Page:United States Statutes at Large Volume 124.djvu/425

 124 STAT. 399 PUBLIC LAW 111–148—MAR. 23, 2010 ‘‘(5) the percent of shared savings specified by the Secretary under subsection (d)(2) and any limit on the total amount of shared savings established by the Secretary under such subsection; and ‘‘(6) the termination of an ACO under subsection (d)(4). ‘‘(h) DEFINITIONS.—In this section: ‘‘(1) ACO PROFESSIONAL.—The term ‘ACO professional’ means— ‘‘(A) a physician (as defined in section 1861(r)(1)); and ‘‘(B) a practitioner described in section 1842(b)(18)(C)(i). ‘‘(2) HOSPITAL.—The term ‘hospital’ means a subsection (d) hospital (as defined in section 1886(d)(1)(B)). ‘‘(3) MEDICARE FEE-FOR-SERVICE BENEFICIARY.—The term ‘Medicare fee-for-service beneficiary’ means an individual who is enrolled in the original Medicare fee-for-service program under parts A and B and is not enrolled in an MA plan under part C, an eligible organization under section 1876, or a PACE program under section 1894.’’. SEC. 3023. NATIONAL PILOT PROGRAM ON PAYMENT BUNDLING. Title XVIII of the Social Security Act, as amended by section 3021, is amended by inserting after section 1886C the following new section: ‘‘NATIONAL PILOT PROGRAM ON PAYMENT BUNDLING ‘‘SEC. 1866D. (a) IMPLEMENTATION.— ‘‘(1) IN GENERAL.—The Secretary shall establish a pilot program for integrated care during an episode of care provided to an applicable beneficiary around a hospitalization in order to improve the coordination, quality, and efficiency of health care services under this title. ‘‘(2) DEFINITIONS.—In this section: ‘‘(A) APPLICABLE BENEFICIARY.—The term ‘applicable beneficiary’ means an individual who— ‘‘(i) is entitled to, or enrolled for, benefits under part A and enrolled for benefits under part B of such title, but not enrolled under part C or a PACE program under section 1894; and ‘‘(ii) is admitted to a hospital for an applicable condition. ‘‘(B) APPLICABLE CONDITION.—The term ‘applicable condition’ means 1 or more of 8 conditions selected by the Secretary. In selecting conditions under the preceding sentence, the Secretary shall take into consideration the following factors: ‘‘(i) Whether the conditions selected include a mix of chronic and acute conditions. ‘‘(ii) Whether the conditions selected include a mix of surgical and medical conditions. ‘‘(iii) Whether a condition is one for which there is evidence of an opportunity for providers of services and suppliers to improve the quality of care furnished while reducing total expenditures under this title. ‘‘(iv) Whether a condition has significant variation in— ‘‘(I) the number of readmissions; and 42 USC 1395cc–4.