110 STAT. 3630 PUBLIC LAW 104-299—OCT. 11, 1996 sion of health services on a prepaid basis or under another managed care arrangement, and for other purposes that promote the development of managed care networks and plans. "(2) LIMITATION.—Not more than two grants may be made under this subsection for the same project, except that upon a showing of good cause, the Secretary may make additional grant awards. " (d) MANAGED CARE LOAN GUARANTEE PROGRAM.— "(1) ESTABLISHMENT.— "(A) IN GENERAL.—The Secretary shall establish a program under which the Secretary may, in accordance with this subsection and to the extent that appropriations are provided in advance for such program, guarantee the principal and interest on loans made by non-Federal lenders to health centers funded under this section for the costs of developing and operating managed care networks or plans. "(B) USE OF FUNDS.—Loan funds guaranteed under this subsection may be used— "(i) to establish reserves for the furnishing of services on a pre-paid basis; or "(ii) for costs incurred by the center or centers, otherwise permitted under this section, as the Secretary determines are necessary to enable a center or centers to develop, operate, and own the network or plan. "(C) PUBLICATION OF GUIDANCE.— Prior to considering an application submitted under this subsection, the Secretary shall publish guidelines to provide guidance on the implementation of this section. The Secretary shall make such guidelines available to the universe of parties affected under this subsection, distribute such guidelines to such parties upon the request of such parties, and provide a copy of such guidelines to the appropriate committees of Congress. "(2) PROTECTION OF FINANCIAL INTERESTS.— "(A) IN GENERAL. —The Secretary may not approve a loan guarantee for a project under this subsection unless the Secretary determines that— "(i) the terms, conditions, security (if any), and schedule and amount of repayments with respect to the loan are sufficient to protect the financial interests of the United States and are otherwise reasonable, including a determination that the rate of interest does not exceed such percent per annum on the principal obligation outstanding as the Secretary determines to be reasonable, taking into account the range of interest rates prevailing in the private market for similar loans and the risks assumed by the United States, except that the Secretary may not require as security any center asset that is, or may be, needed by the center or centers involved to provide health services; "(ii) the loan would not be available on reasonable terms and conditions without the guarantee under this subsection; and
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