Page:United States Statutes at Large Volume 124.djvu/439

124 STAT. 413 PUBLIC LAW 111–148—MAR. 23, 2010 working with those hospitals shall report to the Secretary on the processes employed by the hospital to improve readmission rates and the impact of such processes on readmission rates.’’. SEC. 3026. COMMUNITY-BASED CARE TRANSITIONS PROGRAM. (a) IN GENERAL.—The Secretary shall establish a Community- Based Care Transitions Program under which the Secretary pro- vides funding to eligible entities that furnish improved care transi- tion services to high-risk Medicare beneficiaries. (b) DEFINITIONS.—In this section: (1) ELIGIBLE ENTITY.—The term ‘‘eligible entity’’ means the following: (A) A subsection (d) hospital (as defined in section 1886(d)(1)(B) of the Social Security Act (42 U.S.C. 1395ww(d)(1)(B))) identified by the Secretary as having a high readmission rate, such as under section 1886(q) of the Social Security Act, as added by section 3025. (B) An appropriate community-based organization that provides care transition services under this section across a continuum of care through arrangements with subsection (d) hospitals (as so defined) to furnish the services described in subsection (c)(2)(B)(i) and whose governing body includes sufficient representation of multiple health care stake- holders (including consumers). (2) HIGH-RISK MEDICARE BENEFICIARY.—The term ‘‘high- risk Medicare beneficiary’’ means a Medicare beneficiary who has attained a minimum hierarchical condition category score, as determined by the Secretary, based on a diagnosis of multiple chronic conditions or other risk factors associated with a hos- pital readmission or substandard transition into post-hos- pitalization care, which may include 1 or more of the following: (A) Cognitive impairment. (B) Depression. (C) A history of multiple readmissions. (D) Any other chronic disease or risk factor as deter- mined by the Secretary. (3) MEDICARE BENEFICIARY.—The term ‘‘Medicare bene- ficiary’’ means an individual who is entitled to benefits under part A of title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) and enrolled under part B of such title, but not enrolled under part C of such title. (4) PROGRAM.—The term ‘‘program’’ means the program conducted under this section. (5) READMISSION.—The term ‘‘readmission’’ has the meaning given such term in section 1886(q)(5)(E) of the Social Security Act, as added by section 3025. (6) SECRETARY.—The term ‘‘Secretary’’ means the Secretary of Health and Human Services. (c) REQUIREMENTS.— (1) DURATION.— (A) IN GENERAL.—The program shall be conducted for a 5-year period, beginning January 1, 2011. (B) EXPANSION.—The Secretary may expand the dura- tion and the scope of the program, to the extent determined appropriate by the Secretary, if the Secretary determines (and the Chief Actuary of the Centers for Medicare & Medicaid Services, with respect to spending under this Determination. Certification. 42 USC 1395b–1 note.