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TITLE XI—GENERAL PROVISIONS, PEER REVIEW, AND ADMINISTRATIVE SIMPLIFICATION[1]

TABLE OF CONTENTS OF TITLE[2]

Part A—General Provisions

Sec. 1101. Definitions

Sec. 1102. Rules and regulations

Sec. 1103. Separability

Sec. 1104. Reservation of power

Sec. 1105. Short title

Sec. 1106. Disclosure of information in possession of agency

Sec. 1107. Penalty for fraud

Sec. 1108. Additional grants to Puerto Rico, the Virgin Islands, Guam, and American Samoa; limitation on total payments

Sec. 1109. Amounts disregarded not to be taken into account in determining eligibility of other individuals

Sec. 1110. Cooperative research or demonstration projects

Sec. 1111. Public assistance payments to legal representatives

Sec. 1112. Medical care guides and reports for public assistance and medical assistance

Sec. 1113. Assistance for United States citizens returned from foreign countries

Sec. 1114. Appointment of Advisory Council and other advisory groups

Sec. 1115. Demonstration projects

Sec. 1116. Administrative and judicial review of certain administrative determinations

Sec. 1117. Appointment of the Administrator and Chief Actuary of the Health Care Financing Administration

Sec. 1118. Alternative Federal payment with respect to public assistance expenditures

Sec. 1119. Federal participation in payments for repairs to home owned by recipient of aid or assistance

Sec. 1120. Approval of certain projects

Sec. 1121. Uniform reporting systems for health services facilities and organizations

Sec. 1122. Limitation on Federal participation for capital expenditures

Sec. 1123. Effect of failure to carry out State plan

Sec. 1123A. Reviews of child and family services programs, and of foster care and adoption assistance programs, for conformity with State plan requirements

Sec. 1124. Disclosure of ownership and related information

Sec. 1124A. Disclosure requirements for other providers under part B of Medicare

Sec. 1125. Issuance of subpenas by Comptroller General

Sec. 1126. Disclosure by institutions, organizations, and agencies of owners and certain other individuals who have been convicted of certain offenses

Sec. 1127. Adjustments in SSI benefits on account of retroactive benefits under Title II

Sec. 1128. Exclusion of certain individuals and entities from participation in medicare and State health care programs

Sec. 1128A. Civil monetary penalties

Sec. 1128B. Criminal penalties for acts involving Federal health care programs

Sec. 1128C. Fraud and abuse control program

Sec. 1128D. Guidance regarding application of health care fraud and abuse sanctions

Sec. 1128E. Health care fraud and abuse data collection program

Sec. 1128F. Coordination of Medicare and Medicaid Surety Bond Provisions

Sec. 1129. Civil monetary penalties and assessments for titles II, VIII and XVI

Sec. 1129A. Administrative procedure for imposing penalties for false or misleading statements

Sec. 1129B. Attemps to interfere with administration of social security act

Sec. 1130. Demonstration projects

Sec. 1130A. Effect of failure to carry out State plan

Sec. 1131. Notification of social security claimant with respect to deferred vested benefits

Sec. 1132. Period within which certain claims must be filed

Sec. 1133. Applicants or recipients under public assistance programs not to be required to make election respecting certain veterans' benefits

Sec. 1134. Nonprofit hospital philanthropy

Sec. 1135. Authority to waive requirements during national emergencies

Sec. 1136. Exclusion of representatives and health care providers convicted of violations from participation in social security programs

Sec. 1137. Income and eligibility verification system

Sec. 1138. Hospital protocols for organ procurement and standards for organ procurement agencies

Sec. 1139. National Commission on Children

Sec. 1140. Prohibition of misuse of symbols, emblems, or names in reference to social security or medicare

Sec. 1141. Blood donor locator service

Sec. 1142. Research on outcomes of health care services and procedures

Sec. 1143. Social security account statements

Sec. 1144. Outreach efforts to increase awareness of the availability of medicare cost-sharing

Sec. 1145. Protection of social security and medicare trust funds

Sec. 1146. Public disclosure of certain information on hospital financial interest and referral patterns

Sec. 1147. Recovery of SSI overpayments from other benefits

Sec. 1147A. Recovery of social security benefit overpayments from title VIII benefits

Sec. 1148. The ticket to work and self-sufficiency program

Sec. 1149. Work incentives outreach program

Sec. 1150. State grants for work incentives assistance to disabled beneficiaries

Part B—Peer Review of the Utilization and Quality of Health Care Services

Sec. 1151. Purpose

Sec. 1152. Definition of utilization and quality control peer review organization

Sec. 1153. Contracts with utilization and quality control peer review organizations

Sec. 1154. Functions of peer review organizations

Sec. 1155. Right to hearing and judicial review

Sec. 1156. Obligations of health care practitioners and providers of health care services; sanctions and penalties; hearings and review

Sec. 1157. Limitation on liability

Sec. 1158. Application of this part to certain State programs receiving Federal financial assistance

Sec. 1159. Authorization for use of certain funds to administer the provisions of this part

Sec. 1160. Prohibition against disclosure of information

Sec. 1161. Annual reports

Sec. 1162. Exemptions for religious nonmedical health care institutions

Sec. 1163. Medical officers in American Samoa, the Northern Mariana Islands, and the Trust Territory of the Pacific Islands to be included in the utilization and quality control peer review program

Part C—Administrative Simplification

Sec. 1171. Definitions

Sec. 1172. General requirements for adoption of standards

Sec. 1173. Standards for information transactions and data elements

Sec. 1174. Timetables for adoption of standards

Sec. 1175. Requirements

Sec. 1176. General penalty for failure to comply with requirements and standards

Sec. 1177. Wrongful disclosure of individually identifiable health information

Sec. 1178. Effect on State law

Sec. 1179. Processing payment transactions by financial institutions


[1] Title XI of the Social Security Act is administered by the Department of Health and Human Services and by the Department of Labor.

Title XI appears in the United States Code as §§1301-1320d-8, subchapter XI, chapter 7, Title 42.

Regulations of the Secretary of Health and Human Services relating to Title XI are contained in chapter III, Title 20, in chapters I, II, and IV, Title 42, and in subtitle A and chapters I, III, and XIII, Title 45, Code of Federal Regulations. Regulations of the Secretary of Labor relating to Title XI are contained in chapter V, Title 20, and subtitle A, Title 29, Code of Federal Regulations.

See Vol. II, P.L. 88-164, §124(b)(4), with respect to the membership of the State Planning Councils.

See Vol. II, P.L. 88-352, §601, for prohibition against discrimination in federally assisted programs.

See Vol. II, P.L. 100-204, §724(d), with respect to furnishing information to the United States Commission on Improving the Effectiveness of the United Nations; and §725(b), with respect to the detailing of Government personnel.

See Vol. II, P.L. 100-235, §§5-8, with respect to responsibilities of each Federal agency for computer systems security and privacy.

See Vol. II, P.L. 101-508, §5120, with respect to vocational rehabilitation demonstration projects.

See Vol. II, P.L. 103-432, §232, with respect to measurement and reporting of welfare receipt.

See Vol. II, P.L. 107-105, §2, with respect to the extension of deadline for covered entities submitting compliance plans, and §5, with respect to the implementation of certain regulations.

[2] This table of contents does not appear in the law.

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