Page:United States Statutes at Large Volume 111 Part 1.djvu/524

 Ill STAT. 500 PUBLIC LAW 105-33 —AUG. 5, 1997 not be duplicative of review activities conducted as part of the accreditation process or the external review conducted under such section. "(C) DEEMED COMPLIANCE FOR MEDICARE MANAGED CARE ORGANIZATIONS,—At the option of a State, the requirements of subparagraph (A) shall not apply with respect to a medicaid managed care organization if the organization is an eligible organization with a contract in effect under section 1876 or a Medicare+Choice organization with a contract in effect under C of title XVIII and the organization has had a contract in effect under section 1903(m) at least during the previous 2-year period. (b) INCREASED FFP FOR EXTERNAL QUALITY REVIEW ORGANIZA- TIONS.— Section 1903(a)(3)(C) (42 U.S.C. 1396b(a)(3)(C)) is amended— (1) by inserting "(i)" after "(C)", and (2) by adding at the end the following new clause: "(ii) 75 percent of the sums expended with respect to costs incurred during such quarter (as found necessary by the Secretary for the proper and efficient administration of the State plan) as are attributable to the performance of independent external reviews conducted under section 1932(c)(2); and". 42 USC 1396U-2 (c) STUDIES AND REPORTS. — i^ote. (1) GAO STUDY AND REPORT ON QUALITY ASSURANCE AND ACCREDITATION STANDARDS. — (A) STUDY.— The Comptroller General of the United States shall conduct a study and analysis of the quality assurance programs and accreditation standards applicable to managed care entities operating in the private sector, or to such entities that operate under contracts under the medicare program under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.). Such study shall determine— (i) if such programs and standards include consideration of the accessibility and quality of the health care items and services delivered under such contracts to low-income individuals; and (ii) the appropriateness of applying such programs and standards to medicaid managed care organizations under section 1932(c) of such Act. (B) REPORT. —The Comptroller General shall submit a report to the Committee on Commerce of the House of Representatives and the Committee on Finance of the Senate on the study conducted under subparagraph (A). (2) STUDY AND REPORT ON SERVICES PROVIDED TO INDIVID- UALS WITH SPECIAL HEALTH CARE NEEDS. — (A) STUDY.—The Secretary of Health and Human Services, in consultation with States, managed care organizations, the National Academy of State Health Policy, representatives of beneficiaries with special health care needs, experts in specialized health care, and others, shall conduct a study concerning safeguards (if any) that may be needed to ensure that the health care needs of individuals with special health care needs and chronic conditions who are enrolled with medicaid managed care organizations are adequately met.

