103 STAT. 2260 PUBLIC LAW 101-239—DEC. 19, 1989 SEC. €402. PAYMENT FOR OBSTETRICAL AND PEDIATRIC SERVICES. (a) CODIFICATION OP ADEQUATE PAYMENT LEVEL PROVISIONS. —Sec- tion 1902(a)(30XA) of the Social Security Act (42 U.S.C. 1396a(a)(30XA)) is amended by inserting before the semicolon at the end the following: "and are sufficient to enlist enough providers so that care and services are available under the plan at least to the extent that such care and services are available to the general population in the geographic area". (b) ASSURING ADEQUATE PAYMENT LEVELS FOR OBSTETRICAL AND PEDIATRIC SERVICES.—Title XIX of such Act, as amended by section 303 of the Family Support Act of 1988, is amended by redesignating 42 USC 13968. section 1926 as section 1927 and by inserting after section 1925 the following new section: "ASSURING ADEQUATE PAYMENT LEVELS FOR OBSTETRICAL AND PEDIATRIC SERVICES 42 USC l396r-7. "SEC. 1926. (a)(1) A State plan under this title shall not be considered to meet the requirement of section 1902(a)(30XA) with respect to obstetrical services (as defined in paragraph (4)(A)), as of July 1 of each year (beginning with 1990), unless, by not later than April 1 of such year, the State submits to the Secretary an amend- ment to the plan that specifies the payment rates to be used for such services under the plan in the succeeding period and includes in such submission such additional data as wUl assist the Secretary in evaluating the State's compliance with such requirement, including data relating to how rates established for payments to health maintenance organizations under section 1903(m) take into account such payment rates. "(2) A State plan under this title shall not be considered to meet the requirement of section 1902(a)(30XA) with respect to pediatric services (as defined in paragraph (4)(B)), as of July 1 of each year (beginning with 1990), unless, by not later than Apnl 1 of such year, the State submits to the Secretary an amendment to the plan that specifies, by pediatric procedure, the payment rates to be used for such services under the plan in the succeeding period and includes in such submission such additional data as will assist the Secretary in evaluating the State's compliance with such requirement, includ- ing data relating to how rates established for payments to health maintenance organizations under section 1903(m) take into account such payment rates. "(3) The Secretary, by not later than 90 days after the date of submission of a plan amendment under paragraph (1) or (2), shall— "(A) review each such amendment for compliance with the requirement of section 1902(a)(30XA), and (B) approve or disapprove each such amendment. If the Secretary disapproves such an amendment, the State shall immediately submit a revised amendment which meets such requirement. (4) In this section: "(A) The term 'obstetrical services' means services relating to pregnancy covered under the State plan provided by an obstetri- cian, olx3tetrician-g3mecologist, family practitioner, certified nurse midwife, or certified family nurse practitioner and does not include inpatient or outpatient hospital services or other institutional services.
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