; and (2) was not grossly negligent. (b) Preemption This section preempts the laws of a State or any political subdivision of a State to the extent that such laws are inconsistent with this section, unless such laws provide greater protection from liability for a defendant. (c) Definitions In this section: (1) Physician The term physician has the meaning given such term by section 1861(r) of the Social Security Act. (2) Attending medical personnel The term attending medical personnel means an individual who is licensed to directly support a physician in furnishing medical services. . (b) Effective date The amendments made by this section shall apply to any claim filed to the extent that it is with respect to acts or omissions occurring after the date of the enactment of this Act. II Medicare and Medicaid Reforms A 201. Flexible block grant option for States Title XIX of the Social Security Act is amended— (1) in section 1903 ( 42 U.S.C. 1396b )— (A) in subsection (a), in the matter before paragraph (1), by inserting and section 1903A(a) after except as otherwise provided in this section ; and (B) in subsection (d)(1), by striking to which and inserting to which, subject to section 1903A(a), ; and (2) by inserting after such section 1903 the following new section: 1903A. Flexible block grant option for States (a) In general In the case of a State that elects the option of applying this section for a 10-fiscal-year period (beginning no earlier than fiscal year 2020 and, at the State option, for any succeeding 10-fiscal-year period) and that has a plan approved by the Secretary under subsection (b) to carry out the option for such period— (1) the State shall receive, instead of amounts otherwise payable to the State under this title for medical assistance for block grant individuals within the applicable block grant category (as defined in subsection (f)) for the State during the period in which the election is in effect, the amount specified in subsection (d)