2. IF THE REQUEST IS PROMPTED BY A CHANGE IN THE
REIMBURSEMENT PRACTICES OF A MEDICAID MANAGED CARE ORGANIZATION, THE
DATE THE MANAGED CARE ORGANIZATION CHANGED ITS REIMBURSEMENT TO THE
CENTER, EXCEPT THAT AN ADJUSTMENT UNDER THIS ITEM MAY NOT BE
RETROACTIVE MORE THAN 120 DAYS.

[(ii)] (III) (IV) If a managed care organization payment to a center
is less than the center's reasonable cost, AS DETERMINED IN ACCORDANCE WITH
PARAGRAPH (2) OF THIS SUBSECTION, the Department shall set aside a portion of the
capitation payment to the managed care organization for a supplemental payment to
the center, in accordance with the provisions of paragraphs (1) and (2) (1), (2), AND (3)
of this subsection.

(4) In carrying out the payment requirements of this subsection, the
Department:

(i) May not delegate responsibility for such payments to the
managed care organization or any other entity; and

(ii) Shall be responsible for making such payments directly to the
federally qualified health center.

(5) Payments under this subsection shall be reduced each year and shall
end in Fiscal Year 2004.

SECTION 2. AND BE IT FURTHER ENACTED, That the Laws of Maryland
read as follows:

Article - Health - General

15-103.

(e) (2) (i) The reasonable cost to a federally qualified health center in
providing services to enrollees shall be [determined in accordance with §
1902(a)(13)(C)(i) of the Social Security Act, as amended by the Balanced Budget Act of
1997, and any applicable regulations] A PROSPECTIVE RATE THAT THE
DEPARTMENT, IN CONSULTATION WITH FEDERALLY QUALIFIED HEALTH CENTERS,
ESTABLISHES BY REGULATION.
SECTION 3. AND BE IT FURTHER ENACTED, That, before October, 1999, the
Department of Health and Mental Hygiene, in consultation with federally qualified
health centers, shall adopt regulations that establish as a prospective rate the
reasonable cost to a federally qualified health center in providing services to enrollees
of the State Medical Assistance Program.

SECTION 4. AND BE IT FURTHER ENACTED, That the Department of
Health and Mental Hygiene, in consultation with the Mid-Atlantic Association of
Community Health Centers and the Medicaid managed care organizations, shall:

(a) Study alternative means for improving the viability of federally qualified
health centers serving clients in the HealthChoice Program; and