Page:United States Statutes at Large Volume 111 Part 1.djvu/352

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Ill STAT. 328 PUBLIC LAW 105-33—AUG. 5, 1997 SEC. 4002. TRANSITIONAL RULES FOR CURRENT MEDICARE HMO PRO- GRAM. (a) AUTHORIZING TRANSITIONAL WAIVER OF 50:50 RULE.—Section 1876(f) (42 U.S.C. 1395mm(f)) is amended— (1) in paragraph (1)— (A) by striking "Each" and inserting "For contract periods beginning before January 1, 1999, each"; and (B) by striking "or under a State plan approved under title XIX"; (2) in paragraph (2), by striking "The Secretary" and inserting "Subject to paragraph (4), the Secretary", and (3) by adding at the end the following: Effective date. "(4) Effective for contract periods beginning after December 31, 1996, the Secretary may waive or modify the requirement imposed by paragraph (1) to the extent the Secretary finds that it is in the public interest.". (b) TRANSITION.— (1) RISK-SHARING CONTRACTS.—Section 1876 (42 U.S.C. 1395mm) is amended by adding at the end the following new subsections: "(k)(l) Except as provided in paragraph (2)— "(A) on or after the date standards for Medicare+Choice organizations and plans are first established under section 1856(b)(1), the Secretary shall not enter into any risk-sharing contract under this section with an eligible organization; and "(B) for any contract year beginning on or after January 1, 1999, the Secretary shall not renew any such contract. "(2) An individual who is enrolled in part B only and is enrolled in an eligible organization with a risk-sharing contract under this section on December 31, 1998, may continue enrollment in such organization in accordance with regulations described in section 1856(b)(1). "(3) Notwithstanding subsection (a), the Secretary shall provide that payment amounts under risk-sharing contracts under this section for months in a year (beginning with January 1998) shall be computed— "(A) with respect to individuals entitled to benefits under both parts A and B, by substituting payment rates under section 1853(a) for the payment rates otherwise established under section 1876(a), and "(B) with respect to individuals only entitled to benefits under part B, by substituting an appropriate proportion of such rates (reflecting the relative proportion of payments under this title attributable to such part) for the pa5Tnent rates otherwise established under subsection (a). Applicability. "(4) The following requirements shall apply to eligible organizations with risk-sharing contracts under this section in the same manner as they apply to Medicare+Choice organizations under part C: "(A) Data collection requirements under section 1853(a)(3)(B). "(B) Restrictions on imposition of premium taxes under section 1854(g) in relating to pa3mients to such organizations under this section. "(C) The requirement to accept enrollment of new enrollees during November 1998 under section 1851(e)(6). "(D) Payments under section 1857(e)(2).".