Title 42The Public Health and WelfareRelease 119-73

§1395z Consultation with State agencies and other organizations to develop conditions of participation for providers of services

Title 42 › Chapter CHAPTER 7— - SOCIAL SECURITY › Subchapter SUBCHAPTER XVIII— - HEALTH INSURANCE FOR AGED AND DISABLED › Part Part E— - Miscellaneous Provisions › § 1395z

Last updated Apr 6, 2026|Official source

Summary

When setting rules about who can take part under subsections (e)(9), (f)(4), (j)(15), (o)(6), (cc)(2)(I), (dd)(2), and (mm)(1) of section 1395x, or for ambulatory surgical centers under section 1395k(a)(2)(F)(i), the Secretary must consult with the proper State agencies and with national groups that list or accredit providers, and can consult local agencies too. Those rules can be different for different places or kinds of institutions. If a State or a part of a State requires higher standards to buy services under a State plan approved under subchapter I, XVI, or XIX, the Secretary must apply the same higher standards when paying for those services in that State or subdivision.

Full Legal Text

Title 42, §1395z

The Public Health and Welfare — Source: USLM XML via OLRC

In carrying out his functions, relating to determination of conditions of participation by providers of services, under subsections (e)(9), (f)(4), (j)(15),11 See References in Text note below. (o)(6), (cc)(2)(I), and 22 So in original. The word “and” probably should not appear. (dd)(2), and (mm)(1) of section 1395x of this title, or by ambulatory surgical centers under section 1395k(a)(2)(F)(i) of this title, the Secretary shall consult with appropriate State agencies and recognized national listing or accrediting bodies, and may consult with appropriate local agencies. Such conditions prescribed under any of such subsections may be varied for different areas or different classes of institutions or agencies and may, at the request of a State, provide higher requirements for such State than for other States; except that, in the case of any State or political subdivision of a State which imposes higher requirements on institutions as a condition to the purchase of services (or of certain specified services) in such institutions under a State plan approved under subchapter I, XVI, or XIX, the Secretary shall impose like requirements as a condition to the payment for services (or for the services specified by the State or subdivision) in such institutions in such State or subdivision.

Legislative History

Notes & Related Subsidiaries

Editorial Notes

References in Text

Subsection (j) of section 1395x of this title, referred to in text, was amended generally by Pub. L. 100–203, title IV, § 4201(a)(1), Dec. 22, 1987, 101 Stat. 1330–160, and, as so amended, does not contain a par. (15).

Amendments

1994—Pub. L. 103–432 struck out “or whether screening mammography meets the standards established under section 1395m(c)(3) of this title,” before “the Secretary shall consult”. 1990—Pub. L. 101–508 inserted “or whether screening mammography meets the standards established under section 1395m(c)(3) of this title,” after “section 1395k(a)(2)(F)(i) of this title,”. 1989—Pub. L. 101–239 substituted “(jj)(3), and (mm)(1)” for “and (jj)(3)”. Pub. L. 101–234 repealed Pub. L. 100–360, §§ 203(e)(2), 204(c)(1), and provided that the provisions of law amended or repealed by such sections are restored or revived as if such sections had not been enacted. In the case of the amendment by Pub. L. 100–360, § 203(e)(2), Pub. L. 101–234 was given effect by substituting “and (dd)(2)” for “(dd)(2), (jj)(3)” because of the intervening amendment by Pub. L. 101–239, see note above and 1988 Amendment note below. 1988—Pub. L. 100–360, § 204(c)(1), inserted “or whether screening mammography meets the standards established under section 1395m(e)(3) of this title,” after “1395k(a)(2)(F)(i) of this title,”. Pub. L. 100–360, § 203(e)(2), substituted “(dd)(2), and (jj)(3)” for “and (dd)(2)”. 1984—Pub. L. 98–369, § 2335(c), struck out “(g)(4),” after “(e)(9), (f)(4),”. Pub. L. 98–369, § 2354(b)(32), substituted “(j)(15)” for “(j)(11)”. Pub. L. 98–369, § 2349(b)(1), substituted “appropriate State agencies” for “the Health Insurance Benefits Advisory Council established by section 1395dd of this title, appropriate State agencies,”. 1982—Pub. L. 97–248 substituted “(cc)(2)(I), and (dd)(2)” for “and (cc)(2)(I)”. 1980—Pub. L. 96–499, § 933(f), substituted “(o)(6), and (cc)(2)(I) of section 1395x” for “and (o)(6) of section 1395x”. Pub. L. 96–499, § 934(c)(1), inserted “or by ambulatory surgical centers under section 1395k(a)(2)(F)(i) of this title,”. 1972—Pub. L. 92–603 substituted “subsections (e)(9), (f)(4), (g)(4), (j)(11), and (o)(6) of section 1395x of this title” for “subsections (e)(8), (f)(4), (g)(4), (j)(10), and (o)(5) of section 1395x of this title”.

