SOCIAL HEALTH MAINTENANCE ORGANIZATIONS (SHMOS).

SEC. 4014. SOCIAL HEALTH MAINTENANCE ORGANIZATIONS (SHMOS). (a) Extension of Demonstration Project Authorities.—Section 4018(b) of the Omnibus Budget Reconciliation Act of 1987 is amended—111 STAT. 337 (1) in paragraph (1), by striking “1997” and inserting “2000”, and (2) in paragraph (4), by striking “1998” and inserting “2001”. (b) Expansion of Cap.—Section 13567(c) of the Omnibus Budget Reconciliation Act of 1993 is amended by striking “12,000” and inserting “36,000”. (c) Report on Integration and Transition.— (1) In general.—The Secretary of Health and Human Services shall submit to Congress, by not later than January 1, 1999, a plan for the integration of health plans offered by social health maintenance organizations (including SHMO I and SHMO II sites developed under section 2355 of the Deficit Reduction Act of 1984 and under the amendment made by section 4207(b)(3)(B)(i) of OBRA–1990, respectively) and similar plans as an option under the Medicare+Choice program under part C of title XVIII of the Social Security Act. (2) Provision for transition.—Such plan shall include a transition for social health maintenance organizations operating under demonstration project authority under such section. (3) Payment policy.—The report shall also include recommendations on appropriate payment levels for plans offered by such organizations, including an analysis of the application of risk adjustment factors appropriate to the population served by such organizations.