SOCIAL SECURITY
Title 42 - The Public Health and Welfare
Basic entitlement to benefits
Qualified individuals
Residence outside the United States
Disqualifications
Benefit amount
Applications and furnishing of information
Representative payees
Overpayments and underpayments
Hearings and review
Other administrative provisions
Optional Federal administration of State recognition payments
Penalties for fraud
Definitions
Appropriations
Employment security administration account
Transfers between Federal unemployment account and employment security administration account
Amounts transferred to State accounts
Unemployment Trust Fund
Extended unemployment compensation account
Unemployment compensation research program
Personnel training
Advisory Council on Unemployment Compensation
Federal Employees Compensation Account
Borrowing between Federal accounts
Data exchange standardization for improved interoperability
Authorization of appropriations
State plans for aid to blind
Payment to States
Operation of State plans
“Aid to the blind” defined
Rules and regulations; impact analyses of Medicare and Medicaid rules and regulations on small rural hospitals
Separability
Reservation of right to amend or repeal
Short title of chapter
Disclosure of information in possession of Social Security Administration or Department of Health and Human Services
Public access to State disbursement records
State data exchanges
Restriction on access to the Death Master File
Penalty for fraud
Additional grants to Puerto Rico, Virgin Islands, Guam, and American Samoa; limitation on total payments
Amounts disregarded not to be taken into account in determining eligibility of other individuals
Cooperative research or demonstration projects
Public assistance payments to legal representatives
Medical care guides and reports for public assistance and medical assistance
Assistance for United States citizens returned from foreign countries
Public advisory groups
Measurement and reporting of welfare receipt
National Advisory Committee on the Sex Trafficking of Children and Youth in the United States
Demonstration projects
Center for Medicare and Medicaid Innovation
Providing Federal coverage and payment coordination for dual eligible beneficiaries
Administrative and judicial review of public assistance determinations
Appointment of the Administrator and Chief Actuary of the Centers for Medicare & Medicaid Services
Alternative Federal payment with respect to public assistance expenditures
Federal participation in payments for repairs to home owned by recipient of aid or assistance
Approval of certain projects
Uniform reporting systems for health services facilities and organizations
Limitation on use of Federal funds for capital expenditures
Effect of failure to carry out State plan
Reviews of child and family services programs, and of foster care and adoption assistance programs, for conformity with State plan requirements
Disclosure of ownership and related information; procedure; definitions; scope of requirements
Disclosure requirements for other providers under part B of Medicare
Issuance of subpenas by Comptroller General
Disclosure by institutions, organizations, and agencies of owners, officers, etc., convicted of offenses related to programs; notification requirements; “managing employee” defined
Adjustments in SSI benefits on account of retroactive benefits under subchapter II
Interagency coordination to improve program administration
Exclusion of certain individuals and entities from participation in Medicare and State health care programs
Civil monetary penalties
Criminal penalties for acts involving Federal health care programs
Fraud and abuse control program
Guidance regarding application of health care fraud and abuse sanctions
Health care fraud and abuse data collection program
Coordination of medicare and medicaid surety bond provisions
Funds to reduce medicaid fraud and abuse
Transparency reports and reporting of physician ownership or investment interests
Reporting of information relating to drug samples
Accountability requirements for facilities
Medicare and Medicaid program integrity provisions
Nationwide program for national and State background checks on direct patient access employees of long-term care facilities and providers
Use of predictive modeling and other analytics technologies to identify and prevent waste, fraud, and abuse in the Medicare fee-for-service program
Disclosure of predictive modeling and other analytics technologies to identify and prevent waste, fraud, and abuse
Civil monetary penalties and assessments for subchapters II, VIII and XVI
Administrative procedure for imposing penalties for false or misleading statements
Attempts to interfere with administration of this chapter
Notification of Social Security claimant with respect to deferred vested benefits
Prohibitions relating to references to Social Security or Medicare
Blood donor locator service
Research on outcomes of health care services and procedures
Social security account statements
Outreach efforts to increase awareness of the availability of medicare cost-sharing and subsidies for low-income individuals under subchapter XVIII
Protection of social security and medicare trust funds
Public disclosure of certain information on hospital financial interest and referral patterns
Cross-program recovery of overpayments from benefits
