PUBLIC LAW 106-113—APPENDIX F 113 STAT. 150L^-391 election under the first sentence of such section if such individual were enrolled in a Medicare+Choice plan" before the period; (2) in clause (v)(II), by inserting "any PACE provider under section 1894," after "demonstration project authority,"; and (3) in clause (vi)— (A) by inserting "or in a PACE program under section 1894" after "part C"; and (B) by striking "such plan" and inserting "such plan or such program". (b) EFFECTIVE DATE.— The amendments made by this section shall apply to terminations or discontinuances made on or after the date of the enactment of this Act. Subtitle D—Medicare+Choice Nursing and Allied Health Professional Education Payments SEC. 541. MEDICARE+CHOICE NURSING AND ALLIED HEALTH PROFES- SIONAL EDUCATION PAYMENTS. (a) ADDITIONAL PAYMENTS FOR NURSING AND ALLIED HEALTH EDUCATION. — Section 1886 (42 U.S.C. 1395ww) is amended by adding at the end the following new subsection: " (1) PAYMENT FOR NURSING AND ALLIED HEALTH EDUCATION FOR MANAGED CARE ENROLLEES.— "(1) IN GENERAL.— For portions of cost reporting periods occurring in a year (beginning with 2000), the Secretary shall provide for an additional payment amount for any hospital that receives payments for the costs of approved educational ' activities for nurse and allied health professional training under section 1861(v)(l). "(2) PAYMENT AMOUNT.— The additional payment amount under this subsection for each hospital for portions of cost reporting periods occurring in a year shall be an amount specified by the Secretary in a manner consistent with the following: "(A) DETERMINATION OF MANAGED CARE ENROLLEE PAY- MENT RATIO FOR GRADUATE MEDICAL EDUCATION PAY- MENTS.— The Secretary shall estimate the ratio of payments for all hospitals for portions of cost reporting periods occurring in the year under subsection (h)(3)(D) to total direct graduate medical education payments estimated for such portions of periods under subsection (h)(3). "(B) APPLICATION TO FEE-FOR-SERVICE NURSING AND ALLIED HEALTH EDUCATION PAYMENTS.— Such ratio shall be applied to the Secretary's estimate of total payments for nursing and allied health education determined under section 186 l(v) for portions of cost reporting periods occurring in the year to determine a total amount of additional payments for nursing and allied health education to be distributed to hospitals under this subsection for portions of cost reporting periods occurring in the year; except that in no case shall such total amount exceed $60,000,000 in any year. "(C) APPLICATION TO HOSPITAL. —The amount of pay- ment under this subsection to a hospital for portions of
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