‘‘(2) AGREEMENTS.—A grant may be made 
under subsection (a) for a project only if the appli-
cant involved agrees as follows: 
‘‘(A) Eligibility criteria will be established 
for employers to participate in the project, in-
cluding the requirement that the employers be 
located within the service area defined under 
paragraph (1)(A) for the project, which may in-
clude— 
‘‘(i) a maximum average income 
earned by the employees of the business; 
‘‘(ii) criteria, in addition to the 12- 
month periods under subsection (a), to 
avoid creating any incentive for an em-
ployer or self-employed individual to dis-
continue health plans or health insurance 
policies; and 
‘‘(iii) such other criteria as the con-
sortium under paragraph (1)(B) considers 
to be appropriate. 
‘‘(B) A network of health care providers 
will be formed to provide services to qualifying 
employees and self-employed individuals who 
participate in the project, which services will be 
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provided according to a schedule of fees and co-
payments negotiated by the project. 
‘‘(C) Of the cost of providing health care 
coverage through the project— 
‘‘(i) not more than 30 percent will be 
paid by the project with funds from the 
grant; and 
‘‘(ii) not less than 70 percent will be 
paid by the employer, the employee, and 
any additional sources of funds (such as 
the community in which the project is lo-
cated) that may be available pursuant to 
arrangements with the project. 
‘‘(D) A minimum benefit package will be 
selected that includes— 
‘‘(i) physicians services; 
‘‘(ii) prescription drug benefits; 
‘‘(iii) in-patient hospital services; 
‘‘(iv) out-patient services; 
‘‘(v) emergency room visits; 
‘‘(vi) emergency ambulance services; 
and 
‘‘(vii) diagnostic laboratory tests and 
x-rays. 
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With respect to compliance with the agreement 
under this subparagraph, the project is not re-
quired to provide coverage for any service per-
formed outside the service area of the project, 
except to the extent that a service specified in 
any of clauses (i) through (vii) is not reasonably 
available within the service area. 
‘‘(E) The minimum benefit package will 
not exclude coverage of a medical condition on 
the basis that it is a pre-existing condition. 
‘‘(F) An entity will be selected by the con-
sortium under paragraph (1)(B) to carry out 
administrative and accounting functions with 
respect to the health care coverage to be offered 
by the project, including monthly billings, 
verification and enrollment of eligible employers 
and employees, maintenance of membership ros-
ters, operation of the utilization management 
program under subparagraph (G), and develop-
ment of a marketing plan. 
‘‘(G) A utilization management program 
will be selected that ensures delivery of care in 
the appropriate setting, using appropriate re-
sources and clinical practice guidelines. 
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‘‘(H) A plan will be implemented for meas-
uring quality and efficiency of care provided 
through the project within two years after the 
project begins operation. 
‘‘(I) A plan will be implemented for man-
aging care for enrollees with chronic illness, as 
well as additional cost-control initiatives that 
will be employed by the project within 2 years 
after the project begins operation. 
‘‘(J) A plan will be implemented for pro-
tecting the project from high risks, which may 
include affiliation with State high-risk pool or 
local safety net program, and purchase of rein-
surance. 
‘‘(K) A plan will be implemented for evalu-
ating the project on an interim basis, not less 
frequently than annually. 
‘‘(d) APPLICATION FOR GRANT.—A grant may be 
made under subsection (a) only if an application for the 
grant is submitted to the Secretary and the application 
is in such form, is made in such manner, and contains 
such agreements, assurances, and information as the Sec-
retary determines to be necessary to carry out this section. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of making grants under subsection (a), there is 
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authorized to be appropriated $36,000,000 in the aggre-
gate for the fiscal years 2007 through 2013, of which 
there are authorized to be appropriated amounts as fol-
lows: 
‘‘(1) For fiscal year 2007, $2,000,000. 
‘‘(2) For each of the fiscal years 2008 and 
2009, $5,000,000. 
‘‘(3) For each of the fiscal years 2010 through 
2013, $6,000,000. 
‘‘SEC. 330N. GRANTS FOR VOLUNTEER SPECIALTY PRO-
VIDER NETWORKS. 
‘‘(a) IN GENERAL.—The Secretary shall make grants 
to public or nonprofit private entities to carry out dem-
onstration projects for the purpose of forming and main-
taining networks composed of health care specialists who 
volunteer health services to eligible individuals. 
‘‘(b) ELIGIBLE INDIVIDUALS.—For purposes of this 
section, the term ‘eligible individual’ means an individual 
who has been enrolled by a project under subsection (a) 
and— 
‘‘(1) whose employer does not provide health 
care coverage; 
‘‘(2) is unable to obtain health care coverage 
through a family member or common law partner; 
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