Page:United States Statutes at Large Volume 111 Part 1.djvu/586

 Ill STAT. 562 PUBLIC LAW 105-33 —AUG. 5, 1997 " (3) WAIVER FOR PURCHASE OF FAMILY COVERAGE. —Pay- ment may be made to a State under subsection (a)(1) for the purchase of family coverage under a group health plan or health insurance coverage that includes coverage of targeted low-income children only if the State establishes to the satisfaction of the Secretary that— "(A) purchase of such coverage is cost-effective relative to the amounts that the State would have paid to obtain comparable coverage only of the targeted low-income children involved, and "(B) such coverage shall not be provided if it would otherwise substitute for health insurance coverage that would be provided to such children but for the purchase of family coverage. "(4) USE OF NON-FEDERAL FUNDS FOR STATE MATCHING REQUIREMENT. — Amounts provided by the Federal Government, or services assisted or subsidized to any significant extent by the Federal Government, may not be included in determining the amount of non-Federal contributions required under subsection (a). "(5) OFFSET OF RECEIPTS ATTRIBUTABLE TO PREMIUMS AND OTHER COST-SHARING.—For purposes of subsection (a), the amount of the expenditures under the plgm shall be reduced by the amount of any premiums and other cost-sharing received by the State. " (6) PREVENTION OF DUPLICATIVE PAYMENTS.— "(A) OTHER HEALTH PLANS.— No payment shall be made to a State under this section for expenditures for child health assistance provided for a targeted low-income child under its plan to the extent that a private insurer (as defined by the Secretary by regulation and including a group health plan (as defined in section 607(1) of the Employee Retirement Income Security Act of 1974), a service benefit plan, and a health maintenance organization) would have been obligated to provide such assistance but for a provision of its insurance contract which has the effect of limiting or excluding such obligation because the individual is eligible for or is provided child health assistance under the plan. "(B) OTHER FEDERAL GOVERNMENTAL PROGRAMS.— Except as otherwise provided by law, no payment shall be made to a State under this section for expenditures for child health assistance provided for a targeted lowincome child under its plan to the extent that payment has been made or can reasonably be expected to be made promptly (as determined in accordance with regulations) under any other federally operated or financed health care insurance program, other than an insurance program operated or financed by the Indian Health Service, as identified by the Secretary. For purposes of this paragraph, rules similar to the rules for overpayments under section 1903(d)(2) shall apply. " (7) LIMITATION ON PAYMENT FOR ABORTIONS.— "(A) IN GENERAL. — Payment shall not be made to a State under this section for any amount expended under the State plan to pay for any abortion or to assist in

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