Page:United States Statutes at Large Volume 111 Part 1.djvu/350

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Ill STAT. 326 PUBLIC LAW 105-33 —AUG. 5, 1997 "(C) does not restrict the selection of providers among those who are lawfully authorized to provide the covered services and agree to accept the terms and conditions of payment established by the plan. " (3) MSA PLAN. — "(A) IN GENERAL. —The term 'MSA plan' means a Medicare+Choice plan that— "(i) provides reimbursement for at least the items and services described in section 1852(a)(1) in a year but only after the enrollee incurs countable expenses (as specified under the plan) equal to the amount of an annual deductible (described in subparagraph (B)); "(ii) counts as such expenses (for purposes of such deductible) at least all amounts that would have been payable under parts A and B, and that would have been payable by the enrollee as deductibles, coinsurance, or copayments, if the enrollee had elected to receive benefits through the provisions of such parts; and "(iii) provides, after such deductible is met for a year and for all subsequent expenses for items and services referred to in clause (i) in the year, for a level of reimbursement that is not less than— "(I) 100 percent of such expenses, or "(II) 100 percent of the amounts that would have been paid (without regard to any deductibles or coinsurance) under parts A and B with respect to such expenses, whichever is less. "(B) DEDUCTIBLE. —The amount of annual deductible under an MSA plan— "(i) for contract year 1999 shall be not more than $6,000; and "(ii) for a subsequent contract year shall be not more than the maximum amount of such deductible for the previous contract year under this subparagraph increased by the national per capita Medicare+Choice growth percentage under section 1853(c)(6) for the year. If the amount of the deductible under clause (ii) is not a multiple of $50, the amount shall be rounded to the nearest multiple of $50. " (c) OTHER REFERENCES TO OTHER TERMS. — "(1) MEDICARE+CHOICE ELIGIBLE INDIVIDUAL.—The term 'Medicare+Choice eligible individual' is defined in section 1851(a)(3). "(2) MEDICARE+CHOICE PAYMENT AREA.— The term 'Medicare+Choice payment area' is defined in section 1853(d). " (3) NATIONAL PER CAPITA MEDICARE+CHOICE GROWTH PERCENTAGE.—The 'national per capita Medicare+Choice growth percentage' is defined in section 1853(c)(6). " (4) MEDICARE+CHOICE MONTHLY BASIC BENEFICIARY PRE- MIUM; MEDICARE+CHOICE MONTHLY SUPPLEMENTAL BENEFICIARY PREMIUM. — The terms 'Medicare+Choice monthly basic beneficiary premium' and 'Medicare+Choice monthly supplemental beneficiary premium' are defined in section 1854(a)(2).