Page:United States Statutes at Large Volume 109 Part 1.djvu/797

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PUBLIC LAW 104-73—DEC. 26, 1995 109 STAT. 781 "(3) For purposes of this subsection, the term 'managed care plan' shall mean health maintenance organizations and similar entities that contract at-risk with payors for the provision of health services or plan enrollees and which contract with providers (such as entities described in subsection (g)(4)) for the delivery of such services to plan enrollees.". SEC. 8. COVERAGE FOR PART-TIME PROVTOERS UNDER CONTRACTS. Section 224(g)(5)(B) (42 U.S.C. 223(g)(5)(B)) is amended to read 42 USC 233. as follows: "(B) in the case of an individual who normally performs an average of less than 32 V2 hours of services per week for the entity for the period of the contract, the individual is a licensed or certified provider of services in the fields of family practice, general internal medicine, general pediatrics, or obstetrics and gynecology.". SEC. 9. DUE PROCESS FOR LOSS OF COVERAGE. Section 224(i)(l) (42 U.S.C. 233(i)(l)) is amended by striking "may determine, after notice and opportunity for a hearing" and inserting "may on the record determine, after notice and opportunity for a full and fair hearing". SEC. 10. AMOUNT OF RESERVE FUND. Section 224(k)(2) (42 U.S.C. 223(k)(2)) is amended by striking 42 USC 233. " $30,000,000 " and inserting "$ 10,000,000 ". SEC. 11. REPORT ON RISK EXPOSURE OF COVERED ENTITIES. Section 224 (as amended by section 7) is amended by adding at the end thereof the following subsection: "(n)(l) Not later than one year after the date of the enactment of the Federally Supported Health Centers Assistance Act of 1995, the Comptroller General of the United States shall submit to the Congress a report on the following: "(A) The medical malpractice liability claims experience of entities that have been deemed to be employees for purposes of this section. "(B) The risk exposure of such entities. "(C) The value of private sector risk-management services, and the value of risk-management services and procedures required as a condition of receiving a grant under section 329, 330, 340, or 340A. "(D) A comparison of the costs and the benefits to taxpayers of maintaining medical malpractice liability coverage for such entities pursuant to this section, taking into account— "(i) a comparison of the costs of premiums paid by such entities for private medical malpractice liability insurance with the cost of coverage pursuant to this section; and "(ii) an analysis of whether the cost of premiums for private medical malpractice liability insurance coverage is consistent with the liability claims experience of such entities. "(2) The report under paragraph (1) shall include the following: "(A) A comparison of— "(i) an estimate of the aggregate amounts that such entities (together with the officers, governing board members, employees, and contractors of such entities who have