Page:United States Statutes at Large Volume 117.djvu/2346

 PUBLIC LAW 108–173—DEC. 8, 2003

117 STAT. 2327

on the feasibility and advisability of allowing medicare fee-forservice beneficiaries direct access to outpatient physical therapy services and physical therapy services furnished as comprehensive rehabilitation facility services. (b) REPORT.—Not later than January 1, 2005, the Commission shall submit to Congress a report on the study conducted under subsection (a) together with recommendations for such legislation or administrative action as the Commission determines to be appropriate. (c) DIRECT ACCESS DEFINED.—The term ‘‘direct access’’ means, with respect to outpatient physical therapy services and physical therapy services furnished as comprehensive outpatient rehabilitation facility services, coverage of and payment for such services in accordance with the provisions of title XVIII of the Social Security Act, except that sections 1835(a)(2), 1861(p), and 1861(cc) of such Act (42 U.S.C. 1395n(a)(2), 1395x(p), and 1395x(cc), respectively) shall be applied— (1) without regard to any requirement that— (A) an individual be under the care of (or referred by) a physician; or (B) services be provided under the supervision of a physician; and (2) by allowing a physician or a qualified physical therapist to satisfy any requirement for— (A) certification and recertification; and (B) establishment and periodic review of a plan of care. SEC. 648. DEMONSTRATION PROJECT FOR CONSUMER-DIRECTED CHRONIC OUTPATIENT SERVICES.

Deadline.

42 USC 1395b–8 note.

(a) ESTABLISHMENT.— (1) IN GENERAL.—Subject to the succeeding provisions of this section, the Secretary shall establish demonstration projects (in this section referred to as ‘‘demonstration projects’’) under which the Secretary shall evaluate methods that improve the quality of care provided to individuals with chronic conditions and that reduce expenditures that would otherwise be made under the medicare program on behalf of such individuals for such chronic conditions, such methods to include permitting those beneficiaries to direct their own health care needs and services. (2) INDIVIDUALS WITH CHRONIC CONDITIONS DEFINED.—In this section, the term ‘‘individuals with chronic conditions’’ means an individual entitled to benefits under part A of title XVIII of the Social Security Act, and enrolled under part B of such title, but who is not enrolled under part C of such title who is diagnosed as having one or more chronic conditions (as defined by the Secretary), such as diabetes. (b) DESIGN OF PROJECTS.— (1) EVALUATION BEFORE IMPLEMENTATION OF PROJECT.— (A) IN GENERAL.—In establishing the demonstration projects under this section, the Secretary shall evaluate best practices employed by group health plans and practices under State plans for medical assistance under the medicaid program under title XIX of the Social Security Act, as well as best practices in the private sector or other areas, of methods that permit patients to self-direct the

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