PUBLIC LAW 101-508—NOV. 5, 1990 104 STAT. 1388-209 (b) EFFECTIVE DATE.—The amendment made by subsection (a) 42 USC 1396a shall apply to sanctions effected more than 60 days after the date of "»<><*• the enactment of this Act. SEC. 4755. MISCELLANEOUS PROVISIONS. (a) PSYCHIATRIC HOSPITALS. — (1) CLARIFICATION OF COVERAGE OF INPATIENT PSYCHIATRIC HOS- PITAL SERVICES (A) IN' GENERAL.— Section 1905(h)(1)(A) (42 U.S.C. 1396d(h)(l)(A)), as amended by section 2340(b) of the Deficit Reduction Act of 1984, is amended by inserting "or in another inpatient setting that the Secretary has specified in regulations" after "1861(f)". (B) EFFECTIVE DATE.— The amendment made by subpara- 42 USC I396d graph (A) shall be effective as if included in the enactment note. of the Deficit Reduction Act of 1984. (2) INTERMEDIATE SANCTIONS FOR PSYCHIATRIC HOSPITALS.— Section 1902 (42 U.S.C. 1396a) as amended by this title is further amended by adding at the end the following new subsection: "(y)(l) In addition to any other authority under State law, where a State determines that a psychiatric hospital which is certified for participation under its plan no longer meets the requirements for a psychiatric hospital (referred to in section 1905(h)) and further finds that the hospital's deficiencies— "(A) immediately jeopardize the health and safety of its patients, the State shall terminate the hospital's participation under the State plan; or "(B) do not immediately jeopardize the health and safety of its patients, the State may terminate the hospital's participation under the State plan, or provide that no payment will be made under the State plan with respect to any individual admitted to such hospital after the effective date of the finding, or both. "(2) Except as provided in paragraph (3), if a psychiatric hospital described in paragraph (1)(B) has not complied with the requirements for a psychiatric hospital under this title— "(A) within 3 months after the date the hospital is found to be out of compliance with such requirements, the State shall provide that no payment will be made under the State plan with respect to any individual admitted to such hospital after the end of such 3-month period, or "(B) within 6 months after the date the hospital is found to be out of compliance with such requirements, no Federal financial participation shall be provided under section 1903(a) with respect to further services provided in the hospital until the State finds that the hospital is in compliance with the requirements of this title. "(3) The Secretary may continue payments, over a period of not longer than 6 months from the date the hospital is found to be out of compliance with such requirements, if— "(A) the State finds that it is more appropriate to take alternative action to assure compliance of the hospital with the requirements than to terminate the certification of the hospital, "(B) the State has submitted a plan and timetable for corrective action to the Secretary for approval and the Secretary approves the plan of corrective action, and '(C) the State agrees to repay to the Federal Government payments received under this paragraph if the corrective action
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