Page:United States Statutes at Large Volume 111 Part 1.djvu/561

 PUBLIC LAW 105-33—AUG. 5, 1997 111 STAT. 537 PACE demonstration waiver programs under the PACE protocol. "(B) FLEXIBILITY.— In order to provide for reasonable flexibility in adapting the PACE service delivery model to the needs of particular organizations (such as those in rural areas or those that may determine it appropriate to use nonstaff physicians according to State licensing law requirements) under this section and section 1934, the Secretary (in close consultation with State administering agencies) may modify or waive provisions of the PACE protocol so long as any such modification or waiver is not inconsistent with and would not impair the essential elements, objectives, and requirements of this section, but may not modify or waive any of the following provisions: "(i) The focus on frail elderly qualifying individuals who require the level of care provided in a nursing facility. "(ii) The delivery of comprehensive, integrated acute and long-term care services. "(iii) The interdisciplinary team approach to care management and service delivery. "(iv) Capitated, integrated financing that allows the provider to pool payments received from public and private programs and individuals. "(v) The assumption by the provider of full financial risk. " (3) APPLICATION OF CERTAIN ADDITIONAL BENEFICIARY AND PROGRAM PROTECTIONS.— "(A) IN GENERAL.—In issuing such regulations and subject to subparagraph (B), the Secretary may apply with respect to PACE programs, providers, and agreements such requirements of part C (or, for periods before January 1, 1999, section 1876) and sections 1903(m) and 1932 relating to protection of beneficiaries and program integrity as would apply to Medicare+Choice organizations under part C (or for such periods eligible organizations under risk-sharing contracts under section 1876) and to medicaid managed care organizations under prepaid capitation agreements under section 1903(m). "(B) CONSIDERATIONS.— In issuing such regulations, the Secretary shall— "(i) take into account the differences between populations served and benefits provided under this section and under part C (or, for periods before January 1, 1999, section 1876) and section 1903(m); "(ii) not include any requirement that conflicts with carrying out PACE programs under this section; and "(iii) not include any requirement restricting the proportion of enrollees who are eligible for benefits under this title or title XIX. "(4) CONSTRUCTION. — Nothing in this subsection shall be construed as preventing the Secretary from including in regulations provisions to ensure the health and safety of individuals enrolled in a PACE program under this section that are in addition to those otherwise provided under paragraphs (2) and (3).

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