Page:United States Statutes at Large Volume 117.djvu/2228

 PUBLIC LAW 108–173—DEC. 8, 2003

117 STAT. 2209

(c) EFFECTIVE DATE.—The amendments made by this subsection shall take effect on the date of the enactment of this Act.

42 USC 1395w–24 note.

SEC. 233. MEDICARE MSAS.

(a) EXEMPTION FROM REPORTING REQUIREMENT.— (1) IN GENERAL.—Section 1852(e)(1) (42 U.S.C. 1395w– 22(e)(1)) is amended by inserting ‘‘(other than MSA plans)’’ after ‘‘plans’’. (2) CONFORMING AMENDMENTS.—Section 1852 (42 U.S.C. 1395w–22) is amended— (A) in subsection (c)(1)(I), by inserting before the period at the end the following: ‘‘, if required under such section’’; (B) in subsection (e)(2)(A), by striking ‘‘, a non-network MSA plan,’’; and (C) in subsection (e)(2)(B), by striking ‘‘, NON-NETWORK MSA PLANS,’’ and ‘‘, a non-network MSA plan,’’. (3) EFFECTIVE DATE.—The amendments made by this subsection shall apply on and after the date of the enactment of this Act but shall not apply to contract years beginning on or after January 1, 2006. (b) MAKING PROGRAM PERMANENT AND ELIMINATING CAP.— Section 1851(b)(4) (42 U.S.C. 1395w–21(b)(4)) is amended— (1) in the heading, by striking ‘‘ON A DEMONSTRATION BASIS’’; (2) by striking the first sentence of subparagraph (A); and (3) by striking the second sentence of subparagraph (C). (c) APPLYING LIMITATIONS ON BALANCE BILLING.—Section 1852(k)(1) (42 U.S.C. 1395w–22(k)(1)) is amended by inserting ‘‘or with an organization offering an MSA plan’’ after ‘‘section 1851(a)(2)(A)’’. (d) ADDITIONAL AMENDMENT.—Section 1851(e)(5)(A) (42 U.S.C. 1395w–21(e)(5)(A)) is amended— (1) by adding ‘‘or’’ at the end of clause (i); (2) by striking ‘‘, or’’ at the end of clause (ii) and inserting a semicolon; and (3) by striking clause (iii).

42 USC 1395w–22 note.

SEC. 234. EXTENSION OF REASONABLE COST CONTRACTS.

Subparagraph (C) of section 1876(h)(5) (42 U.S.C. 1395mm(h)(5)) is amended to read as follows: ‘‘(C)(i) Subject to clause (ii), a reasonable cost reimbursement contract under this subsection may be extended or renewed indefinitely. ‘‘(ii) For any period beginning on or after January 1, 2008, a reasonable cost reimbursement contract under this subsection may not be extended or renewed for a service area insofar as such area during the entire previous year was within the service area of— ‘‘(I) 2 or more MA regional plans described in clause (iii); or ‘‘(II) 2 or more MA local plans described in clause (iii). ‘‘(iii) A plan described in this clause for a year for a service area is a plan described in section 1851(a)(2)(A)(i) if the service area for the year meets the following minimum enrollment requirements: ‘‘(I) With respect to any portion of the area involved that is within a Metropolitan Statistical Area with a population

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