Page:United States Statutes at Large Volume 102 Part 1.djvu/786

 102 STAT. 748

PUBLIC LAW 100-360—JULY 1, 1988 (3) by adding at the end the following new subparagraph: "(C) shall include (i) an offer of assistance to such an individual in obtaining the names of participating physicians of appropriate specialty and (ii) an offer to provide a free copy of the appropriate participating physician directory.", (d) EFFECTIVE DATES.—

42 USC 1395b-2 note. 42 USC 1395u note. 42 USC 1395u note.

(1) The Secretary of Health and Human Services shall first distribute the notice required by the amendment made by subsection (a) not later than January 31, 1989. (2) The amendments made by subsection (b) shall apply to annual notices beginning with 1989. (3) The amendments made by subsection (c) shall first apply to explanations of benefits provided for items and services furnished on or after January 1, 1989. SEC. 224. CHANGES IN CIVIL MONEY PENALTIES FOR CERTAIN PRACTICES OF HEALTH MAINTENANCE ORGANIZATIONS AND COMPETITIVE MEDICAL PLANS.

Section 1876(i)(6)(B)(i) (42 U.S.C. 1395mm(i)(6)(B)(i)) is amended by adding at the end the following: "plus, with respect to a determination under subparagraph (A)(ii), double the excess amount charged in violation of such subparagraph (and the excess amount charged shall be deducted from the penalty and returned to the individual concerned), and plus, with respect to a determination under subparagraph (A)(iv), $15,000 for each individual not enrolled as a result of the practice involved,".

TITLE III—PROVISIONS RELATING TO THE MEDICAID PROGRAM SEC. 301. REQUIRING MEDICAID BUY-IN OF PREMIUMS AND COST-SHARING FOR INDIGENT MEDICARE BENEFICIARIES. (a) REQUIREMENT.—

(1) Section 1902(a)(10XE) (42 U.S.C. 1396a(a)(10XE)) is amended by striking "at the option of a State, but". (2) Section 1905(p)(l)(B) (42 U.S.C. 1396d(p)(l)(B)) is amended by striking "and the election of the State". Qy) PHASING-IN REQUIRED INCOME STANDARD TO 100 PERCENT OF POVERTY LEVEL.—Section 1905(p)(2)(A) (42 U.S.C. 1396d(p)(2)(A)) is

amended— (1) by striking "may not exceed a percentage (not more than 100 percent)" and inserting "shall be at least the percent provided under clause (ii) (but not more than 100 percent)", (2) by inserting "(i)" after "(2)(A)", and (3) by adding at the end the following new clause: "(ii) Except as provided in clause (iii), the percent provided under this clause, with respect to eligibility for medical assistance on or after— "(I) January 1, 1989, is 85 percent, "(II) January 1, 1990, is 90 percent, "(HI) January 1, 1991, is 95 percent, and "(TV) January 1, 1992, is 100 percent, "(iii) In the case of a State which has elected treatment under section 1902(f) and which, as of January 1, 1987, used an income standard for individuals age 65 or older which was more restrictive

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