Page:United States Statutes at Large Volume 107 Part 1.djvu/645

 PUBLIC LAW 103-66 —AUG. 10, 1993 107 STAT. 619 (bb) by adding at the end the following: "Any drug, biological product, or insulin excluded from the definition of such term as a result of this paragraph shall be treated as a covered outpatient drug for purposes of determining the best price (as defined in subsection (c)(l)(C)) for such drug, biological product, or insulin."; (iii) in paragraph (6), by striking ", which appears" and all that follows and inserting "or the use of which is supported b^ one or more citations included or approved for mclusion in any of the compendia described in subsection (g)(l)(B)(i). "; (iv) in paragraph (7)(A)(i), by striking "calendar quarter" and inserting "rebate period"; and (v) by redesignating paragraph (8) as paragraph (9) and by inserting after paragraph (7) the following new paragraph: "(8) REBATE PERIOD.— The term 'rebate period* means, with respect to an agreement under subsection (a), a calendar quarter or other period specified by the Secretary with respect to the payment of rebates under such agreement.". (b) LIMITING FEDERAL PAYMENTS FOR CERTAIN DRUGS.—Paragraph (10) of section 1903(i) (42 U.S.C. 1396b(i)) (as inserted by section 4401(a)(l)(B) of OBRA-1990) is amended to read as follows: "(10)(A) with respect to covered outpatient drugs unless there is a rebate agreement in effect under section 1927 with respect to such drugs or unless section 1927(a)(3) applies, and "(B) with respect to any amount expended for an innovator multiple source drug (as defined in section 1927(k)) dispensed on or after July 1, 1991, if, under applicable State law, a less expensive multiple source drug could have been dispensed, but only to the extent that such amount exceeds the upper payment limit for such multiple source drug;". (c) EUMINATION OF PROHIBITION AGAINST STATE USE OF FORMULARIES TO ACHIEVE FEDERAL SAVINGS.— Paragraph (54) of section 1902(a) (42 U.S.C. 1396a(a)) is amended to read as follows: "(54) in the case of a State plan that provides medical assistance for covered outpatient drugs (as defined in section 1927(k)), comply with the applicable requirements of section 1927;". (d) EFFECTIVE DATES. —(1) Except as provided in paragraph 42 USC i396r-8 (2), the amendments made by this section shall take effect as ^°^- if included in the enactment of OBRA-1990. (2) The amendment made by subsection (a)(1) (insofar as such subsection amends section 1927(d) of the Social Security Act) and the amendment made by subsection (c) shall appl^^ to calendar quarters beginning on or after October 1, 1993, without regard to whether or not regulations to carry out such amendments have been promulgated by such date. SEC. 13603. OPTIONAL MEDICAID COVERAGE OF TB-RELATED SERV- ICES FOR CERTAIN TB-INFECTED INDIVIDUALS. (a) COVERAGE AS OPTIONAL, CATEGORICALLY NEEDY GROUP. — Section 1902(a)(10XAXii) (42 U.S.C. 1396a(a)(10XAXii)) is amended— (1) by striking "or" at the end of subclause (X),

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