PUBLIC LAW 108–173—DEC. 8, 2003
117 STAT. 2347
conducted under such section. The first such report shall be submitted not later than 2 years after the report is submitted under paragraph (2). Each such report shall include information on— (A) the scope of implementation (in terms of both regions and chronic conditions) of the chronic care improvement programs; (B) the design of the programs; and (C) the improvements in health outcomes and financial efficiencies that result from such implementation. SEC. 722. MEDICARE ADVANTAGE QUALITY IMPROVEMENT PROGRAMS.
(a) IN GENERAL.—Section 1852(e) (42 U.S.C. 1395w–22(e)) is amended— (1) in the heading, by striking ‘‘ASSURANCE’’ and inserting ‘‘IMPROVEMENT’’; (2) by amending paragraphs (1) through (3) to read as follows: ‘‘(1) IN GENERAL.—Each MA organization shall have an ongoing quality improvement program for the purpose of improving the quality of care provided to enrollees in each MA plan offered by such organization (other than an MA private fee-for-service plan or an MSA plan). ‘‘(2) CHRONIC CARE IMPROVEMENT PROGRAMS.—As part of the quality improvement program under paragraph (1), each MA organization shall have a chronic care improvement program. Each chronic care improvement program shall have a method for monitoring and identifying enrollees with multiple or sufficiently severe chronic conditions that meet criteria established by the organization for participation under the program. ‘‘(3) DATA.— ‘‘(A) COLLECTION, ANALYSIS, AND REPORTING.— ‘‘(i) IN GENERAL.—Except as provided in clauses (ii) and (iii) with respect to plans described in such clauses and subject to subparagraph (B), as part of the quality improvement program under paragraph (1), each MA organization shall provide for the collection, analysis, and reporting of data that permits the measurement of health outcomes and other indices of quality. ‘‘(ii) APPLICATION TO MA REGIONAL PLANS.—The Secretary shall establish as appropriate by regulation requirements for the collection, analysis, and reporting of data that permits the measurement of health outcomes and other indices of quality for MA organizations with respect to MA regional plans. Such requirements may not exceed the requirements under this subparagraph with respect to MA local plans that are preferred provider organization plans. ‘‘(iii) APPLICATION TO PREFERRED PROVIDER ORGANIZATIONS.—Clause (i) shall apply to MA organizations with respect to MA local plans that are preferred provider organization plans only insofar as services are furnished by providers or services, physicians, and other health care practitioners and suppliers that have contracts with such organization to furnish services under such plans.
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