Page:United States Statutes at Large Volume 102 Part 1.djvu/790

 102 STAT. 752

PUBLIC LAW 100-360—JULY 1, 1988 durational limit on medical assistance for inpatient hospital services (whether or not such a limit varies by medical condition or diagnosis), the plan must establish exceptions to such a limit for medically necessary inpatient hospital services furnished with respect to individuals under one year of age in a hospital defined under the State plan, pursuant to section 1923(a)(l)(A), as a disproportionate share hospital and subparagraph (B) (relating to comparability) shall not be construed as requiring such an exception for other individuals, services, or hospitals". (2) ASSURING ADEQUATE PAYMENT FOR INPATIENT HOSPITAL SERVICES FOR INFANTS IN DISPROPORTIONATE SHARE HOSPITALS.—

42 USC l396r-4.

Section 1923(a)(2), as redesignated pursuant to the amendment made by section 411(k)(6)(B) of this Act, is amended by adding at the end the following new subparagraph: "(C) If a State plan under this title provides for payments for inpatient hospital services on a prospective basis (whether per diem, per case, or otherwise), in order for the plan to be considered to have met such requirement of section 1902(a)(13XA) as of July 1, 1989, the State must submit to the Secretary by not later than April 1, 1989, a State plan amendment that provides, in the case of hospitals defined by the State as disproportionate share hospitals under paragraph (I)(A), for an outlier adjustment in payment amounts for medically necessary inpatient hospital services provided on or after July 1, 1989, involving exceptionally high costs or exceptionally long lengths of stay for individuals under one year of age.". (c) CERTAIN STATE PLAN REQUIREMENTS.—

(1) IN GENERAL.—Subsection (c) of section 1902 (42 U.S.C. 1396a) is amended to read as follows: "(c) Notwithstanding subsection (b), the Secretary shall not approve any State plan for medical assistance if— "(1) the State has in effect, under its plan established under part A of title IV, payment levels that are less than the payment levels in effect under such plan on May 1, 1988; or "(2) the State requires individuals described in subsection (IXD to apply for benefits under such part as a condition of applying for, or receiving, medical assistance under this title.". (2) ELIMINATING DUPUCATE REQUIREMENT.—Section 1902G) (42 U.S.C. 1396a(l)) is amended by striking paragraph (4). (3) MAINTENANCE OF EFFORT TO RECEIVE MEDICAL ASSISTANCE FOR OPTIONAL COVERAGE OF PREGNANT WOMEN AND CHILDREN.—

Section 1903(i) (42 U.S.C. 1396b(i)) is amended— (A) by striking the period at the end of paragraph (8) and inserting "; or", and (B) by inserting after paragraph (8) the following new paragraph: "(9) with respect to any amount of medical assistance for pregnant women and children described in section 1902(a)(10XAXiiXIX), if the State has in effect, under its plan established under part A of title IV, payment levels that are less than the payment levels in effect under such plan on July 1, 1987.". (d) TREATMENT OF CERTAIN STATES AND TERRITORIES.—Section

19020) (42 U.S.C. 1396a(l)) is amended by adding at the end the following new paragraph: "(4)(A) In the case of any State which is providing medical assistance to its residents under a waiver granted under section 1115, the

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