Page:United States Statutes at Large Volume 111 Part 1.djvu/528

 Ill STAT. 504 PUBLIC LAW 105-33 —AUG. 5, 1997 "(B) RULE OF CONSTRUCTION.—Clause (i) of subparagraph (A) shall not apply to the provision of abortion services, except that a State may impose a sanction on any medicaid managed care organization that has a contract to provide abortion services if the organization does not provide such services as provided for under the contract. "(2) INTERMEDIATE SANCTIONS.— The sanctions described in this paragraph are as follows: "(A) Civil money penalties as follows: "(i) Except as provided in clause (ii), (iii), or (iv), not more than $25,000 for each determination under paragraph (1)(A). "(ii) With respect to a determination under clause (iii) or (iv)(I) of paragraph (1)(A), not more than $100,000 for each such determination. "(iii) With respect to a determination under paragraph (l)(A)(ii), double the excess amount charged in violation of such subsection (and the excess amount charged shall be deducted from the penalty and returned to the individual concerned). "(iv) Subject to clause (ii), with respect to a determination under paragraph (l)(A)(iii), $15,000 for each individual not enrolled as a result of a practice described in such subsection. "(B) The appointment of temporary management— "(i) to oversee the operation of the medicaid managed care organization upon a finding by the State that there is continued egregious behavior by the organization or there is a substantial risk to the health of enrollees; or "(ii) to assure the health of the organization's enrollees, if there is a need for temporary management while— "(I) there is an orderly termination or reorganization of the organization; or "(II) improvements are made to remedy the violations found under paragraph (1), except that temporary management under this subparagraph may not be terminated until the State has determined that the medicaid managed care organization has the capability to ensure that the violations shall not recur. "(C) Permitting individuals enrolled with the managed care entity to terminate enrollment without cause, and notifying such individuals of such right to terminate enrollment. "(D) Suspension or default of all enrollment of individuals under this title after the date the Secretary or the State notifies the entity of a determination of a violation of any requirement of section 1903(m) or this section. "(E) Suspension of payment to the entity under this title for individuals enrolled after the date the Secretary or State notifies the entity of such a determination and until the Secretary or State is satisfied that the basis for such determination has been corrected and is not likely to recur.

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