Page:United States Statutes at Large Volume 102 Part 1.djvu/851

 PUBLIC LAW 100-360—JULY 1, 1988

102 STAT. 813

(e) AUTHORIZATION OF APPROPRIATIONS.—There are authorized to be appropriated, in appropriate parts from the Federal Hospital Insurance Trust Fund and from the Federal Supplementary Medical Insurance Trust Fund, for fiscal years 1989, 1990, and 1991 such sums as may be necessary to carry out the provisions of this section. SEC. 425. CASE MANAGEMENT DEMONSTRATION PROJECTS.

Contracts.

(a) IN GENERAL.—Within 12 months after the date of the enact- note. ment of this Act, the Secretary of Health and Human Services (in this section referred to as the "Secretary") shall establish 4 demonstration projects under which an appropriate entity agrees to provide case management services to medicare beneficiaries with selected catastrophic illnesses, particularly those with high costs of health care services. At least one such demonstration project shall be conducted through an agreement with a utilization and quality control peer review orgeinization with a contract with the Secretary under part B of title XI of the Social Security Act. (b) PURPOSE OP PROJECTS.—It is the purpose of the demonstration projects established under this section to provide the Secretary and the Congress with the information necessary— (1) to evaluate the appropriateness of providing case management services under the medicare program for medicare beneficiaries with high costs of medical care, and (2) to determine the most effective approach to implementing a case management system under the program for such beneficiaries. (c) AGREEMENT.—The Eigreement entered into under subsection (a) shall specify— (1) the high cost cases with respect to which case management services will be provided under the project, (2) the pa3nnents to be made to the entity conducting the project for carrying out the project, and (3) such other terms and conditions as the Secretary and the entity conducting the project may agree to. (d) WAIVERS.—The Secretary shall waive— (1) such provisions of part B of title XI of the Social Security Act, and (2) such provisions of title XVIII of such Act as relate to limitations or restrictions on benefits under such title, as the Secretary determines to be appropriate for the conduct of demonstration projects under this section. (e) DURATION.—

(1) Except as provided in paragraph (2), a demonstration prmect under this section shall be conducted for a 2-year period. (2) The Secretary may terminate a demonstration project before the end of the 2-year period specified in paragraph (1) if the Secretary determines that the entity conducting the project is not in substantial compliance with the terms of the agreement entered into under subsection (a). (f) INFORMATION AND REPORTS.—

(1) An entity with an agreement under subsection (a) shall furnish the Secretary with such information as the Secretary determines to be necessary to evaluate the results of that prmect. (2)(A) The Secretary shall submit to the Congress an interim report on the projects conducted under this section based upon information that is derived from the first year of project oper-

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