Page:United States Statutes at Large Volume 117.djvu/2360

 PUBLIC LAW 108–173—DEC. 8, 2003

117 STAT. 2341

at non-hospital sites, without regard to the financial arrangement between the hospital and the teaching physician practicing in the non-hospital site to which the resident has been assigned. (b) STUDY AND REPORT.— (1) STUDY.—The Inspector General of the Department of Health and Human Services shall conduct a study of the appropriateness of alternative payment methodologies under such sections for the costs of training residents in non-hospital settings. (2) REPORT.—Not later than 1 year after the date of the enactment of this Act, the Inspector General shall submit to Congress a report on the study conducted under paragraph (1), together with such recommendations as the Inspector General determines appropriate.

Deadline.

Subtitle C—Chronic Care Improvement SEC. 721. VOLUNTARY CHRONIC CARE IMPROVEMENT UNDER TRADITIONAL FEE-FOR-SERVICE.

(a) IN GENERAL.—Title XVIII is amended by inserting after section 1806 the following new section: ‘‘CHRONIC

CARE IMPROVEMENT

‘‘SEC. 1807. (a) IMPLEMENTATION OF CHRONIC CARE IMPROVEMENT PROGRAMS.— ‘‘(1) IN GENERAL.—The Secretary shall provide for the phased-in development, testing, evaluation, and implementation of chronic care improvement programs in accordance with this section. Each such program shall be designed to improve clinical quality and beneficiary satisfaction and achieve spending targets with respect to expenditures under this title for targeted beneficiaries with one or more threshold conditions. ‘‘(2) DEFINITIONS.—For purposes of this section: ‘‘(A) CHRONIC CARE IMPROVEMENT PROGRAM.—The term ‘chronic care improvement program’ means a program described in paragraph (1) that is offered under an agreement under subsection (b) or (c). ‘‘(B) CHRONIC CARE IMPROVEMENT ORGANIZATION.—The term ‘chronic care improvement organization’ means an entity that has entered into an agreement under subsection (b) or (c) to provide, directly or through contracts with subcontractors, a chronic care improvement program under this section. Such an entity may be a disease management organization, health insurer, integrated delivery system, physician group practice, a consortium of such entities, or any other legal entity that the Secretary determines appropriate to carry out a chronic care improvement program under this section. ‘‘(C) CARE MANAGEMENT PLAN.—The term ‘care management plan’ means a plan established under subsection (d) for a participant in a chronic care improvement program. ‘‘(D) THRESHOLD CONDITION.—The term ‘threshold condition’ means a chronic condition, such as congestive heart failure, diabetes, chronic obstructive pulmonary disease (COPD), or other diseases or conditions, as selected

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