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PUBLIC LAW 103-66—AUG. 10, 1993 107 STAT. 613 (5) by inserting after paragraph (23), as so redesignated, the following new paragraph: ''(24) personal care services furnished to an individual who is not an inpatient or resident of a hospital, nursing facility, intermediate care facility for the mentally retarded, or institu- tion for mental disease that are (A) authorized for the individual by a physician in accordance with a plan of treatment or (at the option of the State) otherwise authorized for the individ- ual in accordance with a service plan approved by the State, (B) provided by an individual who is qualified to provide such services and who is not a member of the individual's family, and (C) furnished in a home or other location; and". (b) CONFORMING AMENDMENTS.—(1) Section 1902(aX10XCXiv) (42 U.S.C. 1396a(aX10XCXiv)) is amended by striking "through (21)" and inserting "through (24)". (2) Section 1902(j) (42 U.S.C. 1396a(i)) is amended by striking "through (22)" and inserting "through (25)^. (c) EFFECTIVE DATE.—^The amendments made by subsections 42 use I396a (a) and (b) shall take effect as if included in the enactment of "°^- section 4721(a) of OBRA-1990. SEC. 13602. ADDITIONAL FEDERAL SAVINGS THROUGH MODIFICA- TIONS TO DRUG REBATE PROGRAM. (a) CHANGES IN REBATE PROGRAM.— (1) IN GENERAL.—Section 1927 (42 U.S.C. 1396r-8) is amended by striking subsection (c) and all that follows through "(2)" in subsection (fx2) and inserting the following: "(c) DETERMINATION OF AMOUNT OF REBATE.— "(1) BASIC REBATE FOR SINGLE SOURCE DRUGS AND INNOVA- TOR MULTIPLE SOURCE DRUGS.— "(A) IN GENERAL.—^Except as provided in paragraph (2), the amount of the rebate specified in this subsection for a rebate period (as defined in subsection (kX8)) with respect to each dosage form and strength of a single soiirce drug or an innovator multiple source drug shall be equal to the product of— "(i) the total number of units of each dosage form and strength paid for under the State plan in the rebate period (as reported by the State); ana "(ii) subject to subparagraph (BXii), the greater of— "(I) the difference between the average manu- facturer price and l^e best price (as defined in subparagraph (O) for the dosage form and strength of the drug, or "(II) the minimum rebate percentage (specified in subparagraph (BXi)) of such average manufac- turer price, for the rebate period. "(B) RANGE OF REBATES REQUIRED.— "(i) MINIMUM REBATE PERCENTAGE.—For purposes of subparagraph (AXiiXII), the 'minimum rebate percentage' for rebate periods beginning— "(I) after December 31, 1990, and before Octo- ber 1,1992, is 12.5 percent; "(II) afler September 30, 1992, and before January 1,1994, is 15.7 percent;