120 STAT. 2988
PUBLIC LAW 109–432—DEC. 20, 2006
(1) IN GENERAL.—For purposes of this section, the term ‘‘personal physician’’ means a physician (as defined in section 1861(r)(1) of the Social Security Act (42 U.S.C. 1395x(r)(1)) who— (A) meets the requirements described in paragraph (2); and (B) performs the services described in paragraph (3). Nothing in this paragraph shall be construed as preventing such a physician from being a specialist or subspecialist for an individual requiring ongoing care for a specific chronic condition or multiple chronic conditions (such as severe asthma, complex diabetes, cardiovascular disease, rheumatologic disorder) or for an individual with a prolonged illness. (2) REQUIREMENTS.—The requirements described in this paragraph for a personal physician are as follows: (A) The physician is a board certified physician who provides first contact and continuous care for individuals under the physician’s care. (B) The physician has the staff and resources to manage the comprehensive and coordinated health care of each such individual. (3) SERVICES PERFORMED.—A personal physician shall perform or provide for the performance of at least the following services: (A) Advocates for and provides ongoing support, oversight, and guidance to implement a plan of care that provides an integrated, coherent, cross-discipline plan for ongoing medical care developed in partnership with patients and including all other physicians furnishing care to the patient involved and other appropriate medical personnel or agencies (such as home health agencies). (B) Uses evidence-based medicine and clinical decision support tools to guide decision-making at the point-of-care based on patient-specific factors. (C) Uses health information technology, that may include remote monitoring and patient registries, to monitor and track the health status of patients and to provide patients with enhanced and convenient access to health care services. (D) Encourages patients to engage in the management of their own health through education and support systems. (d) MEDICAL HOME DEFINED.—For purposes of this section, the term ‘‘medical home’’ means a physician practice that— (1) is in charge of targeting beneficiaries for participation in the project; and (2) is responsible for— (A) providing safe and secure technology to promote patient access to personal health information; (B) developing a health assessment tool for the individuals targeted; and (C) providing training programs for personnel involved in the coordination of care. (e) PAYMENT MECHANISMS.— (1) PERSONAL PHYSICIAN CARE MANAGEMENT FEE.—Under the project, the Secretary shall provide for payment under section 1848 of the Social Security Act (42 U.S.C. 1395w– 4) of a care management fee to personal physicians providing
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