his or her self-employment coverage as a minister, member of a religious order, or Christian Science practitioner begin with such first year.

Section 206(b)(1) permits a court that renders a favorable decision to a claimant in a case arising under the Social Security program to set a reasonable fee, not in excess of 25% of the total of the past due benefits which become payable as a result of the court’s decision, for the attorney who represented the claimant before the court.
Section 206(b)(2) provides that any attorney who demands or receives any additional amount for his or her services in representing the claimant before the court shall be guilty of a misdemeanor and subject to a fine of up to $500, or up to one year’s imprisonment, or both.

Section 224(a)(1) and 224(a)(2) provide that if for any month prior to the month in which an individual attains age 62, such individual is entitled both to benefits under Section 223 of the Social Security Act and to periodic benefits under a workmen’s compensation law or plan of the U.S. or a State, and if the HEW Sec. has, in a prior month, received notice of such entitlement, the total of such benefits for such month and any benefits under Section 202 of the Social Security Act based on wages and self-employment income shall be subject to reduction.
Section 224(a)(3), 224(a)(4), 224(a)(5), and 224(a)(6) provide that such reduction shall be in the amount that the sum of such total of benefits under Section 223 and 202 of the Social Security Act and the periodic workmen’s compensation benefit paid for such month exceeds the higher of 80% of the individual’s “average current earnings” or the total of the individual’s DI benefits for such month and of any monthly insurance benefits under Section 202 of the Social Security Act for such month based on wages and self-employment income, prior to reduction under this section.
Section 224(a)(7) and 224(a)(8) provide that in no case shall such reduction for any month after the first month for which reduction is required under this section reduce such total of benefits payable under Section 223 and 202 of the Social Security Act to an amount that is less than the sum of the total of benefits under such sections after reduction under this section for such first month and any increases in the benefits payable under Title II of the Social Security Act effective after such first month with respect to the benefits payable to the disabled worker and the persons entitled to benefits on such worker’s wages and self-employment income in the month such subsequent reduction is made.
Section 224(b) provides that where a periodic workmen’s compensation benefit is payable on other than a monthly basis, the reduction shall be made at such times and in such amounts as the HEW Sec. determines will approximate as nearly as practicable the reduction prescribed in Section 224(a) of the Social Security Act.
Section 224(c) provides that reduction of benefits under this section shall be made after reduction under Section 203(a) of the Social Security Act, relating for reduction to the family maximum, but before deductions under Section 203 and 222(b) of the Social Security Act.
Section 224(d) provides that there shall be no reduction under this section where the workmen’s compensation law or plan under which the periodic benefit is paid contains any provision requiring a reduction of workmen’s compensation when anyone entitled thereto is entitled to benefits under Section 223 of the Social Security Act.
Section 224(e) provides that the HEW Sec. may require that an individual entitled to benefits under Section 223 of the Social Security Act who may be eligible for periodic workmen’s compensation benefits, certify whether he or she has or intends to file a claim for periodic workmen’s compensation benefits, and if so, whether there has been a decision on such claim.
Section 224(f)(1) provides that in the second CY after the year in which reduction of a disabled worker’s Social Security benefit was first required, and in each third year thereafter, the HEW Sec. shall re-determine the amount of the benefits payable on the basis of such individual’s wages and self-employment income.
Section 224(f)(2) provides that in making the re-determination required under Section 224(f)(1) of the Social Security Act, the individual’s “average current earnings” and the ratio of the average of taxable wages of all persons for whom taxable earnings were reported for the first calendar quarter of the CY in which the re-determination is made, to the average of the taxable wages of such persons for the first calendar quarter of the CY in which the individual’s reduction was initially computed.
Section 224(g) provides that whenever a reduction is made under this section in the total of benefits based on an individual’s wages and self-employment income, each benefit, except the DI benefit, shall first be proportionately decreased, and any excess of the reduction that is required for such month over the sum of all such benefits other than the DI benefit.

