PUBLIC LAW 106-554—APPENDIX F 114 STAT. 2763A-511 appropriate criteria based on evidence the Secretary determines to be sufficient, the Secretary shall also pay to a participating health care group (subject to paragraph (4)) an additional bonus for a year, equal to such portion as the Secretary may designate of the saving to the program under this title resulting from process improvements made by and patient outcome improvements attributable to activities of the group. "(4) LIMITATION.—The Secretary shall limit bonus pay- ments under this section as necessary to ensure that the aggregate expenditures under this title (inclusive of bonus payments) with respect to patients within the scope of the demonstration do not exceed the amount which the Secretary estimates would be expended if the demonstration projects under this section were not implemented. ' PROVISIONS FOR ADMINISTRATION OF DEMONSTRATION PROGRAM "SEC. 1866B. (a) GENERAL ADMINISTRATIVE AUTHORITY.— "(1) BENEFICIARY ELIGIBILITY.— Except as otherwise provided by the Secretary, an individual shall only be eligible to receive benefits under the program under section 1866A (in this section referred to as the 'demonstration program') if such individual— "(A) is enrolled under the program under part B and entitled to benefits under part A; and "(B) is not enrolled in a Medicare+Choice plan under part C, an eligible organization under a contract under section 1876 (or a similar organization operating under a demonstration project authority), an organization with an agreement under section 1833(a)(1)(A), or a PACE program under section 1894. " (2) SECRETARY'S DISCRETION AS TO SCOPE OF PROGRAM.— The Secretary may limit the implementation of the demonstration program to— "(A) a geographic area (or areas) that the Secretary designates for purposes of the program, based upon such criteria as the Secretary finds appropriate; "(B) a subgroup (or subgroups) of beneficiaries or individuals and entities furnishing items or services (otherwise eligible to participate in the program), selected on the basis of the number of such participants that the Secretary finds consistent with the effective and efficient implementation of the program; "(C) an element (or elements) of the program that the Secretary determines to be suitable for implementation; or "(D) any combination of any of the limits described in subparagraphs (A) through (C). " (3) VOLUNTARY RECEIPT OF ITEMS AND SERVICES.— Items and services shall be furnished to an individual under the demonstration program only at the individual's election. "(4) AGREEMENTS.—The Secretary is authorized to enter into agreements with individuals and entities to furnish health care items and services to beneficiaries under the demonstration program. " (5) PROGRAM STANDARDS AND CRITERIA. —The Secretary shall establish performance standards for the demonstration program including, as applicable, standards for quality of health
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