(3) to participate in another agreement under 
section 206. 
(c) NON EXCLUSIVE AGREEMENTS.—No agreement 
made under this title shall confer upon any individual or 
other person, or any group or other organization, the right 
of furnishing or providing personal health services as bene-
fits, to the exclusion in whole or in part of other individ-
uals, persons, groups, or organizations qualified to furnish 
or provide such services. 
(d) DISQUALIFICATION.— 
(1) IN GENERAL.—If the State agency after in-
vestigation finds that an individual or other person 
under agreement to furnish or provide personal 
health services as benefits is no longer qualified to 
furnish or provide such services, or has committed a 
substantial breach of the agreement, it shall notify 
such person of its findings, together with the rea-
sons therefor, and in the absence of a request for a 
hearing by such person under title VI, or in the 
event of a final decision sustaining its findings after 
any hearing and further review provided under title 
VI, may terminate the agreement and withdraw the 
person’s name from the list published pursuant to 
title III.
(2) LIMITATION
ON
SUBSEQUENT
AGREE-
MENTS.—After an agreement has been so termi-
nated, no new agreement shall be entered into with 
such person under this Act unless and until such 
person gives reasonable assurances to the State 
agency of the person’s ability and willingness to dis-
charge all obligations and responsibilities under a 
new agreement satisfactorily in accordance with its 
provisions. 
SEC. 208. METHODS OF PAYMENTS FOR SERVICES. 
(a) PROFESSIONAL SERVICES.—Agreements for the 
furnishing of medical, dental, or podiatric services (other 
than specialist services) as benefits under this Act shall 
provide for payment— 
(1) on the basis of fees for services rendered as 
benefits, according to a fee schedule; 
(2) on a per capita basis, the amount being ac-
cording to the number of individuals eligible for ben-
efits who are on the practitioner’s list; 
(3) on a salary basis, whole time or part time; 
or 
(4) on such combinations or modifications of 
these bases, including separate provision for travel 
and related expenses, as may be approved by the 
State agency;
according in each health-service area as the majority of 
the medical practitioners or of the dental practitioners, re-
spectively, under agreement to furnish such services shall 
elect. Provision shall be made for another method or meth-
ods of payment (from among the methods listed in this 
subsection) to those medical practitioners or to those den-
tal practitioners who do not elect the method of such ma-
jority, when it is found that such alternative method of 
making payments contributes to carrying out the provi-
sions of section 305 or otherwise promotes the efficient 
and economical provision of medical or dental services in 
the area. 
(b) SPECIALIST SERVICES.—Agreements for the fur-
nishing of specialist services as benefits under this Act 
may provide for payments on the basis of fee for service, 
per case, per session, per capita, on salary (whole time 
or part time), or other basis, or combination thereof. 
(c) TREATMENT OF GROUPS.—Any of the methods 
of making payments from among the methods listed in 
subsection (a) or subsection (b) may be used in making 
payments to groups or practitioners or organizations or 
other agencies which undertake to provide specialist serv-
ices as well as general medical or general dental services. 
(d) HOSPITAL SERVICES.—
(1) USE OF REASONABLE COSTS.—Agreements 
for the furnishing of hospital services as benefits 
under this Act shall provide for payment on the 
basis of the reasonable costs of hospitalization fur-
nished as benefits. 
(2) MAXIMUM RATES.—The Board, after con-
sultation with the Advisory Council and with rep-
resentatives of interested hospital organizations, may 
by regulation prescribe maximum rates for hos-
pitalization furnished as benefits under this Act, and 
such maximum rates may be varied according to 
classes of localities or types of service. 
(3) PAYMENT
BASIS.—Payments to hospitals 
shall be based on the least expensive multiple-bed ac-
commodations available in the hospital unless the 
patient’s condition makes the use of private accom-
modations essential for the patient’s proper medical 
care. 
(4) ADDITIONAL
CHARGES.—An agreement 
made for furnishing such services shall not affect the 
right of the hospital or other person with whom the 
agreement is made to require payments from pa-
tients with respect to the additional cost of more ex-
pensive facilities occupied at the request of the pa-
tient, or with respect to services not included as ben-
efits under this Act. 
(e) HOME-NURSING
SERVICES
AND
AUXILIARY 
SERVICES.—Agreements for the furnishing of home-nurs-
ing services or auxiliary services as benefits under this Act 
shall provide for payment in accordance with such meth-
ods as the State agency may approve from among those 
set forth in regulations prescribed pursuant to this Act. 
(f) PRO-RATING CERTAIN PER CAPITA PAYMENTS.— 
In any health-service area where agreements for the fur-
nishing of general medical or general dental services pro-
vide for payment only on a per capita basis, the per capita 
payments with respect to those individuals residing in the 
area who have failed to select a practitioner or other per-
son to furnish such services to them shall be made on a 
pro rata basis among the practitioners and other persons 
under agreement to furnish such services in the area. 
SEC. 209. AMOUNT OF PAYMENTS FOR SERVICES. 
(a) CONSIDERATION OF LOCAL CONDITIONS.— 
(1) IN GENERAL.—Rates or amounts of pay-
ment for particular services or classes of services 
furnished as benefits under this Act shall be adapted 
to take account of relevant regional, State, or local 
conditions and practices.
(2) PROFESSIONAL SERVICES.—In arriving at 
the payments to be made for services of general 
medical and dental practitioners, specialists, profes-
sional and practical nurses, or other practitioners, 
regard shall be had for the annual income or its 
equivalent which the payments will provide, and con-
sideration shall be given to degree of specialization, 
and to the skill, experience, and responsibility in-
volved in rendering the services. 
(3) ADEQUACY.—Such payments, together with 
the other terms and conditions of the agreements 
made under this title, shall be adequate to provide 
professional and financial incentives to practitioners 
to advance in their professions and to practice in lo-
calities where their services are most needed, to en-
courage high standards in the quality of services fur-
nished, to give assistance in their use of opportuni-
ties for postgraduate study, and to allow for ade-
quate vacation. 
(b) EQUIVALENCE IN CHOICE OF PAYMENT METH-
ODS.—The rates and amounts of payments fixed under 
the different methods of payments specified in subsections 
(a), (b), (c), and (e) of section 208, and the methods of 
making payments, shall assure reasonably equivalent 
awards for practitioners selecting different methods of