PUBLIC LAW 108–173—DEC. 8, 2003
117 STAT. 2343
care management programs and demonstrated experience in the evaluation of such programs. Each evaluation shall include an assessment of the following factors of the programs: ‘‘(A) Quality improvement measures, such as adherence to evidence-based guidelines and rehospitalization rates. ‘‘(B) Beneficiary and provider satisfaction. ‘‘(C) Health outcomes. ‘‘(D) Financial outcomes, including any cost savings to the program under this title. ‘‘(c) EXPANDED IMPLEMENTATION PHASE (PHASE II).— ‘‘(1) IN GENERAL.—With respect to chronic care improvement programs conducted under subsection (b), if the Secretary finds that the results of the independent evaluation conducted under subsection (b)(6) indicate that the conditions specified in paragraph (2) have been met by a program (or components of such program), the Secretary shall enter into agreements consistent with subsection (f) to expand the implementation of the program (or components) to additional geographic areas not covered under the program as conducted under subsection (b), which may include the implementation of the program on a national basis. Such expansion shall begin not earlier than 2 years after the program is implemented under subsection (b) and not later than 6 months after the date of completion of such program. ‘‘(2) CONDITIONS FOR EXPANSION OF PROGRAMS.—The conditions specified in this paragraph are, with respect to a chronic care improvement program conducted under subsection (b) for a threshold condition, that the program is expected to— ‘‘(A) improve the clinical quality of care; ‘‘(B) improve beneficiary satisfaction; and ‘‘(C) achieve targets for savings to the program under this title specified by the Secretary in the agreement within a range determined to be appropriate by the Secretary, subject to the application of budget neutrality with respect to the program and not taking into account any payments by the organization under the agreement under the program for risk under subsection (f)(3)(B). ‘‘(3) INDEPENDENT EVALUATIONS OF PHASE II PROGRAMS.— The Secretary shall carry out evaluations of programs expanded under this subsection as the Secretary determines appropriate. Such evaluations shall be carried out in the similar manner as is provided under subsection (b)(5). ‘‘(d) IDENTIFICATION AND ENROLLMENT OF PROSPECTIVE PROGRAM PARTICIPANTS.— ‘‘(1) IDENTIFICATION OF PROSPECTIVE PROGRAM PARTICIPANTS.—The Secretary shall establish a method for identifying targeted beneficiaries who may benefit from participation in a chronic care improvement program. ‘‘(2) INITIAL CONTACT BY SECRETARY.—The Secretary shall communicate with each targeted beneficiary concerning participation in a chronic care improvement program. Such communication may be made by the Secretary and shall include information on the following: ‘‘(A) A description of the advantages to the beneficiary in participating in a program.
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