; and (2) by adding at the end the following new paragraph: (4) (A) An agreement under this section may be authorized by the Secretary or any Department official authorized by the Secretary, and any such action is not an award for purposes of such laws that would otherwise require the use of competitive procedures for the furnishing of hospital care, medical services, and extended care services. (B) (i) Except as provided in clause (ii), and unless otherwise provided in this section or regulations prescribed pursuant to this section, a State home that enters into an agreement under this section is not subject to, in the carrying out of the agreement, any provision of law to which providers of services and suppliers under the Medicare program under title XVIII of the Social Security Act ( 42 U.S.C. 1395 et seq.) are not subject. (ii) A State home that enters into an agreement under this section is subject to— (I) all provisions of law regarding integrity, ethics, or fraud, or that subject a person to civil or criminal penalties