Page:United States Statutes at Large Volume 123.djvu/528

 123STA T .508PUBLIC LA W 111 – 5 —FE B.1 7, 200 9‘ ‘ (A)DEMONSTRA T I ONO F A C CESS TO IN D IAN H EA L TH CARE P RO V IDERS AND APPLICATION OF ALTERNATIVE PA Y- MENT ARRAN G EMENTS .—Subject t os ub par a g rap h ( C ) , to— ‘‘( i ) d e m o n strate that the number o fI ndian hea l th care pro v iders that are participating providers w ith respect to such entit y are sufficient to ensure timely access to covered M edicaid managed care services for those Indian enrollees who are eligible to receive serv- ices from such providers and ‘‘(ii) agree to pay Indian health care providers, whether such providers are participating or nonpartici- pating providers with respect to the entity, for covered Medicaid managed care services provided to those Indian enrollees who are eligible to receive services from such providers at a rate e q ual to the rate nego- tiated between such entity and the provider involved or, if such a rate has not been negotiated, at a rate that is not less than the level and amount of payment which the entity would ma k e for the services if the services were furnished by a participating provider which is not an Indian health care provider. T he Secretary shall establish procedures for applying the requirements of clause (i) in States where there are no or few Indian health providers. ‘‘( B ) P ROMPT PAYMENT.—To agree to make prompt pay- ment (consistent with rule for prompt payment of providers under section 1932 (f)) to Indian health care providers that are participating providers with respect to such entity or, in the case of an entity to which subparagraph (A)(ii) or (C) applies, that the entity is required to pay in accord- ance with that subparagraph. ‘‘(C) APPLICATION OF SPECIAL PAYMENT RE QU IREMENTS FOR FEDERALLY-QUALIFIED HEALTH CENTERS AND FOR SERV- ICES PROVIDED B Y CERTAIN INDIAN HEALTH CARE PRO- VIDERS.— ‘‘(i) F EDERALLY-QUALIFIED HEALTH CENTERS.— ‘‘(I) MANAGED CARE ENTITY PAYMENT REQUIRE- MENT.—To agree to pay any Indian health care provider that is a federally-qualified health center under this title but not a participating provider with respect to the entity, for the provision of covered Medicaid managed care services by such provider to an Indian enrollee of the entity at a rate equal to the amount of payment that the entity would pay a federally-qualified health center that is a participating provider with respect to the entity but is not an Indian health care provider for such services. ‘‘(II) CONTINUED APPLICATION OF STATE REQUIREMENT TO MA K E SUPPLEMENTAL PAYMENT.— N othing in subclause (I) or subparagraph (A) or (B) shall be construed as waiving the application of section 19 0 2(bb)( 5 ) regarding the State plan requirement to make any supplemental payment due under such section to a federally-qualified health center for services furnished by such center to an enrollee of a managed care entity (regardless Procedu re s.