Page:United States Statutes at Large Volume 124.djvu/981

 124 STAT. 955 PUBLIC LAW 111–148—MAR. 23, 2010 ‘‘(B) is an environmental exposure affected individual described in subsection (e)(3) who— ‘‘(i) is deemed under subsection (a)(2); and ‘‘(ii) meets such other criteria or conditions for participation in a pilot program under paragraph (1)(B) as the Secretary specifies. ‘‘(3) FLEXIBLE BENEFITS AND SERVICES.—A pilot program under this subsection may provide for the furnishing of benefits, items, or services not otherwise covered or authorized under this title, if the Secretary determines that furnishing such benefits, items, or services will further the purposes of such pilot program (as described in paragraph (1)). ‘‘(4) INNOVATIVE REIMBURSEMENT METHODOLOGIES.—For purposes of the pilot program under this subsection, the Sec- retary— ‘‘(A) shall develop and implement appropriate meth- odologies to reimburse providers for furnishing benefits, items, or services for which payment is not otherwise cov- ered or authorized under this title, if such benefits, items, or services are furnished pursuant to paragraph (3); and ‘‘(B) may develop and implement innovative approaches to reimbursing providers for any benefits, items, or services furnished under this subsection. ‘‘(5) LIMITATION.—Consistent with section 1862(b), no pay- ment shall be made under the pilot program under this sub- section with respect to benefits, items, or services furnished to an environmental exposure affected individual (as defined in subsection (e)) to the extent that such individual is eligible to receive such benefits, items, or services through any other public or private benefits plan or legal agreement. ‘‘(6) WAIVER AUTHORITY.—The Secretary may waive such provisions of this title and title XI as are necessary to carry out pilot programs under this subsection. ‘‘(7) FUNDING.—For purposes of carrying out pilot programs under this subsection, the Secretary shall provide for the transfer, from the Federal Hospital Insurance Trust Fund under section 1817 and the Federal Supplementary Medical Insurance Trust Fund under section 1841, in such proportion as the Secretary determines appropriate, of such sums as the Sec- retary determines necessary, to the Centers for Medicare & Medicaid Services Program Management Account. ‘‘(8) WAIVER OF BUDGET NEUTRALITY.—The Secretary shall not require that pilot programs under this subsection be budget neutral with respect to expenditures under this title. ‘‘(c) DETERMINATIONS.— ‘‘(1) BY THE COMMISSIONER OF SOCIAL SECURITY.—For pur- poses of this section, the Commissioner of Social Security, in consultation with the Secretary, and using the cost allocation method prescribed in section 201(g), shall determine whether individuals are environmental exposure affected individuals. ‘‘(2) BY THE SECRETARY.—The Secretary shall determine eligibility for pilot programs under subsection (b). ‘‘(d) EMERGENCY DECLARATION DEFINED.—For purposes of this section, the term ‘emergency declaration’ means a declaration of a public health emergency under section 104(a) of the Comprehen- sive Environmental Response, Compensation, and Liability Act of 1980.