Standard changes are made to conform with the definitions applicable and the style of this title as outlined in the preface to the report.

Section 1310(d)(1) of title XIII of the Public Health Service Act (42 U.S.C. 300c–9(d)), referred to in subsec. (l), probably is intended as a reference to section 300e–9(d) of Title 42, The Public Health and Welfare. Section 300e–9(d) of Title 42 was redesignated section 300e–9(c) of Title 42 by Puspan. L. 100–517, § 7(span), Oct. 24, 1988, 102 Stat. 2580.

The Assisted Suicide Funding Restriction Act of 1997, referred to in subsec. (o), is Puspan. L. 105–12, Apr. 30, 1997, 111 Stat. 23, which is classified principally to chapter 138 (§ 14401 et seq.) of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see Short Title note set out under section 14401 of Title 42 and Tables.

Sections 2799A–1, 2799A–2, 2799A–7, 2799B–1, 2799B–2, 2799B–3, and 2799B–5 of the Public Health Service Act, referred to in subsec. (p), are classified to sections 300gg–111, 300gg–112, 300gg–117, 300gg–131, 300gg–132, 300gg–133, and 300gg–135, respectively, of Title 42, The Public Health and Welfare.

Sections 716, 717, and 722 of the Employee Retirement Income Security Act of 1974, referred to in subsec. (p), are classified to sections 1185e, 1185f, and 1185k, respectively, of Title 29, Labor.

Sections 9816, 9817, and 9822 of the Internal Revenue Code of 1986, referred to in subsec. (p), are classified to sections 9816, 9817, and 9822, respectively, of Title 26, Internal Revenue Code.

Another section 1 of title IV of Puspan. L. 101–509, 104 Stat. 1416, enacted sections 2701 to 2706 of Title 44, Public Printing and Documents, and provisions set out as a note under section 2102 of Title 44.

2020—Subsec. (p). Puspan. L. 116–260 added subsec. (p).

2011—Subsec. (a). Puspan. L. 111–350 substituted “section 6101(span) to (d) of title 41” for “section 5 of title 41”.

1998—Subsec. (k)(2), (3). Puspan. L. 105–266, § 8, added par. (2) and redesignated former par. (2) as (3).

Subsec. (m)(1). Puspan. L. 105–266, § 3(c), added par. (1) and struck out former par. (1) which read as follows: “The provisions of any contract under this chapter which relate to the nature or extent of coverage or benefits (including payments with respect to benefits) shall supersede and preempt any State or local law, or any regulation issued thereunder, which relates to health insurance or plans to the extent that such law or regulation is inconsistent with such contractual provisions.”

1997—Subsec. (o). Puspan. L. 105–12 added subsec. (o).

1992—Puspan. L. 102–393 amended subsec. (k) generally. Prior to amendment, subsec. (k) read as follows:

“(1) When a contract under this chapter requires payment or reimbursement for services which may be performed by a clinical psychologist, optometrist, nurse midwife, or nurse practitioner/clinical specialist, licensed or certified as such under Federal or State law, as applicable, or by a qualified clinical social worker as defined in section 8901(11), an employee, annuitant, family member, former spouse, or person having continued coverage under section 8905a of this title covered by the contract shall be free to select, and shall have direct access to, such a clinical psychologist, qualified clinical social worker, optometrist, nurse midwife, or nurse practitioner/nurse clinical specialist without supervision or referral by another health practitioner and shall be entitled under the contract to have payment or reimbursement made to him or on his behalf for the services performed.

“(2) The provisions of this subsection shall not apply to group practice prepayment plans.”

1990—Subsec. (k)(1). Puspan. L. 101–509 substituted “performed by a clinical psychologist, optometrist, nurse midwife, or nurse practitioner/clinical specialist” for “performed by a clinical psychologist or optometrist” and “qualified clinical social worker, optometrist, nurse midwife, or nurse practitioner/nurse clinical specialist” for “qualified clinical social worker or optometrist”.

Subsec. (n). Puspan. L. 101–508 added subsec. (n).

1988—Subsecs. (g), (j), (k)(1). Puspan. L. 100–654 substituted “former spouse, or person having continued coverage under section 8905a of this title” for “or former spouse” wherever appearing.

1987—Subsec. (k)(1). Puspan. L. 100–202, § 101(m) [title VI, § 626(1), (2)], inserted “or by a qualified clinical social worker as defined in section 8901(11),” after “as applicable,”, and “, qualified clinical social worker” after “such a clinical psychologist”.

