PUBLIC LAW 105-33—AUG. 5, 1997 111 STAT. 429 "(1) the individual has an election in effect for such benefits under subsection (b); and "(2) the individual has a condition such that the individual would qualify for benefits under this part for inpatient hospital services or extended care services, respectively, if the individual were an inpatient or resident in a hospital or skilled nursing facility that was not such an institution. " (b) ELECTION. — "(1) IN GENERAL.—An individual may make an election under this subsection in a form and manner specified by the Secretary consistent with this subsection. Unless otherwise provided, such an election shall take effect immediately upon its execution. Such an election, once made, shall continue in effect until revoked. "(2) FORM. —The election form under this subsection shall include the following: "(A) A written statement, signed by the individual (or such individual's legal representative), that— "(i) the individual is conscientiously opposed to acceptance of nonexcepted medical treatment; and "(ii) the individual's acceptance of nonexcepted medical treatment would be inconsistent with the individual's sincere religious beliefs. "(B) A statement that the receipt of nonexcepted medical services shall constitute a revocation of the election and may limit further receipt of services described in subsection (a). "(3) REVOCATION.—An election under this subsection by an individual may be revoked by voluntarily notifying the Secretary in writing of such revocation and shall be deemed to be revoked if the individual receives nonexcepted medical treatment for which reimbursement is made under this title. " (4) LIMITATION ON SUBSEQUENT ELECTIONS.— Once an individual's election under this subsection has been made and revoked twice— "(A) the next election may not become effective until the date that is 1 year after the date of most recent previous revocation, and "(B) any succeeding election may not become effective until the date that is 5 years after the date of the most recent previous revocation. "(5) EXCEPTED MEDICAL TREATMENT.—For purposes of this subsection: "(A) EXCEPTED MEDICAL TREATMENT. —The term 'excepted medical treatment' means medical care or treatment (including medical and other health services)— "(i) received involuntarily, or "(ii) required under Federal or State law or law of a political subdivision of a State. "(B) NONEXCEPTED MEDICAL TREATMENT.—The term 'nonexcepted medical treatment' means medical care or treatment (including medical and other health services) other than excepted medical treatment. "(c) MONITORING AND SAFEGUARD AGAINST EXCESSIVE EXPENDI- TURES.— "(1) ESTIMATE OF EXPENDITURES.— Before the beginning of each fiscal year (beginning with fiscal year 2000), the Secretary
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