; and (II) the use of which is supported by peer-reviewed literature, clinical guidelines, or expert opinion within the National Institutes of Health Rare Diseases Clinical Research Network consortia or its participating clinical centers. . (3) Effective date The amendments made by this subsection apply with respect to items and services furnished on or after the date that is 30 days after the date of the enactment of this Act. (b) Medicaid (1) In general Section 1927(k)(6) of the Social Security Act ( 42 U.S.C. 1396r–8(k)(6) ) is amended— (A) by striking , or and inserting a comma; and (B) by inserting before the period the following: , or the use of which is related to the treatment or management of a disease or condition affecting 200,000 or fewer individuals in the United States and is supported by peer-reviewed literature, clinical guidelines, or expert opinion within the National Institutes of Health Rare Diseases Clinical Research Network consortia or its participating clinical centers . (2) Prohibition of coverage exclusions for formularies Section 1927(d)(4) of the Social Security Act ( 42 U.S.C. 1396r–8(d)(4) ) is amended— (A) in subparagraph (C), by striking A covered outpatient drug and inserting Subject to subparagraph (E), a covered outpatient drug ; (B) by redesignating subparagraph (E) as subparagraph (F); and (C) by inserting after subparagraph (D) the following new subparagraph: (E) Notwithstanding subparagraph (C), the State may not impose a limitation or exclusion of benefits with respect to coverage of a covered outpatient drug that is— (i) used in the treatment or management of a disease or condition affecting 200,000 or fewer individuals in the United States