Page:United States Statutes at Large Volume 124.djvu/231

124 STAT. 205 PUBLIC LAW 111–148—MAR. 23, 2010 (C) REPORT.—The Secretary shall annually report to Congress concerning actions taken by the Secretary with respect to applications for waivers under this section. (5) COORDINATED WAIVER PROCESS.—The Secretary shall develop a process for coordinating and consolidating the State waiver processes applicable under the provisions of this section, and the existing waiver processes applicable under titles XVIII, XIX, and XXI of the Social Security Act, and any other Federal law relating to the provision of health care items or services. Such process shall permit a State to submit a single application for a waiver under any or all of such provisions. (6) DEFINITION.—In this section, the term ‘‘Secretary’’ means— (A) the Secretary of Health and Human Services with respect to waivers relating to the provisions described in subparagraph (A) through (C) of paragraph (2); and (B) the Secretary of the Treasury with respect to waivers relating to the provisions described in paragraph (2)(D). (b) GRANTING OF WAIVERS.— (1) IN GENERAL.—The Secretary may grant a request for a waiver under subsection (a)(1) only if the Secretary deter- mines that the State plan— (A) will provide coverage that is at least as comprehen- sive as the coverage defined in section 1302(b) and offered through Exchanges established under this title as certified by Office of the Actuary of the Centers for Medicare & Medicaid Services based on sufficient data from the State and from comparable States about their experience with programs created by this Act and the provisions of this Act that would be waived; (B) will provide coverage and cost sharing protections against excessive out-of-pocket spending that are at least as affordable as the provisions of this title would provide; (C) will provide coverage to at least a comparable number of its residents as the provisions of this title would provide; and (D) will not increase the Federal deficit. (2) REQUIREMENT TO ENACT A LAW.— (A) IN GENERAL.—A law described in this paragraph is a State law that provides for State actions under a waiver under this section, including the implementation of the State plan under subsection (a)(1)(B). (B) TERMINATION OF OPT OUT.—A State may repeal a law described in subparagraph (A) and terminate the authority provided under the waiver with respect to the State. (c) SCOPE OF WAIVER.— (1) IN GENERAL.—The Secretary shall determine the scope of a waiver of a requirement described in subsection (a)(2) granted to a State under subsection (a)(1). (2) LIMITATION.—The Secretary may not waive under this section any Federal law or requirement that is not within the authority of the Secretary. (d) DETERMINATIONS BY SECRETARY.— (1) TIME FOR DETERMINATION.—The Secretary shall make a determination under subsection (a)(1) not later than 180 Deadline. Determination.