Page:United States Statutes at Large Volume 111 Part 1.djvu/477

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PUBLIC LAW 105-33—AUG. 5, 1997 111 STAT. 453 SEC. 4532. DEMONSTRATION OF COVERAGE OF AMBULANCE SERVICES 42 USC 1395m UNDER MEDICARE THROUGH CONTRACTS WITH UNITS note. OF LOCAL GOVERNMENT. (a) DEMONSTRATION PROJECT CONTRACTS WITH LOCAL GOVERN- MENTS.—The Secretary of HegJth and Human Services shall establish up to 3 demonstration projects under which, at the request of a unit of local government, the Secretary enters into a contract with the unit of local government under which— (1) the unit of local government furnishes (or arranges for the furnishing of) ambulance services for which payment may be made under part B of title XVIII of the Social Security Act for individuals residing in the unit of local government who are enrolled under such part, except that the unit of local government may not enter into the contract unless the contract covers at least 80 percent of the individuals residing in the unit of local government who are enrolled under such part but not in a Medicare+Choice plan; (2) any individual or entity furnishing ambulance services under the contract meets the requirements otherwise applicable to individuals and entities furnishing such services under such part; and (3) for each month during which the contract is in effect, the Secretary makes a capitated payment to the unit of local government in accordance with subsection (b). The projects may extend over a period of not to exceed 3 years each. (b) AMOUNT OF PAYMENT.— (1) IN GENERAL. — The amount of the monthly payment made for months occurring during a calendar year to a unit of local government under a demonstration project contract under subsection (a) shall be equal to the product of— (A) the Secretary's estimate of the number of individugQs covered under the contract for the month; and (B) Vi2 of the capitated payment rate for the year established under paragraph (2). (2) CAPITATED PAYMENT RATE DEFINED. —In this subsection, the "capitated payment rate" applicable to a contract under this subsection for a calendar year is equal to 95 percent of— (A) for the first calendar year for which the contract is in effect, the average annual per capita payment made under part B of title XVIII of the Social Security Act with respect to ambulance services furnished to such individuals during the 3 most recent calendar years for which data on the amount of such payment is available; and (B) for a subsequent year, the amount provided under this paragraph for the previous year increased by the percentage increase in the consumer price index for all urban consumers (U.S. city average) for the 12-month period ending with June of the previous year. (c) OTHER TERMS OF CONTRACT.—The Secretary and the unit of local government may include in a contract under this section such other terms as the parties consider appropriate, including— (1) covering individuals residing in additional units of local government (under arrangements entered into between such units and the unit of local government involved);