Page:United States Statutes at Large Volume 111 Part 1.djvu/343

 PUBLIC LAW 105-33—AUG. 5, 1997 111 STAT. 319 and republication of such rule by not later than 1 year after the target date of publication. " (b) ESTABLISHMENT OF OTHER STANDARDS. — "(1) IN GENERAL.— The Secretary shall establish by regulation other standards (not described in subsection (a)) for Medicare+Choice organizations and plans consistent with, and to carry out, this part. The Secretary shall publish such regula- Publication, tions by June 1, 1998. In order to carry out this requirement in a timely manner, the Secretary may promulgate regulations that take effect on an interim basis, after notice and pending opportunity for public comment. "(2) USE OF CURRENT STANDARDS. —Consistent with the requirements of this part, standards established under this subsection shall be based on standards established under section 1876 to carry out analogous provisions of such section. "(3) RELATION TO STATE LAWS. — "(A) IN GENERAL.— The standards established under this subsection shall supersede any State law or regulation (including standards described in subparagraph (B)) with respect to Medicare+Choice plans which are offered by Medicare+Choice organizations under this part to the extent such law or regulation is inconsistent with such standards. " (B) STANDARDS SPECIFICALLY SUPERSEDED.— State standards relating to the following are superseded under this paragraph: "(i) Benefit requirements. "(ii) Requirements relating to inclusion or treatment of providers. "(iii) Coverage determinations (including related appeals and grievance processes). " CONTRACTS WITH MEDICARE+CHOICE ORGANIZATIONS "SEC. 1857. (a) IN GENERAL. —The Secretary shall not permit 42 USC the election under section 1851 of a Medicare+Choice plan offered i395w-27. by a Medicare+Choice organization under this part, and no payment shall be made under section 1853 to an organization, unless the Secretary has entered into a contract under this section with the organization with respect to the offering of such plan. Such a contract with an organization may cover more than 1 Medicare+Choice plan. Such contract shall provide that the organization agrees to comply with the applicable requirements and standards of this part and the terms and conditions of payment as provided for in this part. "(b) MINIMUM ENROLLMENT REQUIREMENTS. — "(1) IN GENERAL.— Subject to paragraph (2), the Secretary may not enter into a contract under this section with a Medicare+Choice organization unless the organization has— "(A) at least 5,000 individuals (or 1,500 individuals in the case of an organization that is a provider-sponsored organization) who are receiving health benefits through the organization, or "(B) at least 1,500 individuals (or 500 individuals in the case of an organization that is a provider-sponsored organization) who are receiving health benefits through the organization if the organization primarily serves individuals residing outside of urbanized areas.

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