Section 222(d)(1) provides that for the purpose of making vocational rehabilitation services more readily available to disabled individuals who are entitled to DI benefits under Section 223 of the Social Security Act or child’s insurance benefits under Section 202(d) of the Social Security Act after having attained age 18, to the end that savings will result to the Trust Funds as a result of rehabilitating the maximum number of such individuals into productive activity, there are authorized to be transferred from the Trust Funds such sums as may be necessary to enable the HEW Sec. to pay the costs of vocational rehabilitation services for such individuals and so much of the expenditures for the administration of any State plan as is attributable to carrying out this section.
Section 222(d)(2)(A) provides that, in the case of each State willing to do so, such vocational rehabilitation services shall be furnished under a State plan which has been approved under Section 5 of the Vocational Rehabilitation Act.
Section 222(d)(2)(B) provides that, to the extent funds provided under this section are adequate for the purpose, such services will be furnished with reasonable promptness to any person in the State meeting the criteria prescribed by the HEW Sec. pursuant to Section 222(d)(1) of the Social Security Act and in accordance with the order of selection determined under such criteria.
Section 222(d)(2)(C) provides that such services will be furnished to any individual without regard to his or her citizenship, place of residence, his or her need for financial assistance, or any order of selection followed under the State plan pursuant to Section 5(a)(4) of the Vocational Rehabilitation Act.
Section 222(d)(3) provides that where a State does not have a plan which meets the requirements of Section 222(d)(2) of the Social Security Act, the HEW Sec. may provide such services by agreement or contract with other public or private agencies, organizations, institutions, or individuals.
Section 222(d)(4) provides that payments under this section may be made in installments, and in advance or by way of reimbursement, with necessary adjustments on account of overpayments or underpayments.
Section 222(d)(5) provides that money paid from the Trust Funds under this section to pay the costs of providing services to individuals who are entitled to benefits under Section 223 of the Social Security Act shall be charged to the Federal DI Trust Fund, and all other money paid out from the Trust Funds under this section shall be charged to the Federal OASI Trust Fund.
Section 222(d)(6) provides that for the purposes of this section the term “vocational rehabilitation services” shall have the meaning assigned to it in the Vocational Rehabilitation Act, except that such services may be limited in type, scope, or amount in accordance with regulations of the HEW Sec. designed to achieve the purposes of this section.

Section 216(h)(3) makes benefits payable, under certain circumstances, on the basis of an insured worker’s earnings to an applicant who is the son or daughter of the worker, but who cannot meet the definition of “child” under present law.
Section 216(h)(3)(A) provides that in the case of a worker entitled to old-age insurance benefits, such written acknowledgement of a son or daughter, court decree, or court order must have occurred not less than one year before the worker became entitled to benefits or attained age 65, whichever is earlier, or the worker must have been living with or contributing to the support of the child at the time the worker became entitled to benefits or attained age 65, whichever is earlier.
Section 216(h)(3)(B) provides that in the case of a worker who is entitled to DI benefits, such written acknowledgement of a son or daughter, court decree, or court order must have occurred before such individual’s most recent period of disability, or the worker must have been living with or contributing to the support of the child at the time the disability began.
Section 216(h)(3)(C) provides that in the case of a deceased worker such written acknowledgement of a son or daughter, court decree, or court order must have occurred before the worker’s death, or the worker must have been living with or contributing to the support of the child at the time he or she died.

Section 1402(e)(3)(D) provides that, if an individual files a certificate after the date of enactment of this section and on or before the due date of the return for his second taxable year ending after 1963, such certificate shall be effective for his or her first taxable year ending after 1962 and all succeeding years.

