(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

(b) On or before January 1, 2000, submit a report on its findings to the
Governor and, subject to § 2-1246 of the State Government Article, the Senate
Finance Committee and the House Environmental Matters Committee.

SECTION 5. AND BE IT FURTHER ENACTED, That Section 2 of this Act shall
take effect July 1, 1999, contingent on the taking effect of regulations as provided
under Section 3 of this Act on the date that the regulations adopted under Section 3 of
this Act take effect. Within 5 days after final adoption of the regulations under Section
3 of this Act, the Department of Health and Mental Hygiene shall certify in writing to
the Department of Legislative Services the date on which the regulations take effect.

SECTION 2. 6. AND BE IT FURTHER ENACTED, That That, subject to
Section 5 of this Act, this Act shall take effect July 1, 1999.

May 27, 1999

The Honorable Thomas V. Mike Miller, Jr.
President of the Senate
State House
Annapolis MD 21401

Dear Mr. President: