note. 104 STAT. 1388-168 PUBLIC LAW 101-508—NOV. 5, 1990 regard to whether or not final regulations to carry out such amendments have been promulgated by such date. SEC. 4603. MANDATORY CONTINUATION OF BENEFITS THROUGHOUT PREGNANCY OR FIRST YEAR OF LIFE. (a) IN GENERAL. — Section 1902(e) (42 U.S.C. 1396a(e)) is amended— (1) in the first sentence of paragraph (4), by inserting "(or would remain if pregnant)" after "remains"; and (2) in paragraph (6)— (A) by striking "At the option of a State, in" and inserting "In"; (B) by striking "the State plan may nonetheless treat the woman as being" and inserting the woman shall be deemed to continue to be"; and (C) by adding at the end the following new sentence: "The preceding sentence shall not apply in the case of a woman who has been provided ambulatory prenatal care pursuant to section 1920 during a presumptive eligibility period and is then, in accordance with such section, determined to be ineligible for medical assistance under the State plan.". 42 USC 1396a (b) EFFECTIVE DATE. — (1) INFANTS.— The amendment made by subsection (a)(1) shall apply to individuals born on or after January 1, 1991, without regard to whether or not final regulations to carry out such amendment have been promulgated by such date. (2) PREGNANT WOMEN.— The amendments made by subsection (a)(2) shall apply with respect to determinations to terminate the eligibility of women, based on change of income, made on or after January 1, 1991, without regard to whether or not final regulations to carry out such amendments have been promulgated by such date. SEC. 4604. ADJUSTMENT IN PAYMENT FOR HOSPITAL SERVICES FUR- NISHED TO LOW-INCOME CHILDREN UNDER THE AGE OF 6 YEARS. (a) IN GENERAL.— Section 1902 (42 U.S.C. 1396a) is amended by adding at the end the following new subsection: "(s) In order to meet the requirements of subsection (a)(55), the State plan must provide that payments to hospitals under the plan for inpatient hospital services furnished to infants who have not attained the age of 1 year, and to children who have not attained the age of 6 years and who receive such services in a disproportionate share hospital described in section 1923(b)(1), shall— "(1) if made on a prospective basis (whether per diem, per case, or otherwise) provide for an outlier adjustment in payment amounts for medically necessary inpatient hospital services involving exceptionally high costs or exceptionally long lengths of stay, "(2) not be limited by the imposition of day limits with respect to the delivery of such services to such individuals, and "(3) not be limited by the imposition of dollar limits (other than such limits resulting from prospective payments as adjusted pursuant to paragraph (1)) with respect to the delivery of such services to any such individual who has not attained their first birthday (or in the case of such an individual who is an inpatient on his first birthday until such individual is discharged).".
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