Page:United States Statutes at Large Volume 111 Part 1.djvu/581

 PUBLIC LAW 105-33—AUG. 5, 1997 111 STAT. 557 and other cost sharing imposed. Any such charges shall be imposed pursuant to a public schedule. "(B) PROTECTION FOR LOWER INCOME CHILDREN.—The State child health plan may only vary premiums, deductibles, coinsurance, and other cost sharing based on the family income of targeted low-income children in a manner that does not favor children from families with higher income over children from families with lower income. "(2) No COST SHARING ON BENEFITS FOR PREVENTIVE SERV- ICES. —The State child health plan may not impose deductibles, coinsurance, or other cost sharing with respect to benefits for services within the category of services described in subsection (c)(1)(D). " (3) LIMITATIONS ON PREMIUMS AND COST-SHARING. — " (A) CHILDREN IN FAMILIES WITH INCOME BELOW I50 PERCENT OF POVERTY LINE.— In the case of a targeted lowincome child whose family income is at or below 150 percent of the poverty line, the State child health plan may not impose— "(i) an enrollment fee, premium, or similar charge that exceeds the maximum monthly charge permitted consistent with standards established to carry out section 1916(b)(1) (with respect to individuals described in such section); and "(ii) a deductible, cost sharing, or similar charge that exceeds an amount that is nominal (as determined consistent with regulations referred to in section 1916(a)(3), with such appropriate adjustment for inflation or other reasons as the Secretary determines to be reasonable). "(B) OTHER CHILDREN.— For children not described in subparagraph (A), subject to paragraphs (1)(B) and (2), any premiums, deductibles, cost sharing or similar charges imposed under the State child health plan may be imposed on a sliding scale related to income, except that the total annual aggregate cost-sharing with respect to all targeted low-income children in a family under this title may not exceed 5 percent of such family's income for the year involved. "(4) RELATION TO MEDICAID REQUIREMENTS.— Nothing in this subsection shall be construed as affecting the rules relating to the use of enrollment fees, premiums, deductions, cost sharing, and similar charges in the case of targeted low-income children who are provided child health assistance in the form of coverage under a medicaid program under section 2101(a)(2). "(f) APPLICATION OF CERTAIN REQUIREMENTS.— " (1) RESTRICTION ON APPLICATION OF PREEXISTING CONDI- TION EXCLUSIONS.— "(A) IN GENERAL. — Subject to subparagraph (B), the State child health plan shall not permit the imposition of any preexisting condition exclusion for covered benefits under the plan. "(B) GROUP HEALTH PLANS AND GROUP HEALTH INSUR- ANCE COVERAGE. —I f the State child health plan provides for benefits through payment for, or a contract with, a group health plan or group health insurance coverage, the

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