Statutory Notes and Related Subsidiaries

Effective Date

of 1994 AmendmentAmendment by Pub. L. 103–432 applicable to mammography furnished by a facility on and after the first date that the certificate requirements of section 263b(b) of this title apply to such mammography conducted by such facility, see section 145(d) of Pub. L. 103–432, set out as a note under section 1395m of this title.

Effective Date

of 1990 AmendmentAmendment by Pub. L. 101–508 applicable to screening mammography performed on or after Jan. 1, 1991, see section 4163(e) of Pub. L. 101–508, set out as a note under section 1395l of this title.

Effective Date

of 1989 AmendmentAmendment by Pub. L. 101–234 effective Jan. 1, 1990, see section 201(c) of Pub. L. 101–234, set out as a note under section 1320a–7a of this title.

Effective Date

of 1988 AmendmentAmendment by section 203(e)(2) of Pub. L. 100–360 applicable to items and services furnished on or after Jan. 1, 1990, see section 203(g) of Pub. L. 100–360, set out as a note under section 1320c–3 of this title. Amendment by section 204(c)(1) of Pub. L. 100–360 applicable to screening mammography performed on or after Jan. 1, 1990, see section 204(e) of Pub. L. 100–360, set out as a note under section 1395m of this title.

Effective Date

of 1984 AmendmentAmendment by section 2335(c) of Pub. L. 98–369 effective
July 18, 1984, see section 2335(g) of Pub. L. 98–369, set out as a note under section 1395f of this title. Amendment by section 2349(b)(1) of Pub. L. 98–369 effective
July 18, 1984, see section 2349(c) of Pub. L. 98–369, set out as a note under section 907a of this title. Amendment by section 2354(b)(32) of Pub. L. 98–369 effective
July 18, 1984, but not to be construed as changing or affecting any right, liability, status, or interpretation which existed (under the provisions of law involved) before that date, see section 2354(e)(1) of Pub. L. 98–369, set out as a note under section 1320a–1 of this title.

Effective Date

of 1982 AmendmentAmendment by Pub. L. 97–248 applicable to hospice care provided on or after Nov. 1, 1983, see section 122(h)(1) of Pub. L. 97–248, set out as a note under section 1395c of this title.

Effective Date

of 1980 AmendmentAmendment by section 933(f) of Pub. L. 96–499 effective with respect to a comprehensive outpatient rehabilitation facility’s first accounting period beginning on or after July 1, 1981, see section 933(h) of Pub. L. 96–499, set out as a note under section 1395k of this title.

Effective Date

of 1972 AmendmentAmendment by Pub. L. 92–603 applicable with respect to providers of services for fiscal years beginning after the fifth month following October 1972, see section 234(i) of Pub. L. 92–603, set out as a note under section 1395x of this title. Termination of Advisory CouncilsAdvisory councils in existence on Jan. 5, 1973, to terminate not later than the expiration of the 2-year period following Jan. 5, 1973, unless, in the case of a council established by the President or an officer of the Federal Government, such council is renewed by appropriate action prior to the expiration of such 2-year period, or in the case of a council established by the Congress, its duration is otherwise provided by law. See section 1001(2) and 1013 of Title 5, Government Organization and Employees.

Reference

Citations & Metadata

Citation

42 U.S.C. § 1395z

Title 42The Public Health and Welfare

Last Updated

Apr 6, 2026

Release point: 119-73