Page:United States Statutes at Large Volume 117.djvu/2344

 PUBLIC LAW 108–173—DEC. 8, 2003

117 STAT. 2325

that encourage the delivery of improved quality in patient care, including— ‘‘(1) the provision of incentives to improve the safety of care provided to beneficiaries; ‘‘(2) the appropriate use of best practice guidelines by providers and services by beneficiaries; ‘‘(3) reduced scientific uncertainty in the delivery of care through the examination of variations in the utilization and allocation of services, and outcomes measurement and research; ‘‘(4) encourage shared decision making between providers and patients; ‘‘(5) the provision of incentives for improving the quality and safety of care and achieving the efficient allocation of resources; ‘‘(6) the appropriate use of culturally and ethnically sensitive health care delivery; and ‘‘(7) the financial effects on the health care marketplace of altering the incentives for care delivery and changing the allocation of resources. ‘‘(c) ADMINISTRATION BY CONTRACT.— ‘‘(1) IN GENERAL.—Except as otherwise provided in this section, the Secretary may administer the demonstration program established under this section in a manner that is similar to the manner in which the demonstration program established under section 1866A is administered in accordance with section 1866B. ‘‘(2) ALTERNATIVE PAYMENT SYSTEMS.—A health care group that receives assistance under this section may, with respect to the demonstration project to be carried out with such assistance, include proposals for the use of alternative payment systems for items and services provided to beneficiaries by the group that are designed to— ‘‘(A) encourage the delivery of high quality care while accomplishing the objectives described in subsection (b); and ‘‘(B) streamline documentation and reporting requirements otherwise required under this title. ‘‘(3) BENEFITS.—A health care group that receives assistance under this section may, with respect to the demonstration project to be carried out with such assistance, include modifications to the package of benefits available under the original medicare fee-for-service program under parts A and B or the package of benefits available through a Medicare Advantage plan under part C. The criteria employed under the demonstration program under this section to evaluate outcomes and determine best practice guidelines and incentives shall not be used as a basis for the denial of medicare benefits under the demonstration program to patients against their wishes (or if the patient is incompetent, against the wishes of the patient’s surrogate) on the basis of the patient’s age or expected length of life or of the patient’s present or predicted disability, degree of medical dependency, or quality of life. ‘‘(d) ELIGIBILITY CRITERIA.—To be eligible to receive assistance under this section, an entity shall— ‘‘(1) be a health care group; ‘‘(2) meet quality standards established by the Secretary, including—

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