Section 18(a) provides that, effective the first day of the third month which begins after the date of enactment of this amendment each annuity payable from the Civil Service Retirement and Disability Fund which has a commencing date not later than such effective date shall be increased by the per centum rise in the price index, adjusted to the nearest one-tenth of 1%, determined by the Civil Service Commission on the basis of the annual average price index for CY 1962 and the price index for the month latest published on the date of enactment of this amendment.
Section 18(b) provides that each month after the first increase under this section, the Civil Service Commission shall determine the per centum change in the price index.
Section 18(c)(1) provides that eligibility for an annuity increase under this section shall be governed by the commencing date of each annuity payable from the Civil Service Retirement and Disability Fund as of the effective date of an increase, except an annuity payable from such fund to an annuitant’s survivor, which annuity commences the day after an annuitant’s death and after the effective date of the first increase under this section, shall be increased by the total per centum increase the annuitant was receiving under this section at death.
Section 18(c)(2) provides that eligibility for an annuity increase under this section shall be governed by the commencing date of each annuity payable from the Civil Service Retirement and Disability Fund as of the effective date of an increase, except for purposes of computing an annuity which commences after the effective date of the first increase under this section to a child under Section 10(d) of the Civil Service Retirement Act.
Section 18(d) provides that no increase in annuity provided by this section shall be computed on any individual annuity purchased at retirement by voluntary contributions.
Section 18(e) provides that the monthly installment of annuity after adjustment under this section shall be fixed at the nearest dollar, except that such installment shall after adjustment reflect an increase of at least $1.

Section 701(c) provides that whenever a determination is made under Section 701(a) of the Classification Act of 1949 that the work of an officer or employee is not of an acceptable level of competence, he or she shall be given prompt written notice of that determination and an opportunity for reconsideration of the determination within his or her department under uniform procedures, and the right of appeal if the determination is affirmed upon reconsideration.

Section 111(a) provides for the economic and efficient purchase, lease, and maintenance of automatic data processing equipment by Federal agencies.
Section 111(b)(1) provides that automatic data processing equipment suitable for efficient and effective use by Federal agencies shall be provided through purchase, lease, or transfer of equipment from other Federal agencies.
Section 111(b)(2) provides that one or more Federal agencies may be delegated authority by the Administrator of the GSA to operate automatic data processing equipment pools and automatic data processing centers, and to lease, purchase, or maintain individual automatic data processing systems or specific units of equipment.
Section 111(c) establishes on the books of the Treasury an automatic data processing fund, which shall be available without FY limitation for expenses, including personal services, other costs, and the procurement by lease, purchase, or transfer of equipment, maintenance, and repair of such equipment by contract or otherwise, necessary for the efficient coordination, operation, and utilization of such equipment by Federal agencies.
Section 111(d) authorizes there to be appropriated to the automatic data processing fund such sums as may be required which, together with the value of supplies and equipment from time to time transferred to the Administrator of the GSA, shall constitute the capital of such fund.
Section 111(e) provides that no other provision of this Act or any other Act which is inconsistent with the provisions of this section shall be applicable in the administration of this section.
Section 111(f) provides that the Commerce Sec. is authorized to provide Federal agencies, and the Administrator of the GSA in the exercise of the authority delegated in this section, with scientific and technological advisory services relating to automatic data processing and related systems.
Section 111(g) provides that authority so conferred by this section upon the Administrator of the GSA shall not be so construed as to impair or interfere with the determination by Federal agencies of their individual automatic data processing equipment requirements, including the development of specifications for and the selection of the types and configurations of equipment needed.

Section 18(f) provides that each annuity payable from the Civil Service Retirement and Disability Fund which has a commencing date after 12/1/65, but not later than 12/31/65, shall be increased from its commencing date as if the annuity commencing date were 12/1/65.

Section 210(i)(1) provides that any executive agency is authorized to install, repair, and replace sidewalks around buildings, installations, properties, or grounds under the control of such agency and owned by the U.S.
Section 210(i)(2) provides that installation, repair, and replacement under this section shall be performed in accordance with regulations to be prescribed by the Administrator of the GSA with the approval of the Director of the Bureau of the Budget.
Section 210(i)(3) provides that funds appropriated to such agency for installation, repair, and maintenance, generally, shall be available for expenditure to accomplish the purposes of this section.
Section 210(i)(4) provides that nothing contained in this section shall increase or enlarge the tort liability of the U.S. for injuries to persons or damages to property beyond such liability presently existing by virtue of any other law.

