Page:United States Statutes at Large Volume 122.djvu/2596

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12 2 STA T . 2 573PUBLIC LA W 11 0– 275 —J UL Y 15 , 200 8Suchsta t em e n t sha l l b e i nclu d ed w ith an y desc r i p ti o no f benefits offered by the plan .‘ ‘ (D)T he plan has a contract with the State M edicaid a g ency to pro v ide benefits , or arrange for benefits to be provided, for which such individual is entitled to receive as medical assistance under title XI X. Such benefits may include long - term care services consistent with State policy. ‘‘( 4 ) AD D IT I ONALREQU IRE M ENT SF OR SE V ERE OR DISA B LIN GCH RONIC CONDITION SN P S. — In the case of a speciali z ed MA plan for special needs individuals described in subsection (b)( 6 )( B )(iii), the applicable re q uirements described in this para- graph are as follows

‘‘(A) E ach individual that enrolls in the plan on or after J anuary 1 , 20 10, is a special needs individual described in subsection (b)(6)(B)(iii). ‘‘(B) The plan meets the requirements described in paragraph ( 5 ). ’ ’. (2) AUTHORIT Y TO OPERATE BUT NO SERVICE AREA E X PAN- SION FOR DUAL SNPS THAT DO NOT MEET CERTAIN REQUIRE- MENTS.— N otwithstanding subsection (f) of section 1 8 5 9 of the Social Security Act (42 U .S. C . 1 3 95w – 28), during the period beginning on January 1, 2010, and ending on December 31, 2010, in the case of a specialized Medicare Advantage plan for special needs individuals described in subsection (b)(6)(B)(ii) of such section, as amended by this section, that does not meet the requirement described in subsection (f)(3)(D) of such section, the Secretary of H ealth and Human Services— (A) shall permit such plan to be offered under part CoftitleX V III of such Act

and (B) shall not permit an e x pansion of the service area of the plan under such part C. (3) R ESOURCES FOR STATE MEDICAID AGENCIES.—The Sec- retary of Health and Human Services shall provide for the designation of appropriate staff and resources that can address State inquiries with respect to the coordination of State and F ederal policies for specialized MA plans for special needs individuals described in section 1859(b)(6)(B)(ii) of the Social Security Act (42 U.S.C. 1395w–28(b)(6)(B)(ii)), as amended by this section. (4) NO REQUIREMENT FOR CONTRACT.—Nothing in the provi- sions of, or amendments made by, this subsection shall require a State to enter into a contract with a Medicare Advantage organization with respect to a specialized MA plan for special needs individuals described in section 1859(b)(6)(B)(ii) of the Social Security Act (42 U.S.C. 1395w–28(b)(6)(B)(ii)), as amended by this section. (d) CARE MANAGEMENT REQUIREMENTS FOR ALL SN P S.— (1) REQUIREMENTS.—Section 1859(f) of the Social Security Act (42 U.S.C. 1395w–28(f)), as amended by subsection (c)(1), is amended by adding at the end the following new paragraph: ‘‘(5) CARE MANAGEMENT REQUIREMENTS FOR ALL SNPS.— The requirements described in this paragraph are that the organization offering a specialized MA plan for special needs individuals described in subsection (b)(6)(B)(i)— ‘‘(A) have in place an evidenced-based model of care with appropriate networ k s of providers and specialists; and Timep e r i od.42USC1395w– 2 8n o t e. Ef fe c ti v ed a te.