These individuals, however, would be excluded in computing your aggregate cap for the year. Eliminates Secretary's authority to approve new 1115 waivers that expand the number of individuals eligible for assistance, as of October 1, 1997. Existing waivers can be modified or extended. Part 3 - Managed Care Sec. Amends 1915 to allow states to restrict freedom of choice of providers to choice between two plans, or two managers, or a plan and a manager.
States can also limit number or plans or managers.
States would have to publish notice and allow time for comment on a proposed plan for limiting enrollment. Access to family planning services could not be restricted. There are special provisions for Indians and for rural areas. The states would also be allowed to lock in beneficiary eligibility for up to six months in any managed care risk plan. Expands the Secretary's authority to require information from the states, including detailed individual enrollee encounter data, in order to monitor the quality, cost, and accessibility of medical care provided under managed care arrangements.