; (3) ensure that such Medicaid demonstration project is not duplicative of any Federal program or funding opportunity; and (4) require that the State submitting such application or renewal submit to the Secretary, and make publicly available, an analysis of the degree to which such Medicaid demonstration project, if at all, precludes efforts undertaken by private sector and charitable sector entities to improve medical care and health outcomes for the individuals described in paragraph (1). . (b) Effective date The amendment made by subsection (a) shall apply with respect to applications or renewals submitted on or after January 1, 2018.