Page:United States Statutes at Large Volume 100 Part 1.djvu/231

 PUBLIC LAW 99-272—APR. 7, 1986

100 STAT. 195

(4) counseling on and instruction in— (A) diet and nutrition, (B) reduction of stress, (C) exercise and exercise programs, (D) sleep regulation, (E) injury prevention, (F) prevention of alcohol and drug abuse, (G) prevention of mental health disorders, (H) self-care, including use of medication, and (I) reduction or cessation of smoking. (c) CONDUCT OF PROGRAM.—The demonstration program shall— (1) be conducted under the direction of accredited public or private nonprofit schools of public health or preventive medicine departments accredited by the Council on Education for Public Health; (2) be conducted in no fewer than five sites, which sites shall be chosen so as to be geographically diverse and shall be readily accessible to a significant number of medicare beneficiaries; (3) involve community outreach efforts at each site to enroll the maximum number of medicare beneficiaries in the program; and (4) be designed— (A) to test alternative methods of payment for preventive health services, including payment on a prepayment basis as well as payment on a fee-for-service basis, (B) to permit a variety of appropriate health care providers to furnish preventive health services, including physicians, health educators, nurses, allied health personnel, dieticians, and clinical psychologists, and (C) to facilitate evaluation under subsection (d). (d) EVALUATION.—The Secretary shall evaluate the demonstration project in order to determine— (1) the short-term and long-term costs and benefits of providing preventive health services for medicare beneficiaries, including any reduction in inpatient services resulting from providing the services, and (2) what practical mechanisms exist to finance preventive health services under title XVIII of the Social Security Act. (e) REPORTS TO CONGRESS.—(1) Not later than three years after the date of the enactment of this Act, the Secretary shall submit a preliminary report to the Committees on Ways and Means and Energy and Commerce of the House of Representatives and to the Committee on Finance of the Senate on the progress made in the demonstration program, including a description of the sites at which the program is being conducted and the preventive health services being provided at the different sites. (2) Not later than five years after the date of the enactment of this Act, the Secretary shall submit a final report to those Committees on the demonstration program and shall include in the report— (A) the evaluation described in subsection (d), and (B) recommendations for appropriate legislative changes to incorporate payment for cost-effective preventive health services into the medicare program. (f) FUNDING.—Expenditures made for the demonstration program shall be made from the Federal Supplementary Medical Insurance Trust Fund (established by section 1841 of the Social Security Act). Grants and payments under contracts may be made either in ad-

Schools and colleges,

42 USC 1395.

42 USC I395t.