Subsec. (k)(2), (3). Puspan. L. 100–202, § 101(m) [title VI, § 626(3)], redesignated par. (3) as (2) and struck out former par. (2) which read as follows: “When a contract under this chapter requires payment or reimbursement for services which may be performed by a qualified clinical social worker, an employee, annuitant, family member, or former spouse covered by the contract shall be entitled under the contract to have payment or reimbursement made to him or on his behalf for the services performed. As a condition for the payment or reimbursement, the contract—

“(A) may require that the services be performed pursuant to a referral by a psychiatrist; but

“(B) may not require that the services be performed under the supervision of a psychiatrist or other health practitioner.”

Subsec. (m)(2)(A). Puspan. L. 100–202, § 101(m) [title VI, § 626(4)], struck out “This paragraph shall apply with respect to a qualified clinical social worker covered by subsection (k)(2) of this section without regard to whether such contract contains the requirement authorized by clause (i) of the second sentence of subparagraph (A) of such subsection (k)(2).”

1986—Subsec. (k). Puspan. L. 99–251, § 105(span), designated existing provisions as par. (1), struck out last sentence providing that the provisions of this subsection shall not apply to group practice prepayment plans, and added pars. (2) and (3).

Subsec. (m)(2)(A). Puspan. L. 99–251, § 106(a)(3), inserted last sentence relating to applicability of this paragraph with respect to a qualified clinical social worker covered by subsection (k)(2) of this section.

1985—Subsecs. (a), (e), (i). Puspan. L. 99–53 inserted reference to section 8903a of this title.

1984—Subsec. (g). Puspan. L. 98–615, § 3(2)(A), substituted “employee, annuitant, family member, or former spouse” for “employee or annuitant” in two places.

Subsecs. (j), (k). Puspan. L. 98–615, § 3(2)(B), substituted “family member, or former spouse” for “or family member”.

1980—Subsec. (m)(2)(A). Puspan. L. 96–179 substituted “in a State where 25 percent or more of the population is located in primary medical care manpower shortage areas designated pursuant to section 332 of the Public Health Service Act (42 U.S.C. 254e)” for “who is a member of a medically underserved population (within the meaning of section 1302(7) of the Public Health Service Act (42 U.S.C. 300e–17))”.

1978—Subsecs. (a), (c) to (e), (i), (j), (l). Puspan. L. 95–454 substituted “Office of Personnel Management” for “Civil Service Commission” and “Office” for “Commission” wherever appearing.

Subsec. (m). Puspan. L. 95–368 added subsec. (m).

1976—Subsec. (l). Puspan. L. 94–460 added subsec. (l).

1975—Subsecs. (j), (k). Puspan. L. 94–183 redesignated subsec. (j), added by Puspan. L. 93–363 and relating to services performed by a clinical psychologist or optometrist, as (k).

1974—Subsec. (j). Puspan. L. 93–363 added subsec. (j) covering services performed by a clinical psychologist or optometrist.

Puspan. L. 93–246 added subsec. (j) requiring the carrier to pay for or provide a health service or supply in specified cases.

Puspan. L. 116–260, div. BB, title I, § 102(e), Dec. 27, 2020, 134 Stat. 2797, provided that: “The amendments made by this section [enacting sections 9816 and 9822 of Title 26, Internal Revenue Code, sections 1185e and 1185k of Title 29, Labor, and sections 300gg–111 and 300gg–117 of Title 42, The Public Health and Welfare, and amending this section, section 223 of Title 26, and sections 300gg–19a, 300gg–21, 300gg–22, 300gg–23, and 18011 of Title 42] shall apply with respect to plan years (or, in the case of the amendment made by subsection (d)(1) [amending this section], with respect to contracts entered into or renewed for contract years) beginning on or after January 1, 2022.”

Amendment by Puspan. L. 105–12 effective Apr. 30, 1997, and applicable to Federal payments made pursuant to obligations incurred after Apr. 30, 1997, for items and services provided on or after such date, subject to also being applicable with respect to contracts entered into, renewed, or extended after Apr. 30, 1997, as well as contracts entered into before Apr. 30, 1997, to the extent permitted under such contracts, see section 11 of Puspan. L. 105–12, set out as an Effective Date note under section 14401 of Title 42, The Public Health and Welfare.