Section 228(a) states that every individual who has attained the age of 72 before 1968, or has not less than three quarters of coverage for each calendar year elapsing after 1966 and before the year in which he or she attained the age of 72, is a resident of the U.S., and is a citizen of the U.S. or an alien lawfully admitted for permanent residence who has resided in the U.S. continuously during the five years immediately preceding the month in which he or she files an application, and has filed an application for benefits, shall be entitled to a benefit for each month beginning with the first month after 9/66 in which he or she becomes so entitled and ending with the month preceding the month in which he or she dies.
Section 228(b) states that the benefit amount an individual is entitled to under this Section for any month is $35. If both husband and wife are entitled to benefits under this Section for any month, the amount of the husband’s benefit for such month is $35 and the amount of the wife’s benefit for such month is $17.50.
Section 228(c)(1) provides that the benefit amount of any individual for any month shall be reduced by the amount of any periodic benefit under a governmental pension system he or she is eligible for such month.
Section 228(c)(2) states that in the case of a husband and wife only one of whom is entitled to benefits for any month, the benefit amount shall be further reduced by the excess of the total amount of any periodic benefits under governmental pension systems for which the spouse who is not entitled to benefits is eligible for such month, over $17.50.
Section 228(c)(3) states that in the case of a husband and wife both of whom are entitled to benefits for any month (A) the benefit amount of the wife shall be further reduced by the excess of the total amount of any periodic benefits under governmental pension systems for which the husband is eligible for such month, over $35, and (B) the benefit amount of the husband shall be further reduced by the excess of the total amount of any periodic benefits under governmental pension systems for which the wife is eligible for such month, over $17.50.
Section 228(c)(4) provides that in determining whether an individual is eligible for periodic benefits under a governmental pension system (A) such individual shall have filed an application for such benefits, (B) if entitlement depends on an application by such individual’s spouse, such spouse shall have filed an application, (C) if entitlement depends on such individual or spouse having retired, such individual and spouse shall have retired before the month for which the determination of eligibility is being made.
Section 228(c)(5) states that if any periodic benefit is payable on any basis other than a calendar month, the HEW Sec. shall allocate the amount of such benefit to the appropriate calendar months.
Section 228(c)(6) provides that if the amount payable for any month would be less than $1, such amount shall be reduced to zero. In the case of a husband and wife both of who are entitled to benefits for the month, the preceding sentence shall be applied to the aggregate amount so payable for such months.
Section 228(c)(7) states that if any benefit amount computed is not a multiple of $0.10, it shall be raised to the next higher multiple of $0.10.

Section 228(c)(8) provides that under regulations prescribed by the HEW Sec., benefit payments to an individual or aggregate benefit payments in the case of a husband and wife of less than $5 may be accumulated until they equal or exceed $5.
Section 228(d) states that the benefit to which any individual is entitled to for any month shall not be paid for such month if (1) such individual receives aid or assistance in the form of money payments in such month under a State plan approved under Title I, IV, X, XIV, or XVI, or (2) such individual’s husband or wife receives aid or assistance in such month, and under the State plan the needs of such individual were taken into account in determining eligibility for such aid or assistance, unless the State agency administering or supervising such plan notifies the HEW Sec. that such payments to such individual under such plan are being terminated with the payment or payments made in such month.
Section 228(e) provides that the benefit any individual is entitled for any month shall not be paid if, during such month, the individual is not a resident of the U.S. The term U.S. means the 50 States and the District of Columbia.
Section 228(f) states for the purposes of subsections (t) and (u) of Section 202, and Section 1840, a monthly benefit shall be treated as a monthly insurance benefit payable under Section 202.
Section 228(g) authorizes sums be appropriated to the Federal Old-Age and Survivors Insurance Trust Fund for the FY ending 6/30/69, and for each FY thereafter, as the HEW Sec. deems necessary on account of (1) payments made during the second preceding FY and all FYs prior to individuals who, as of the beginning of the calendar year in which falls the month for which payment was made, had less than three quarters of coverage, (2) the additional administrative expenses resulting from the payments described in paragraph (1), and (3) any loss in interest to such Trust Fund resulting from such payments and expenses, in order to place the Trust Fund in the same position at the end of the FY as it would have been in if such payments had not been made.
Section 228(h)(1) defines “quarter of coverage” includes a quarter of coverage as defined in Section 5(l) of the Railroad Retirement Act (RRA) of 1937.
Section 228(h)(2) defines “governmental pension system” to mean the insurance system established by this Title or any other system or fund established by the U.S., a State, any political subdivision of a State, or any wholly owned instrumentality of any one or more of the foregoing which provides for payment of (A) pensions, (B) retirement or retired pay, or (C) annuities or similar amounts payable on account of personal services performed.
Section 228(h)(3) defines “period benefit” to include a benefit payable in a lump sum if it is a commutation of, or a substitute for, periodic payments.
Section 228(h)(4) states that the determination of whether an individual is a husband or wife for any month shall be made under subsection (h) of Section 216 without regard to subsections (b) and (f) of Section 216.

