PUBLIC LAW 108–173—DEC. 8, 2003
117 STAT. 2207
and inserting ‘‘monthly amount of the premium charged to an individual.’’; and (iv) by amending subparagraph (E) of subsection (d)(4) to read as follows: ‘‘(E) SUPPLEMENTAL BENEFITS.—Supplemental health care benefits, including any reductions in cost-sharing under section 1852(a)(3) and the terms and conditions (including premiums) for such benefits.’’. (C) Section 1857(d)(1) (42 U.S.C. 1395w–27(d)(1)) is amended by striking ‘‘, costs, and computation of the adjusted community rate’’ and inserting ‘‘and costs, including allowable costs under section 1858(c)’’. (D) Section 1851(a)(3)(B)(ii) (42 U.S.C. 1395w– 21(a)(3)(B)(ii)) is amended by striking ‘‘section 1851(e)(4)(A)’’ and inserting ‘‘subsection (e)(4)(A)’’. (E) Section 1851(f)(1) (42 U.S.C. 1395w–21(f)(1)) is amended by striking ‘‘subsection (e)(1)(A)’’ and inserting ‘‘subsection (e)(1)’’. SEC. 223. EFFECTIVE DATE.
(a) EFFECTIVE DATE.—The amendments made by this subtitle shall apply with respect to plan years beginning on or after January 1, 2006. (b) ISSUANCE OF REGULATIONS.—The Secretary shall revise the regulations previously promulgated to carry out part C of title XVIII of the Social Security Act to carry out the provisions of this Act.
42 USC 1395w–21 note. 42 USC 1395w–21 note.
Subtitle D—Additional Reforms SEC. 231. SPECIALIZED MA PLANS FOR SPECIAL NEEDS INDIVIDUALS.
(a) TREATMENT AS COORDINATED CARE PLAN.—Section 1851(a)(2)(A) (42 U.S.C. 1395w–21(a)(2)(A)), as amended by section 221(a), is amended by adding at the end the following new clause: ‘‘(ii) SPECIALIZED MA PLANS FOR SPECIAL NEEDS INDIVIDUALS.—Specialized MA plans for special needs individuals (as defined in section 1859(b)(6)) may be any type of coordinated care plan.’’. (b) SPECIALIZED MA PLAN FOR SPECIAL NEEDS INDIVIDUALS DEFINED.—Section 1859(b) (42 U.S.C. 1395w–29(b)), as amended by section 221(b), is amended by adding at the end the following new paragraph: ‘‘(6) SPECIALIZED MA PLANS FOR SPECIAL NEEDS INDIVIDUALS.— ‘‘(A) IN GENERAL.—The term ‘specialized MA plan for special needs individuals’ means an MA plan that exclusively serves special needs individuals (as defined in subparagraph (B)). ‘‘(B) SPECIAL NEEDS INDIVIDUAL.—The term ‘special needs individual’ means an MA eligible individual who— ‘‘(i) is institutionalized (as defined by the Secretary); ‘‘(ii) is entitled to medical assistance under a State plan under title XIX; or ‘‘(iii) meets such requirements as the Secretary may determine would benefit from enrollment in such
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