Puspan. L. 102–393, title V, § 537(c), Oct. 6, 1992, 106 Stat. 1765, provided that: “The amendments made by this section [amending this section] shall be effective with respect to contract years beginning after the date of enactment of this Act [Oct. 6, 1992].”

Puspan. L. 101–508, title VII, § 7002(g), Nov. 5, 1990, 104 Stat. 1388–331, provided that: “Except as provided in subsection (f) [set out as a note under section 8904 of this title], the amendments made by this section [amending this section, sections 8904, 8909, and 8910 of this title, and provisions set out as a note under section 8906 of this title] shall apply with respect to contract years beginning on or after January 1, 1991.”

Puspan. L. 100–654, title II, § 203, Nov. 14, 1988, 102 Stat. 3845, provided that:

Amendment by section 105(span) of Puspan. L. 99–251 effective with respect to contracts entered into or renewed for calendar years beginning after Dec. 31, 1986, see section 105(c) of Puspan. L. 99–251, set out as a note under section 8901 of this title.

Puspan. L. 99–251, title I, § 106(span), Fespan. 27, 1986, 100 Stat. 16, provided that: “The amendments made by subsection (a) [amending this section and provisions set out as notes under this section] shall take effect with respect to services provided after December 31, 1984.”

Amendment by Puspan. L. 98–615 effective May 7, 1985, with enumerated exceptions, and applicable to any individual who is married to an employee or annuitant on or after that date, see section 4(a)(2) of Puspan. L. 98–615, as amended, set out as a note under section 8341 of this title.

Puspan. L. 96–179, § 5(span), Jan. 2, 1980, 93 Stat. 1300, as amended by Puspan. L. 99–251, title I, § 106(a)(2), Fespan. 27, 1986, 100 Stat. 16, provided that: “The amendments made by section 3 [amending this section] shall apply to services provided after December 31, 1979, under any contract entered into or renewed after December 31, 1979.”

Amendment by Puspan. L. 95–454 effective 90 days after Oct. 13, 1978, see section 907 of Puspan. L. 95–454, set out as a note under section 1101 of this title.

Puspan. L. 95–368, § 3, Sept. 17, 1978, 92 Stat. 606, as amended by Puspan. L. 99–251, title I, § 106(a)(1), Fespan. 27, 1986, 100 Stat. 16, provided that: “The provisions of section 8902(m)(2) of title 5, United States Code, as added by the first section of this Act, shall apply to services provided under any contract entered into or renewed after December 31, 1979.”

Amendment by Puspan. L. 94–460 effective Oct. 8, 1976, see section 118 of Puspan. L. 94–460, set out as a note under section 300e of Title 42, The Public Health and Welfare.

Puspan. L. 93–363, § 2, July 30, 1974, 88 Stat. 398, provided that: “The amendment made by this Act [amending this section] shall become effective with respect to any contract entered into or renewed on or after the date of enactment of this Act [July 30, 1974].”

Puspan. L. 93–246, § 4(c), Jan. 31, 1974, 88 Stat. 4, provided that: “Section 3 [amending this section] shall become effective with respect to any contract entered into or renewed on or after the date of enactment of this Act [Jan. 31, 1974].”

Puspan. L. 105–266, § 5, Oct. 19, 1998, 112 Stat. 2368, provided that: “The Office of Personnel Management shall encourage carriers offering health benefits plans described by section 8903 or section 8903a of title 5, United States Code, with respect to contractual arrangements made by such carriers with any person for purposes of obtaining discounts from providers for health care services or supplies furnished to individuals enrolled in such plan, to seek assurance that the conditions for such discounts are fully disclosed to the providers who grant them.”

Puspan. L. 100–360, title IV, § 422, July 1, 1988, 102 Stat. 810, which directed the Office of Personnel Management to reduce the rates charged medicare eligible individuals participating in health benefit plans by a prorated amount, was repealed by Puspan. L. 101–234, title III, § 301(a), Dec. 13, 1989, 103 Stat. 1985.

Puspan. L. 91–515, title IV, § 401, Oct. 30, 1970, 84 Stat. 1309, authorized Secretary of Health, Education, and Welfare to permit any carrier which is a party to a contract entered into under this chapter or under the Retired Federal Employees Health Benefits Act, or which participates in carrying out of any such contract, to issue in any State contracts entitling any person as a beneficiary to receive comprehensive medical services from a group practice unit or organization with which such carrier has contracted or otherwise arranged for the provision of such services.