Title VI, SEC. 6202. COMPUTATION OF PLAN BID, AFDC, AND SSI PROPORTIONS. 
      (a) In General. For purposes of this subtitle: 

        (1) Plan bid proportion. The ``plan bid proportion'' is, for a type of 
      enrollment, 1 minus the sum of (A) the AFDC proportion, and (B) the SSI 
      proportion. 

        (2) AFDC proportion. The ``AFDC proportion'' is, for a class of family 
      enrollment for a year, the ratio of 

          (A) the average of the number of AFDC recipients (as determined under 
        subsection (c)) enrolled in regional alliance health plans in that 
        class of enrollment for the year, to 

          (B) the average of the total number of individuals enrolled in 
        regional alliance health plans in that class of enrollment for the 
        year. 

        (3) SSI proportion. The ``SSI proportion'' is, for a class of family 
      enrollment for a year, the ratio of 

          (A) the average of the number of SSI recipients (as determined under 
        subsection (c)) enrolled in regional alliance health plans in that 
        class of enrollment for the year, to 

          (B) the average described in paragraph (2)(B). 

      (b) Computation. 

        (1) Projections. The proportions described in subsection (a) shall be 
      determined and applied by the State, based upon the best available data, 
      at least 1 month before the date bids are submitted under section 6004 
      before the beginning of the calendar year involved. 

        (2) Actual. For purposes of making adjustments under subsection (d), 
      the regional alliance shall determine, after the end of each year, the 
      actual proportions described in subsection (a). 

      (c) Counting of AFDC and SSI Recipients. For purposes of subsections 
    (a)(2)(A) and (a)(3)(A), the terms ``SSI recipient'' and ``AFDC recipient'' 
    do not include a medicare-eligible individual. 

      (d) Adjustments For Discrepancies In Estimations. 

        (1) In general. If the actual AFDC proportion or SSI proportion (as 
      determined under subsection (a)) for a year (in this subsection referred 
      to as the ``reference year''), determined after the end of the year based 
      upon actual number of AFDC recipients and SSI recipients in the year, is 
      different from the projected AFDC and SSI proportions (as determined 
      under subsection (b)(1)) used in computing the blended plan payment 
      amount for the year, then, subject to section 1361(b)(3), the regional 
      alliance shall adjust the blended plan payment amount in the second 
      succeeding year (in this subsection referred to as the ``applicable 
      year'') in the manner described in paragraph (2). By regulation the 
      Secretary may apply the adjustment, based on estimated amounts, in the 
      year before the applicable year, with final adjustment in the applicable 
      year. 

        (2) Adjustment described. 

          (A) Positive cash flow. If the cash flow difference (as defined in 
        paragraph (3)(A)) for the reference year is positive, then in the 
        applicable year the blended plan payment amount shall be increased by 
        the adjustment percentage described in paragraph (4). 

          (B) Negative cash flow. If the cash flow difference (as defined in 
        paragraph (3)(A)) for the reference year is negative, then in the 
        applicable year the blended plan payment amount shall be reduced by the 
        adjustment percentage described in paragraph (4). 

        (3) Cash flow difference defined. In this subsection: 

          (A) In general. The term ``cash flow difference'' means, for a 
        regional alliance for a reference year, the amount by which 

            (i) the actual cash flow (as defined in subparagraph (B)) for the 
          alliance for the year, exceeds 

            (ii) the reconciled cash flow (as defined in subparagraph (C)) for 
          the alliance for the year. 

          (B) Actual cash flow. The term ``actual cash flow'' means, for a 
        regional alliance for a reference year, the total amount paid by the 
        regional alliance to the regional alliance health plans in the year 
        based on the blended plan payment amount (computed on the basis of 
        projected AFDC and SSI proportions determined under subsection (b)(1). 

          (C) Reconciled cash flow. The term ``reconciled cash flow'' means, 
        for a regional alliance for a reference year, the total amount that 
        would have been paid to regional alliance health plans in the year if 
        such payments had been made based on the blended plan payment amount 
        computed on the basis of the actual AFDC and SSI proportions for the 
        year (determined under subsection (b)(2), rather than based on such 
        payment amount computed on the basis of the projected AFDC and SSI 
        proportions for the year (determined under subsection (b)(1)). 

        (4) Percentage adjustment. The percentage adjustment described in this 
      paragraph for a regional alliance for an applicable year is the ratio 
      (expressed as a percentage) of 

          (A) the cash flow difference for the reference year, to 

          (B) the total payments estimated by the regional alliance to be paid 
        to regional alliance health plans under this subtitle in the applicable 
        year (determined without regard to any adjustment under this 
        subsection).