Page:United States Statutes at Large Volume 104 Part 2.djvu/607

This page needs to be proofread.


s*(§*i^ *'-. '^ tf- PUBLIC LAW 101-508—NOV. 5, 1990 104 STAT. 1388-199 (2) Section 9412(b) of the Omnibus Budget Reconciliation Act of 1986, as amended by subsection (a), is amended by adding at the end the following new paragraph: "(4) Section 1924 of the Social Security Act shall apply to any individual receiving services from an organization receiving a waiver under this subsection.". SEC. 4745. DEMONSTRATION PROJECTS TO STUDY THE EFFECT OF 42 USC 1396a ALLOWING STATES TO EXTEND MEDICAID COVERAGE TO »o*e. CERTAIN LOW-INCOME FAMILIES NOT OTHERWISE QUALI- FIED TO RECEIVE MEDICAID BENEFITS. (a) DEMONSTRATION PROJECTS.— (1) IN GENERAL. —(A) The Secretary of Health and Human Services (hereafter in this section referred to as the "Secretary") shall enter into agreements with 3 and no more than 4 States submitting applications under this section for the purpose of conducting demonstration projects to study the effect on access to, and costs of, health care of eliminating the categorical eligibility requirement for medicaid benefits for certain lowincome individuals. (B) In entering into agreements with States under this section the Secretary shall provide that at least 1 and no more than 2 of the projects are conducted on a substate basis. (2) REQUIREMENTS. —(A) The Secretary may not enter into an agreement with a State to conduct a project unless the Secretary determines that— (i) the project can reasonably be expected to improve access to health insurance coverage for the uninsured; (ii) with respect to projects for which the statewideness requirement has not been waived, the State provides, under its plan under title XIX of the Social Security Act, for eligibility for medical assistance for all individuals described in subparagraphs (A), (B), (C), and (D) of paragraph (1) of section 1902(1) of such Act (based on the State's election of certain eligibility options the highest income standards and, based on the State's waiver of the application of any resource standard); (iii) eligibility for benefits under the project is limited to individuals in families with income below 150 percent of the income official poverty line and who are not individuals receiving benefits under title XIX of the Social Security Act; (iv) if the Secretary determines that it is cost-effective for the project to utilize employer coverage (as described in section 1925(b)(4)(D) of the Social Security Act), the project must require an employer contribution and benefits under the State plan under title XIX of such Act will continue to be made available to the extent they are not available under the employer coverage; (v) the project provides for coverage of benefits consistent with subsection (b); and (vi) the project only imposes premiums, coinsurance, and other cost-sharing consistent with subsection (c). (B) The Secretary may waive the requirements of clause (ii) of this paragraph with respect to those projects described in subparagraph (B) of paragraph (1),