Page:United States Statutes at Large Volume 111 Part 1.djvu/530

 Ill STAT. 506 PUBLIC LAW 105-33—AUG. 5, 1997 42 USC 1396U-2. 42 USC 1396b note. (c) APPLICATION OF DISCLOSURE REQUIREMENTS TO MANAGED CARE ENTiTiES.^ection 1124(a)(2)(A) (42 U.S.C. 1320a-3(a)(2)(A)) is amended by inserting "a managed care entity, as defined in section 1932(a)(1)(B)," after "renal disease facility,". SEC. 4708. IMPROVED ADMINISTRATION. (a) CHANGE IN THRESHOLD AMOUNT FOR CONTRACTS REQUIRING SECRETARY'S PRIOR APPROVAL.— Section 1903(m)(2)(A)(iii) (42 U.S.C. 1396b(m)(2)(A)(iii)) is amended by striking "$100,000 " and inserting "$1,000,000 for 1998 and, for a subsequent year, the amount established under this clause for the previous year increased by the percentage increase in the consumer price index for all urban consumers over the previous year". (b) PERMITTING SAME COPAYMENTS IN HEALTH MAINTENANCE ORGANIZATIONS AS IN FEE-FOR-SERVICE. —Section 1916 (42 U.S.C. 1396o) is amended— (1) in subsection (a)(2)(D), by striking "or services furnished" and all that follows through "enrolled,"; and (2) in subsection (b)(2)(D), by striking "or (at the option" and all that follows through "enrolled,". (c) ASSURING TIMELINESS OF PROVIDER PAYMENTS.— Section 1932 is further amended by adding at the end the following: "(f) TIMELINESS OF PAYMENT.—A contract under section 1903(m) with a medicaid managed care organization shall provide that the organization shall make payment to health CEire providers for items and services which are subject to the contract and that are furnished to individuals eligible for medical assistance under the State plsui under this title who are enrolled with the organization on a timely basis consistent with the claims payment procedures described in section 1902(a)(37)(A), unless the health care provider and the organization agree to an alternate payment schedule.". (d) CLARIFICATION OF APPLICATION OF FFP DENIAL RULES TO PAYMENTS MADE PURSUANT TO MANAGED CARE ENTITIES.—Section 1903(i) (42 U.S.C. 1396b(i)) is amended by adding at the end the following new sentence: "Paragraphs (1), (2), (16), (17), and (18) shall apply with respect to items or services furnished and amounts expended by or through a managed care entity (as defined in section 1932(a)(1)(B)) in the same manner as such paragraphs apply to items or services furnished and amounts expended directly by the State.". SEC. 4709. e -MONTH GUARANTEED ELIGIBILITY FOR ALL INDIVIDUALS ENROLLED IN MANAGED CARE. Section 1902(e)(2) (42 U.S.C. 1396a(e)(2)) is amended— (1) by striking "who is enrolled" and all that follows through "section 1903(m)(2)(A)" and inserting "who is enrolled with a medicaid managed care organization (as defined in section 1903(m)(l)(A)), with a primary care case manager (as defined in section 1905(t)),"; and (2) by inserting before the period "or by or through the case manager". SEC. 4710. EFFECTIVE DATES. (a) GENERAL EFFECTIVE DATE.— Except as otherwise provided in this chapter and section 4759, the amendments made by this chapter shall take effect on the date of the enactment of this Act and shall apply to contracts entered into or renewed on or after October 1, 1997.

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