The Ticket to Work and Self-Sufficiency Program
Period within which certain claims must be filed
Work incentives outreach program
State grants for work incentives assistance to disabled beneficiaries
Grants to develop and establish State infrastructures to support working individuals with disabilities
Pharmacy benefit managers transparency requirements
Consultation with Tribal Technical Advisory Group
Reporting to law enforcement of crimes occurring in federally funded long-term care facilities
Funding for providers relating to COVID–19
Applicants or recipients under public assistance programs not to be required to make election respecting certain veterans’ benefits
Nonprofit hospital or critical access hospital philanthropy
Authority to waive requirements during national emergencies
Exclusion of representatives and health care providers convicted of violations from participation in social security programs
Income and eligibility verification system
Hospital protocols for organ procurement and standards for organ procurement agencies
Improved access to, and delivery of, health care for Indians under subchapters XIX and XXI
Child health quality measures
Adult health quality measures
Purpose
Definition of quality improvement organization
Annual reports
Exemptions for religious nonmedical health care institutions
Medical officers in American Samoa, the Northern Mariana Islands, and the Trust Territory of the Pacific Islands to be included in the quality improvement program
Contracts with quality improvement organizations
Functions of quality improvement organizations
Right to hearing and judicial review
Obligations of health care practitioners and providers of health care services; sanctions and penalties; hearings and review
Limitation on liability
Application of this part to certain State programs receiving Federal financial assistance
Authorization for use of certain funds to administer provisions of this part
Prohibition against disclosure of information
General requirements for adoption of standards
Standards for information transactions and data elements
Timetables for adoption of standards
Requirements
General penalty for failure to comply with requirements and standards
Wrongful disclosure of individually identifiable health information
Effect on State law
Processing payment transactions by financial institutions
Application of HIPAA regulations to genetic information
Comparative clinical effectiveness research
Limitations on certain uses of comparative clinical effectiveness research
Trust Fund transfers to Patient-Centered Outcomes Research Trust Fund
Information exchange with payroll data providers
Establishment of program
Selection of negotiation-eligible drugs as selected drugs
Manufacturer agreements
Negotiation and renegotiation process
Publication of maximum fair prices
Administrative duties and compliance monitoring
Limitation on administrative and judicial review
Eligibility requirements for transfer of funds; reimbursement by State; application; certification; limitation
Repayment by State; certification; transfer; interest on loan; credit of interest on loan
Repayable advances to Federal unemployment account
“Governor” defined
State plans for aid to permanently and totally disabled
Payments to States
Statement of purpose; authorization of appropriations
Eligibility for benefits
Income; earned and unearned income defined; exclusions from income
Resources
Rehabilitation services for blind and disabled individuals
Supplementary assistance by State or subdivision to needy individuals
Cost-of-living adjustments in benefits
Payments to State for operation of supplementation program
Benefits for individuals who perform substantial gainful activity despite severe medical impairment
Medical and social services for certain handicapped persons
Attribution of sponsor’s income and resources to aliens
Procedure for payment of benefits
Administration
Eligibility for medical assistance of aged, blind, or disabled individuals under State’s medical assistance plan
Outreach program for children
Treatment referrals for individuals with alcoholism or drug addiction condition
Annual report on program
Availability of funds during certain fiscal years; limitation on amount; utilization of grant
Applications; single State agency designation; essential planning services; plans for expenditure; final activities report and other necessary reports; records; accounting
Payments to States; adjustments; advances or reimbursement; installments; conditions
Prohibition against any Federal interference
Free choice by patient guaranteed
Agreements with States
Contract with a consensus-based entity regarding performance measurement
Quality and efficiency measurement
Option to individuals to obtain other health insurance protection
Incentives for economy while maintaining or improving quality in provision of health services
Addressing health care disparities
Notice of medicare benefits; medicare and medigap information
Health insurance advisory service for medicare beneficiaries
Health insurance information, counseling, and assistance grants
Beneficiary incentive programs
Medicare Payment Advisory Commission
Explanation of medicare benefits
Chronic care improvement
Provisions relating to administration
Effect of accreditation
Conditions of participation for home health agencies; home health quality