Page:United States Statutes at Large Volume 117.djvu/2175

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[117 STAT. 2156]
PUBLIC LAW 107-000—MMMM. DD, 2003
[117 STAT. 2156]

117 STAT. 2156

PUBLIC LAW 108–173—DEC. 8, 2003 1903(a), in accordance with the Federal Claims Collection Act of 1996 and applicable regulations. ‘‘(D) DATA MATCH.—The Secretary shall perform such periodic data matches as may be necessary to identify and compute the number of full-benefit dual eligible individuals for purposes of computing the amount under subparagraph (A). ‘‘(2) AMOUNT.— ‘‘(A) IN GENERAL.—The amount computed under this paragraph for a State described in paragraph (1) and for a month in a year is equal to— 1⁄12 of the product of— ‘‘(i) ‘‘(I) the base year State medicaid per capita expenditures for covered part D drugs for fullbenefit dual eligible individuals (as computed under paragraph (3)); and ‘‘(II) a proportion equal to 100 percent minus the Federal medical assistance percentage (as defined in section 1905(b)) applicable to the State for the fiscal year in which the month occurs; and ‘‘(ii) increased for each year (beginning with 2004 up to and including the year involved) by the applicable growth factor specified in paragraph (4) for that year. ‘‘(B) NOTICE.—The Secretary shall notify each State described in paragraph (1) not later than October 15 before the beginning of each year (beginning with 2006) of the amount computed under subparagraph (A) for the State for that year. ‘‘(3) BASE YEAR STATE MEDICAID PER CAPITA EXPENDITURES FOR COVERED PART D DRUGS FOR FULL-BENEFIT DUAL ELIGIBLE INDIVIDUALS.— ‘‘(A) IN GENERAL.—For purposes of paragraph (2)(A), the ‘base year State medicaid per capita expenditures for covered part D drugs for full-benefit dual eligible individuals’ for a State is equal to the weighted average (as weighted under subparagraph (C)) of— ‘‘(i) the gross per capita medicaid expenditures for prescription drugs for 2003, determined under subparagraph (B); and ‘‘(ii) the estimated actuarial value of prescription drug benefits provided under a capitated managed care plan per full-benefit dual eligible individual for 2003, as determined using such data as the Secretary determines appropriate. ‘‘(B) GROSS PER CAPITA MEDICAID EXPENDITURES FOR PRESCRIPTION DRUGS.— ‘‘(i) IN GENERAL.—The gross per capita medicaid expenditures for prescription drugs for 2003 under this subparagraph is equal to the expenditures, including dispensing fees, for the State under this title during 2003 for covered outpatient drugs, determined per fullbenefit-dual-eligible-individual for such individuals not receiving medical assistance for such drugs through a medicaid managed care plan. ‘‘(ii) DETERMINATION.—In determining the amount under clause (i), the Secretary shall—

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