Page:United States Statutes at Large Volume 101 Part 2.djvu/859

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101 STAT. 1330-65
PUBLIC LAW 100-000—MMMM. DD, 1987
101 STAT. 1330-65

PUBLIC LAW 100-203—DEC. 22, 1987 s

101 STAT. 1330-65

(6) ways of establishing capitation rates on a basis other than fee-for-service experience in areas with high prepaid market penetration; and (7) methods for providing the rate levels necessary to maintain access to quality prepaid services in rural or medically underserved areas (while maintaining cost savings),

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(b) REPORTS.

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(1) Not later than January 1 of 1989 and 1990, the Comptroller General shall submit to the Committee on Finance of the Senate and the Committee on Energy and Commerce and Committee on Ways and Means of the House of Representatives interim reports on the progress of the study conducted under subsection (a). (2) Not later than January 1, 1991, the Comptroller General shall submit to each such committee a final report on the results of such study.

SEC. 4018. SPECIAL RULES. (a) ASSIGNMENT OF MEMBERS FOR HIP

HEALTH MAINTENANCE

ORGANIZATION.—Section 1876(f) of such Act (42 U.S.C. 1395mm(f)) is amended by redesignating paragraph (3) as paragraph (4) and by inserting after paragraph (2) the following new paragraph: "(3)(A) An eligible organization described in subparagraph (B) may elect, for purposes of determining the compliance of a subdivi.,,r.. sion, subsidiary, or affiliate described in subparagraph (B)(iii) with .jr. the requirement of paragraph (1) for the period before October 1, .-a% 1992, to have members of the subdivision, subsidiary, or affiliate considered to be members of the parent organization. "(B) An eligible organization described in this subparagraph is an eligible organization which— "(i) is described in section 1903(m)(2)(B)(iii); "(ii) has members who have a collectively bargained contractual right to obtain health benefits from the organization; "(iii) elects to provide benefits under a risk-sharing contract Contracts. to individuals residing in a service area, who have a collectively bargained contractual right to obtain benefits from the organization, through a subdivision, subsidiary, or affiliate which itself is an eligible organization serving the area and which is owned or controlled by the parent eligible organization; and T "(iv) has assumed any risk of insolvency and quality assurance with respect to individuals receiving benefits through such a subdivision, subsidiary, or affiliate.". (b) EXTENSION OF WAIVERS FOR SOCIAL HEALTH MAINTENANCE ORGANIZATIONS.—

(1) The Secretary of Health and Human Services shall extend without interruption, through September 30, 1992, the approval of waivers granted under subsection (a) of section 2355 of the Deficit Reduction Act of 1984 for the demonstration project described in subsection (b) of that section, subject to the terms and conditions (other than duration of the project) established under that section (as amended by paragraph (2) of this subsection). (2) Section 2355(b)(5) of the Deficit Reduction Act of 1984 is 98 Stat. 1103. amended by inserting "and in succeeding years" after "third year".