Page:United States Statutes at Large Volume 114 Part 5.djvu/607

 PUBLIC LAW 106-554—APPENDIX F 114 STAT. 2763A-567 "(A) BASIC CAPITATION RATE.— The basic capitation rate paid for services covered under the project (other than case management services) per enrollee per month and furnished during— "(i) the period beginning with October 1, 2000, and ending with December 31, 2000, shall be determined by actuarially adjusting the actual capitation rate paid for such services in 1999 for inflation, utilization, and other changes to the CNO service package, and by reducing such adjusted capitation rate by 10 percent in the case of the demonstration sites located in Arizona, Minnesota, and Illinois, and 15 percent for the demonstration site located in New York; and "(ii) 2001 shall be determined by actuarially adjusting the capitation rate determined under clause (i) for inflation, utilization, and other changes to the CNO service package. "(B) TARGETED CASE MANAGEMENT FEE.— Effective October 1, 2000— "(i) the case management fee per enrollee per month for— "(I) the period described in subparagraph (A)(i) shall be determined by actuarially adjusting the case management fee for 1999 for inflation; and "(II) 2001 shall be determined by actuarially adjusting the amount determined under subclause (I) for inflation; and "(ii) such case management fee shall be paid only for enrollees who are classified as moderately frail or frail pursuant to criteria established by the Secretary. "(C) GREATER UNIFORMITY IN CLINICAL FEATURES AMONG SITES. —Each project shall implement for each site— "(i) protocols for periodic telephonic contact with enrollees based on— "(I) the results of such standardized written health assessment; and "(II) the application of appropriate care planning approaches; "(ii) disease management programs for targeted diseases (such as congestive heart failure, arthritis, diabetes, and hypertension) that are highly prevalent in the enrolled populations; "(iii) systems and protocols to track enrollees through hospitalizations, including pre-admission planning, concurrent management during inpatient hospital stays, and post-discharge assessment, planning, and follow-up; and "(iv) standardized patient educational materials for specified diseases and health conditions. "(D) QUALITY IMPROVEMENT.—Each project shall implement at each site once during the 15-month period— "(i) enrollee satisfaction surveys; and "(ii) reporting on specified quality indicators for the enrolled population. " (c) EVALUATION.—

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