Page:United States Statutes at Large Volume 124.djvu/967

 124 STAT. 941 PUBLIC LAW 111–148—MAR. 23, 2010 may limit a partial capitation model to ACOs that are highly integrated systems of care and to ACOs capable of bearing risk, as determined to be appropriate by the Secretary. ‘‘(B) NO ADDITIONAL PROGRAM EXPENDITURES.—Pay- ments to an ACO for items and services under this title for beneficiaries for a year under the partial capitation model shall be established in a manner that does not result in spending more for such ACO for such beneficiaries than would otherwise be expended for such ACO for such beneficiaries for such year if the model were not imple- mented, as estimated by the Secretary. ‘‘(3) OTHER PAYMENT MODELS.— ‘‘(A) IN GENERAL.—Subject to subparagraph (B), a model described in this paragraph is any payment model that the Secretary determines will improve the quality and efficiency of items and services furnished under this title. ‘‘(B) NO ADDITIONAL PROGRAM EXPENDITURES.— Subparagraph (B) of paragraph (2) shall apply to a payment model under subparagraph (A) in a similar manner as such subparagraph (B) applies to the payment model under paragraph (2). ‘‘(j) INVOLVEMENT IN PRIVATE PAYER AND OTHER THIRD PARTY ARRANGEMENTS.—The Secretary may give preference to ACOs who are participating in similar arrangements with other payers. ‘‘(k) TREATMENT OF PHYSICIAN GROUP PRACTICE DEMONSTRA- TION.—During the period beginning on the date of the enactment of this section and ending on the date the program is established, the Secretary may enter into an agreement with an ACO under the demonstration under section 1866A, subject to rebasing and other modifications deemed appropriate by the Secretary.’’. SEC. 10308. REVISIONS TO NATIONAL PILOT PROGRAM ON PAYMENT BUNDLING. (a) IN GENERAL.—Section 1866D of the Social Security Act, as added by section 3023, is amended— (1) in paragraph (a)(2)(B), in the matter preceding clause (i), by striking ‘‘8 conditions’’ and inserting ‘‘10 conditions’’; (2) by striking subsection (c)(1)(B) and inserting the fol- lowing: ‘‘(B) EXPANSION.—The Secretary may, at any point after January 1, 2016, expand the duration and scope of the pilot program, to the extent determined appropriate by the Secretary, if— ‘‘(i) the Secretary determines that such expansion is expected to— ‘‘(I) reduce spending under title XVIII of the Social Security Act without reducing the quality of care; or ‘‘(II) improve the quality of care and reduce spending; ‘‘(ii) the Chief Actuary of the Centers for Medicare & Medicaid Services certifies that such expansion would reduce program spending under such title XVIII; and Certification. Determinations. 42 USC 1395cc–4. Time period. Contracts. Applicability. Determination. Estimate.