Page:United States Statutes at Large Volume 104 Part 1.djvu/627

 PUBLIC LAW 101-381—AUG. 18, 1990 104 STAT. 593 for any calendar year, impose charges in an amount exceeding 7 percent of the annual gross income of the individual involved; and "(E) in the case of individuals with an income greater than 800 percent of the official poverty line, the provider will not, for any calendar year, impose charges in an amount exceeding 10 percent of the annual gross income of the individual involved. "(2) ASSESSMENT OF CHARGE. —With respect to compliance with the assurance made under paragraph (1), a grantee under this part may, in the case of individuals subject to a charge for purposes of such paragraph— "(A) assess the amount of the charge in the discretion of the grantee, including imposing only a nominal charge for the provision of services, subject to the provisions of such paragraph regarding public schedules regarding limitation on the maximum amount of charges; and "(B) take into consideration the medical expenses of individuals in sissessing the amount of the charge, subject to such provisions. " (3) APPLICABILITY OF LIMITATION ON AMOUNT OF CHARGE.— The Secretary may not make a grant under section 2611 unless the applicant of the grant agrees that the limitations established in subparagraphs (C), (D), and (E) of paragraph (1) regarding the imposition of charges for services applies to the annual aggregate of charges imposed for such services, without regard to whether they are characterized as enrollment fees, premiums, deductibles, cost sharing, copayments, coinsurance, or other charges. " (4) WAIVER.— "(A) IN GENERAL.— The State shall waive the requirements established in paragraphs (1) through (3) in the case of an entity that does not, in providing health care services, impose a charge or accept reimbursement from any thirdparty payor, including reimbursement under any insurance policy or under any Federal or State health benefits program. "(B) DETERMINATION.— A determination by the State of whether an entity referred to in subparagraph (A) meets the criteria for a waiver under such subparagraph shall be made without regard to whether the entity accepts voluntary donations regarding the provision of services to the public. " (d) REQUIREMENT OF MATCHING FUNDS REGARDING STATE ALLOT- MENTS. — "(1) IN GENERAL. — In the case of any State to which the criterion described in paragraph (3) applies, the Secretary may not make a grant under this part unless the State agrees that, with respect to the costs to be incurred by the State in carrying out the program for which the grant was awarded, the State will, subject to subsection (b)(2), make available (directly or through donations from public or private entities) non-Federal contributions toward such costs in an amount equal to— "(A) for the first fiscal year of payments under the grsint, not less than 16% percent of such costs ($1 for each $5 of Federal funds provided in the grant);

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