Pub. L. 101-645, tit. V, subtit. A, sec. 501

WAIVER FOR CERTAIN ORGANIZATIONS OF REQUIREMENT OF STATUS AS MEDICAID PROVIDER.

EnactedYear: 1990Length: 301 wordsOfficial source
SEC. 501. WAIVER FOR CERTAIN ORGANIZATIONS OF REQUIREMENT OF STATUS AS MEDICAID PROVIDER. Section 340(b) of the Public Health Service Act (42 U.S.C. 256(b)) is amended to read as follows: “(b) Minimum Qualifications of Grantees.—(1) Subject to paragraph (2), the Secretary may not make a grant under subsection (a) to an applicant unless— “(A) the applicant is a public or nonprofit private entity; “(B) the applicant has the capacity to effectively administer a grant under subsection (a); and “(C) in the case of any health service that is covered in the State plan approved under title XIX of the Social Security Act for the State involved— “(i) the applicant for the grant will provide the health service directly, and the applicant has entered into a participation agreement under the State plan and is qualified to receive payments under such plan; or “(ii) the applicant for the grant will enter into an agreement with an organization under which the organization will provide the health service, and the organization has entered into such a participation agreement and is qualified to receive such payments. “(2) (A) In the case of an organization making an agreement under paragraph (1)(C)(ii) regarding the provision of health services under subsection (a), the requirement established in such paragraph regarding a participation agreement shall be waived by the Secretary if the organization does not, in providing health care services, impose a charge or accept reimbursement available from any third- party payor, including reimbursement under any insurance policy or under any Federal or State health benefits program. “(B) A determination by the Secretary of whether an organization referred to in subparagraph (A) meets the criteria for a waiver under such subparagraph shall be made without regard to whether the organization accepts voluntary donations regarding the provision of services to the public.”.