Provides that, during the period beginning on 7/1/66, and ending on 6/30/67, the public debt limit set forth in the first sentence of section 21 of the Second Liberty Bond Act shall be temporarily increased to $330,000,000,000.

Section 3 states that every agency shall make available to the public the following information:
Section 3(a) provides that every agency shall separately state and currently publish in the Federal Register for the guidance of the public (A) descriptions of its central and field organization and the established places, with whom, and the method, that the public may secure information, make submittals, or request or obtain decisions; (B) statements of the methods by which its functions are determined, including the requirements of all formal and informal procedures; (C) rules of procedures, descriptions of forms, places where the forms may be obtained, and instructions of the scope and content of all papers, reports, or examinations; (D) substantive rules, and statements of general policy or interpretations of its general applicability; and (E) every amendment, revision, or repeal of the foregoing.
Section 3(b) states that every agency shall make available for public inspection and copying (A) all final opinions and all orders made in the adjudication of cases, (B) those statements of policy and interpretations which have been adopted by the agency and are not published in the Federal Register, and (C) administrative staff manuals and instructions to staff that affect any member of the public. To prevent a clearly unwarranted invasion of person privacy, an agency may delete identifying details when it makes available or publishes an opinion, statement of policy, interpretation, or staff manual or instructions, provided that in every case the justification for the deletion must be fully explained in writing.
Section 3(c) provides that except with respect to the records made available pursuant to subsections (a) and (b), every agency shall, upon request for identifiable records made in accordance with published rules stating the time, place, fees to the extent authorized by statute and procedure to be followed, make such records promptly available to any person.
Section 3(d) states that every agency having more than one member shall keep a record of the final votes of each member in every agency proceeding and such record shall be available for public inspection.
Section 3(e) provides that the provisions of this Section shall not be applicable to matter that are (1) specifically required by Executive order to be kept secret in the interest of national defense or foreign policy; (2) related solely to the internal personnel rules and practices of any agency; (3) specifically exempted from disclosure by statute; (4) trade secrets and commercial or financial information obtained from any person and privileged or confidential; (5) inter-agency or intra-agency memorandums or letters which would not be available by law to a private party in litigation with the agency; (6) personnel and medical files and similar files the disclosure of which would constitute a clearly unwarranted invasion of personal privacy; (7) investigatory files complied for law enforcement purposes except to the extent available by law to a private party; (8) contained in or related to examination, operating, or condition reports prepared by, on behalf of, or for the use of any agency responsible for the regulation or supervision of financial institutions; and (9) geological and geophysical information and data (including maps) concerning wells.
Section 3(f) states that nothing in this Section authorizes withholding of information or limiting the availability of records to the public except as specifically stated in this Section, not shall this Section be authority to withhold information from Congress.
Section 3(g) defines “private party” to mean any party other than an agency.
Section 3(h) provides that this amendment shall be effective one year following the date of enactment.