contract

(6) (A) For purposes of this subsection and section 1396a(e)(2)(A) of this title , in the case of the State of New Jersey, the term “contract” shall be deemed to include an undertaking by the State agency, in the State plan under this subchapter, to operate a program meeting all requirements of this subsection. (B) The undertaking described in subparagraph (A) must provide— (i) for the establishment of a separate entity responsible for the operation of a program meeting the requirements of this subsection, which entity may be a subdivision of the State agency administering the State plan under this subchapter; (ii) for separate accounting for the funds used to operate such program; and (iii) for setting the capitation rates and any other payment rates for services provided in accordance with this subsection using a methodology satisfactory to the Secretary designed to ensure that total Federal matching payments under this subchapter for such services will be lower than the matching payments that would be made for the same services, if provided under the State plan on a fee for service basis to an actuarially equivalent population. (C) The undertaking described in subparagraph (A) shall be subject to approval (and annual re-approval) by the Secretary in the same manner as a contract under this subsection. (D) The undertaking described in subparagraph (A) shall not be eligible for a waiver under section 1396n(b) of this title .

Source

42 USC § 1396b(m)(6)


Scoping language

None identified. Default scope is assumed to be the entire title.
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