Ill STAT. 524 PUBLIC LAW 105-33 —AUG. 5, 1997 SEC. 4743. ELIMINATION OF REQUIREMENT OF PRIOR INSTITUTIONAL- IZATION WITH RESPECT TO HABILITATION SERVICES FLTRNISHED UNDER A WAIVER FOR HOME OR COMMU- NITY-BASED SERVICES. (a) IN GENERAL.—Section 1915(c)(5) (42 U.S.C. 1396n(c)(5)) is amended, in the matter preceding subparagraph (A), by striking ", with respect to individuals who receive such services after discharge from a nursing facility or intermediate care facility for the mentally retarded". 42 USC I396n (b) EFFECTIVE DATE.— The amendment made by subsection (a) "oteapply to services furnished on or after October 1, 1997. 42 USC 1396d SEC. 4744. STUDY AND REPORT ON EPSDT BENEFIT. (a) STUDY.— (1) IN GENERAL.—The Secretary of Health and Human Services, in consultation with Governors, directors of State medicaid programs, the American Academy of Actuaries, and representatives of appropriate provider and beneficiary organizations, shall conduct a study of the provision of early and periodic screening, diagnostic, and treatment services under the medicaid program under title XIX of the Social Security Act in accordance with the requirements of section 1905(r) of such Act (42 U.S.C. 1396d(r)). (2) REQUIRED CONTENTS.— The study conducted under paragraph (1) shall include examination of the actuarial value of the provision of such services under the medicaid program and an examination of the portions of such actuarial value that are attributable to paragraph (5) of section 1905(r) of such Act and to the second sentence of such section. (b) REPORT. —Not later than 12 months after the date of the enactment of this Act, the Secretary of Health and Human Services shall submit a report to Congress on the results of the study conducted under subsection (a). CHAPTER 6—ADMINISTRATION AND MISCELLANEOUS SEC. 4751. ELIMINATION OF DUPLICATIVE INSPECTION OF CARE REQUIREMENTS FOR ICFS/MR AND MENTAL HOSPITALS. (a) MENTAL HOSPITALS.—Section 1902(a)(26) (42 U.S.C. 1396a(a)(26)) is amended— (1) by striking "provide— "(A) with respect to each patient" and inserting "provide, with respect to each patient"; and (2) by striking subparagraphs (B) and (C). (b) ICFS/MR.-^ection 1902(a)(31) (42 U.S.C. 1396a(a)(31)) is amended— (1) by striking "provide— "(A) with respect to each patient" and inserting "provide, with respect to each patient"; and (2) by striking subparagraphs (B) and (C). 42 USC 1396a (c) EFFECTIVE DATE.— The amendments made by this section note. take effect on the date of the enactment of this Act. SEC. 4752. ALTERNATIVE SANCTIONS FOR NONCOMPLIANT ICFS/MR. (a) IN GENERAL. —Section 1902(i)(l)(B) (42 U.S.C. 1396a(i)(l)(B)) is amended by striking "provide" and inserting "establish alternative remedies if the State demonstrates to the
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