; (B) in paragraph (29), by striking at the end and ; (C) by inserting after paragraph (29) the following new paragraph: (30) qualifying reconstructive breast surgery services (as defined in section 1861(kkk)); and ; and (D) by adding at the end of the flush matter following paragraph (31), as redesignated by subparagraph (A), the following new sentence: For purposes of paragraph (30), qualifying reconstructive breast surgery services described in section 1861(kkk)(4) shall be deemed to be medically reasonable and necessary. . (2) Effective date (A) In general Subject to subparagraph (B), the amendments made by this section shall take effect with respect to medical assistance provided on or after January 1 of the first year beginning after the date of the enactment of this Act. (B) Exception for State legislation In the case of a State plan under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq.) that the Secretary of Health and Human Services determines requires State legislation in order for the respective plan to meet any requirement imposed by the amendments made by this section, the respective plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet such an additional requirement before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of the enactment of this Act. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of the session shall be considered to be a separate regular session of the State legislature.