Page:United States Statutes at Large Volume 98 Part 1.djvu/1151

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PUBLIC LAW 98-000—MMMM. DD, 1984

PUBLIC LAW 98-369—JULY 18, 1984

98 STAT. 1108

(2) The amendments made by paragraphs (1), (2), and (3) of subsection (c) shall be effective as if they had been originally included in Public Laws 96-499, 97-35, and 97-248, respectively. WAIVERS FOR SOCIAL HEALTH MAINTENANCE ORGANIZATIONS

94 Stat. 2599; 95 Stat. 357. 26 USC 1 note.

SEC. 2355. (a) In the case of a project described in subsection (b), the Secretary of Health and Human Services shall approve, with appropriate terms and conditions as defined by the Secretary, applications or protocols submitted for waivers described in subsection (c), and the evaluation of such protocols, in order to carry out such project. Such approval shall be effected not later than 30 days after the date on which the application or protocol for a waiver is submitted or not later than 30 days after the date of the enactment of this Act in the case of an application or protocol submitted before the date of the enactment of this Act. Qa) A project referred to in subsection (a) is a project— (1) to demonstrate the concept of a social health maintenance organization with the organizations as described in Project No. 18-P-9 7604/1—04 of the University Health Policy Consortium of Brandeis University; (2) which provides for the integration of health and social services under the direct financial management of a provider of services; (3) under which all medicare services will be provided by or under arrangements made by the organization at a fixed annual • prepaid capitation rate for medicare of 100 percent of the adjusted average per capita cost; (4) under which medicaid services will be provided at a rate approved by the Secretary; (5) under which all payors will share risk for no more than two years, with the organization being at full risk in the third year; (6) which is being provided funds under a grant provided by the Secretary of Health and Human Services; and (7) with respect to which substantial private funds are being provided other than under the grant referred to in paragraph (5). (c) The waivers referred to in subsection (a) are appropriate waivers of— (1) certain requirements of title XVIII of the Social Security Act, pursuant to section 402(a) of the Social Security Amend- 42 USC 1395. ments of 1967 (as amended by section 222 of the Social Security Amendments of 1972); and 42 USC 1395b-l. (2) certain requirements of title XIX of the Social Security Act, pursuant to section 1115 of such Act. 42 USC 1396, (d)(1) The Secretary of Health and Human Services shall submit a 1315. preliminary report to the Congress on the status of the projects and Report. waivers referred to in subsection (a) 45 days after the date of the enactment of this Act. (2) The Secretary shall submit a final report to the Congress on Report the projects referred to in subsection (a) not later than 42 months after the date of the enactment of this Act.