ChiPACC, whether made on a capitated basis or fee- 
for-service basis, do not exceed on average the ag-
gregate payments that would have been paid under 
the State plan for such individuals if they were not 
so enrolled, taking into account the comparative case 
mix of ChiPACC enrollees and such other factors as 
the Secretary determines to be appropriate. 
‘‘(f) REGULATIONS.— 
‘‘(1) IN GENERAL.—The Secretary shall issue 
such regulations, including interim final regulations, 
as may be necessary to carry out this section. 
‘‘(2) CONTINUATION
OF
MODIFICATIONS
OR 
WAIVERS OPERATIONAL REQUIREMENTS.—If a State 
agency administering a program of all-inclusive co-
ordinated care for seriously ill children approved 
pursuant to waiver authority under section 1115 or 
1915(c) has contractual or other operating arrange-
ments relating to such program which are not other-
wise recognized in regulation and which were in ef-
fect as of the date of the enactment of this section, 
the Secretary shall permit the agency to continue 
such arrangements so long as such arrangements 
are found by the Secretary to be reasonably con-
sistent with the objectives of a ChiPACC. 
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‘‘(3) CONSTRUCTION.—Nothing in this sub-
section shall be construed as preventing the Sec-
retary from including in regulations provisions to en-
sure the health and safety of individuals enrolled in 
a ChiPACC under this section that are in addition 
to those otherwise provided under this section. 
‘‘(g) APPLICABILITY OF REQUIREMENTS.—With re-
spect to carrying out a ChiPACC under this section, the 
following requirements of this title (and regulations relat-
ing to such requirements) shall not apply: 
‘‘(1) Section 1902(a)(1), relating to any re-
quirement that ChiPACCs or ChiPACC services be 
provided in all areas of a State. 
‘‘(2) Section 1902(a)(10), insofar as such sec-
tion relates to comparability of services among dif-
ferent population groups. 
‘‘(3) Sections 1902(a)(23) and 1915(b)(4), re-
lating to freedom of choice of providers under a 
ChiPACC. 
‘‘(4) Section 1903(m)(2)(A), insofar as it re-
stricts a ChiPACC provider from receiving prepaid 
capitation payments. 
‘‘(5) Section 1905(o), limiting the scope of hos-
pice care. 
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‘‘(6) Such other provisions of this title that the 
Secretary determines are inapplicable to carrying out 
a ChiPACC under this section.’’. 
(c) CONTINUED
DEMONSTRATION
PROJECT
AU-
THORITY.—Section 1944 of the Social Security Act, as 
added by subsection (b), shall not be construed as pre-
venting a State from developing, or the Secretary of 
Health and Human Services from approving, a project 
similar to or related to ChiPACCs (as described in such 
section) under existing authorities, including demonstra-
tion project and waiver authorities under title XIX of such 
Act or other provisions of such Act. 
(d) OTHER CONFORMING AMENDMENTS.—Section 
1905(r)(5) of such Act (42 U.S.C. 1396d(r)(5)) is amend-
ed by inserting before the period at the end the following: 
‘‘, other than items and services that are only covered as 
section 1944 ChiPACC benefits’’. 
(e) TIMELY ISSUANCE OF REGULATIONS; EFFECTIVE 
DATE.—The Secretary of Health and Human Services 
shall promulgate regulations to carry out the amendments 
made by this section in a timely manner, so as to assure 
that it will be feasible for State agencies and entities to 
establish and operate ChiPACCs for periods beginning not 
later than 1 year after the date of the enactment of this 
Act. 
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(f) FUNDS FOR TECHNICAL ASSISTANCE.—The Sec-
retary is authorized to expend funds appropriated to carry 
out title XIX of the Social Security Act to make grants 
to, or enter into contracts with, private entities or organi-
zations that are qualified to provide technical or other as-
sistance in developing and establishing ChiPACCs within 
the States, except that— 
(1) such funds may be expended solely for the 
purposes of implementing this section; and 
(2) a private entity or organization in receipt of 
such funds must have demonstrated expertise and a 
minimum of 5 years of experience in working with 
or assisting in the establishment of programs for 
comprehensive care of children meeting the descrip-
tion of ChiPACC eligible individuals under section 
1944(b) of the Social Security Act, as added by sub-
section (b). 
Æ 
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