Page:United States Statutes at Large Volume 124.djvu/346

 124 STAT. 320 PUBLIC LAW 111–148—MAR. 23, 2010 ‘‘(i) may be tiered to reflect, with respect to each eligible individual with chronic conditions provided such services by a designated provider, a team of health care professionals operating with such a provider, or a health team, as well as the severity or number of each such individual’s chronic conditions or the specific capabilities of the provider, team of health care profes- sionals, or health team; and ‘‘(ii) shall be established consistent with section 1902(a)(30)(A). ‘‘(B) ALTERNATE MODELS OF PAYMENT.—The method- ology for determining payment for provision of health home services under this section shall not be limited to a per- member per-month basis and may provide (as proposed by the State and subject to approval by the Secretary) for alternate models of payment. ‘‘(3) PLANNING GRANTS.— ‘‘(A) IN GENERAL.—Beginning January 1, 2011, the Sec- retary may award planning grants to States for purposes of developing a State plan amendment under this section. A planning grant awarded to a State under this paragraph shall remain available until expended. ‘‘(B) STATE CONTRIBUTION.—A State awarded a plan- ning grant shall contribute an amount equal to the State percentage determined under section 1905(b) (without regard to section 5001 of Public Law 111–5) for each fiscal year for which the grant is awarded. ‘‘(C) LIMITATION.—The total amount of payments made to States under this paragraph shall not exceed $25,000,000. ‘‘(d) HOSPITAL REFERRALS.—A State shall include in the State plan amendment a requirement for hospitals that are participating providers under the State plan or a waiver of such plan to establish procedures for referring any eligible individuals with chronic condi- tions who seek or need treatment in a hospital emergency depart- ment to designated providers. ‘‘(e) COORDINATION.—A State shall consult and coordinate, as appropriate, with the Substance Abuse and Mental Health Services Administration in addressing issues regarding the prevention and treatment of mental illness and substance abuse among eligible individuals with chronic conditions. ‘‘(f) MONITORING.—A State shall include in the State plan amendment— ‘‘(1) a methodology for tracking avoidable hospital readmis- sions and calculating savings that result from improved chronic care coordination and management under this section; and ‘‘(2) a proposal for use of health information technology in providing health home services under this section and improving service delivery and coordination across the care continuum (including the use of wireless patient technology to improve coordination and management of care and patient adherence to recommendations made by their provider). ‘‘(g) REPORT ON QUALITY MEASURES.—As a condition for receiving payment for health home services provided to an eligible individual with chronic conditions, a designated provider shall report to the State, in accordance with such requirements as the Secretary shall specify, on all applicable measures for determining Effective date.