PUBLIC LAW 101-239—DEC. 19, 1989 103 STAT. 2261 "(B) The term 'pediatric services' means services covered under the State plan provided by a pediatrician, family practi- v tioner, or certified pediatric nurse practitioner to children under 18 years of age and does not include inpatient or out- patient hospital services or other institutional services. "(b) For amendments submitted under subsection (a)(l) in 1992 and thereafter, the data submitted under such subsection must include, for the second previous year, at least the statewide average payment rates under the State plan for obstetrical services furnished by obstetricians, obstetrician-gynecologists, family practitioners, certified family nurse practitioners, and certified nurse midwives, by procedure. Such information shall be provided separately for providers located in each metropolitan statistical area (or similar area) in the State and in the remainder of the State. "(c) For amendments submitted under subsection (a)(2) in 1992 and thereafter, the data submitted under such subsection must include, for the second previous year, at least the statewide average payment rates under the State plan for pediatric services furnished ^- by pediatricians, family practitioners, and certified pediatric nurse practitioners by procedure. Such information shall be provided sepa- rately for providers located in each metropolitan statistical area (or similar area) in the State and in the remainder of the State. "(d) Nothing in this title (including section 1902(a)(30XA)) shall be construed as preventing a State from establishing payment levels for obstetrical or pediatric services that are higher for those services furnished in rural areas than those furnished in metropolitan statis- tical areas.". (c) PAYMENT FOR CERTAIN SERVICES IN CERTAIN FEDERALLY -^ FUNDED HEALTH CENTERS. — (1) COVERAGE.— Section 1905(a)(2) of the Social Security Act (42 U.S.C. 1396d(a)(2)) is amended by striking "and" before "(B)" and by inserting before the semicolon at the end the following:, ", and (C) ambulatory services offered by a health center receiv- ing funds under section 329, 330, or 340 of the Public Health Service Act to a pregnant woman or individual under 18 years of age". (2) PAYMENT AMOUNTS.— Section 1902(a)(13XE) of such Act (42 U.S.C. 1396a(a)(13XE)) is amended by inserting ", and for pay- ment for services described in section 1905(a)(2)(C) under the plan," after "provided by a rural health clinic under the plan". (d) EFFECTIVE DATE.— (1) The amendments made by subsections (a) 42 USC I396a and (b) (except as otherwise provided in such amendments) shall ^°^- take effect on the date of the enactment of this Act. (2)(A) The amendments made by subsection (c) apply (except as provided under subparagraph (B)) to payments under title XIX of the Social Security Act for calendar quarters beginning on or after July 1, 1990, without regard to whether or not final regulations to carry out such amendments have been promulgated by such date. (B) In the case of a State plan for medical assistance under title XIX of the Social Security Act which the Secretary of Health and Human Services determines requires State legislation (other than legislation appropriating funds) in order for the plan to meet the additional requirements imposed by the amendments made by subsection (c), the State plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet these additional requirements before the first day of the first calendar quarter beginning after the close of the first
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