117 STAT. 2330
PUBLIC LAW 108–173—DEC. 8, 2003
(3) PRACTICE STANDARDS.—Each physician participating in the demonstration program under this section must demonstrate the ability— (A) to assess each eligible beneficiary for conditions other than chronic conditions, such as impaired cognitive ability and co-morbidities, for the purposes of developing care management requirements; (B) to serve as the primary contact of eligible beneficiaries in accessing items and services for which payment may be made under the medicare program; (C) to establish and maintain health care information system for such beneficiaries; (D) to promote continuity of care across providers and settings; (E) to use evidence-based guidelines and meet such clinical quality and outcome measures as the Secretary shall require; (F) to promote self-care through the provision of patient education and support for patients or, where appropriate, family caregivers; (G) when appropriate, to refer such beneficiaries to community service organizations; and (H) to meet such other complex care management requirements as the Secretary may specify. The guidelines and measures required under subparagraph (E) shall be designed to take into account beneficiaries with multiple chronic conditions. (c) PAYMENT METHODOLOGY.—Under the demonstration program under this section the Secretary shall pay a per beneficiary amount to each participating physician who meets or exceeds specific performance standards established by the Secretary with respect to the clinical quality and outcome measures reported under subsection (b)(1)(B). Such amount may vary based on different levels of performance or improvement. (d) ADMINISTRATION.— (1) USE OF QUALITY IMPROVEMENT ORGANIZATIONS.—The Secretary shall contract with quality improvement organizations or such other entities as the Secretary deems appropriate to enroll physicians and evaluate their performance under the demonstration program under this section. (2) TECHNICAL ASSISTANCE.—The Secretary shall require in such contracts that the contractor be responsible for technical assistance and education as needed to physicians enrolled in the demonstration program under this section for the purpose of aiding their adoption of health information technology, meeting practice standards, and implementing required clinical and outcomes measures. (e) FUNDING.— (1) IN GENERAL.—The Secretary shall provide for the transfer from the Federal Supplementary Medical Insurance Trust Fund established under section 1841 of the Social Security Act (42 U.S.C. 1395t) of such funds as are necessary for the costs of carrying out the demonstration program under this section. (2) BUDGET NEUTRALITY.—In conducting the demonstration program under this section, the Secretary shall ensure that the aggregate payments made by the Secretary do not exceed
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