104 STAT. 1388-196 PUBLIC LAW 101-508—NOV. 5, 1990 42 USC 1396b. 42 USC 1396a note. 42 USC 1396b note. "(ii) in the next month (or in the next 2 months) is not eligible for such benefits, but "(iii) in the succeeding month is again eligible for such benefits, the State plan, subject to subparagraph (A)(vi), may enroll the individual for that succeeding month with the health maintenance organization described in clause (i) if the organization continues to have a contract under this paragraph with the State.". (d) ELIMINATION OF PROVISIONAL QUALIFICATION FOR HMOS. — Section 1903(m) is amended— (1) in paragraph (2)(A)(i), by striking "(or the State as authorized by paragraph (3))", and (2) by striking paragraph (3). (e) EFFECTIVE DATE. —The amendments made by this section shall take effect on the date of the enactment of this Act. SEC. 4733. EXTENSION AND EXPANSION OF MINNESOTA PREPAID MEDIC- AID DEMONSTRATION PROJECT. Section 507 of the Family Support Act of 1988 is amended— (1) by striking "1991" and inserting "1996"; and (2) by striking the period at the end and inserting the following: ", and shall amend such waiver to permit the State to expand such demonstration project to other counties if the amount of medical assistance provided under title XIX of such Act after such expansion will not exceed the amount of medical assistance provided under such title had the project not been expanded to other counties.". SEC. 4734. TREATMENT OF CERTAIN COUNTY-OPERATED HEALTH INSUR- ING ORGANIZATIONS. Section 9517(c) of the Consolidated Omnibus Budget Reconciliation Act of 1985 is amended— (1) in paragraph (2)(A), by inserting "and in paragraph (3)" after "subparagraph (B)", and (2) by adding at the end the following new paragraph: "(3)(A) Subject to subparagraph (C), in the case of up to 3 health insuring organizations which are described in subparagraph (B), which first become operational on or after January 1, 1986, and which are designated by the Governor, and approved by the Legislature, of California, the amendments made by paragraph (1) shall not apply. "(B) A health insuring organization described in this subparagraph is one that— "(i) is operated directly by a public entity established by a county government in the State of California under a State enabling statute; "(ii) enrolls all medicaid beneficiaries residing in the county in which it operates; "(iii) meets the requirements for health maintenance organizations under the Knox-Keene Act (Cal. Health and Safety Code, section 1340 et seq.) and the Waxman-Duffy Act (Cal. Welfare and Institutions Code, section 14450 et seq.); "(iv) assures a reasonable choice of providers, which includes providers that have historically served medicaid beneficiaries and which does not impose any restriction which substantially impairs access to covered services of adequate quality where medically necessary;
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