Index for HR3962: Affordable Health Care for America Act

EXPENDITURES for items and services covered under parts A and B ;   Resulting from normal variation in

INCENTIVE payment for year equal to portion of amount by which payments under title for year estimated below performance target for year as determined by Secretary ;   Qualifying ACO meeting or exceeding annual quality and performance targets for year receiving

INCENTIVE payment being made under subsection ;   Secretary treating receipt of incentive payment for year by organization under physician group practice demonstration pursuant to section 1866a as year For which

CERTIFICATION as marriage and family therapist pursuant to State law ;   Possessing master or doctoral degree qualifying for licensure or

CERTIFICATION for practice of mental health counseling in State in which services performed ;   Possessing master or doctor's degree qualifying individual for licensure or

MARRIAGE and family therapist for diagnosis and treatment of mental illnesses ;   Term marriage and family therapist services meaning services performed by

MARRIAGE and family therapist pursuant to State law ;   Possessing master or doctoral degree qualifying for licensure or certification as

MARRIAGE and family therapy ;   Obtaining degree performed 2 years of clinical supervised experience in

MARRIAGE and family therapist services For which payment to be made directly to marriage and family therapist under part B of title XVIII of Social Security Act 42 USC 1395j et seq ;   Secretary of Health and Human Services developing criteria with respect to payment for

MEDICAL homes ;   Secretary establishing process for practices to qualify as

BENEFICIARY risk scores to ensure that higher payments being made for higher risk beneficiaries ;   Secretary adjusting payments to medical homes based on

HOME services under title on permanent basis ;   Feasability and advisability of reimbursing medical homes for medical

MEDICAL homes meeting updated standards ;   Secretary periodically reviewing and updating standards for qualification as independent patient centered medical home and community based medical home and establishing process for ensuring that

HOME medical practice meaning legal entity ;   Term independence at

SAVINGS under demonstration program ;   Nothing in subsection to be construed as preventing independence at home medical practice from including provider of services or participating practitioner described in section 1842(b) affiliated with practice under arrangement structured so that provider of services or practitioner participating in demonstration program and shares in

HOME medical practice participating in demonstration program reporting on quality measures and report to Secretary ;   Independence at

EXPENDITURES for items and services under parts A and B with respect to applicable beneficiaries for independence at home medical practice not exceeding amount ;   Secretary limiting incentive payments to qualifying independence at home medical practice under paragraph as necessary to ensure that aggregate

HOME medical practice under demonstration program ;   Secretary determining appropriate method of ensuring that applicable beneficiaries agreed to enroll in independence at

BENEFICIARY access to services covered under title and applicable beneficiaries not to be required to relinquish access to benefit under title as condition of receiving services from independence at home medical practice ;   Nothing in section to be construed as encouraging physicians or nurse practitioners to limit applicable

HOME medical practice under demonstration program covering not more than 3-year period ;   Agreement with independence at

HOME medical practice under section participating in section 1866d or sectioning 1866e ;   Secretary not paying independence at

HOME medical practice under section participating in programs under section 1866d or sectioning 1866e ;   Secretary ensuring that no applicable beneficiary enrolled in independence at

HOME medical practice under demonstration program to assess whether practice achieving results described in subsection ;   Secretary evaluating independence at

EXPENDITURES and quality of services under title after applicable beneficiary discontinuing receiving services under title through qualifying independence at home medical practice ;   Secretary monitoring data on

INCENTIVE payments under subsection or consistently failing to meet quality standards ;   Secretary terminating agreement with independence at home medical practice if practice not receiving

HEALTH counselor for diagnosis and treatment of mental illnesses ;   Term mental health counselor services meaning services performed by mental

HEALTH counseling in State in which services performed ;   Possessing master or doctor's degree qualifying individual for licensure or certification for practice of mental

HEALTH counselor services For which payment to be made directly to mental health counselor under part B of title XVIII of Social Security Act 42 USC 1395j et seq ;   Secretary of Health and Human Services developing criteria with respect to payment for mental

HEALTH Centers ;   Coverage of mental health counselor Services provided in rural health clinics and federally qualified

MENTAL illnesses ;   Term marriage and family therapist services meaning services performed by marriage and family therapist for diagnosis and treatment of

MENTAL illnesses ;   Term mental health counselor services meaning services performed by mental health counselor for diagnosis and treatment of

TRAINING Services ;   Recognition of certified diabetes Educators as certified Providers for Purposes of medicare diabetes outpatient self-management

TRAINING services furnished after first day of first calendar year being 6 months after date of enactment of Act ;   Amendments making by subsection applying to diabetes outpatient self-management

INCENTIVE payments under pilot program ;   Nothing in subsection to be construed as preventing qualifying ACO from including hospital or other provider of services or supplier furnishing items or services For which payment to be made under title affiliated with ACO under arrangement structured so that provider or supplier participating in pilot program and shares in

PAYMENT to be made as physicians' services under title ;   Individual furnishing services For which

HOME services furnished by independent patient-centered medical homes ;   Secretary establishing methodolology for payment for medical

PAYMENT being not made under title as of date of enactment of section ;   Clinical work and practice expenses involved in providing medical home services provided by independent patient-centered medical home For which

HOME services furnished under CBMH model ;   Secretary establishing methodolology for payment for medical

PAYMENT being not made under title as of date of enactment of section ;   Clinical work and practice expenses involved in providing medical home services provided by primary or principal care practice For which

PAYMENT for medical visits making under title  ;  

PAYMENT of psychologist under clause ;   Amounts paid to be 80 percent of lesser of actual charge for services or 75 percent of amount determined for

MARRIAGE and family therapist services For which payment to be made directly to marriage and family therapist under part B of title XVIII of Social Security Act 42 USC 1395j et seq ;   Secretary of Health and Human Services developing criteria with respect to payment for

PAYMENT of psychologist under clause ;   Amounts paid to be 80 percent of lesser of actual charge for services or 75 percent of amount determined for

HEALTH counselor services For which payment to be made directly to mental health counselor under part B of title XVIII of Social Security Act 42 USC 1395j et seq ;   Secretary of Health and Human Services developing criteria with respect to payment for mental

PREVENTIVE services meaning following ;   Term Medicare covered

PREVENTIVE services ;   Respect to specific Medicare covered

PREVENTIVE services ;   Respect to Medicare covered

PREVENTIVE services ;   Section 1833(t)(1)(b)( iv of Social Security Act 42 USC 1395l(t)(1)(b)( iv amended by striking screening mammography and diagnostic mammography and inserting diagnostic mammograms and Medicare covered

PREVENTIVE services ;   Clause, striking items and services described in section 1861(s) and inserting Medicare covered

PREVENTIVE services ;   Section 1866(a)(2)(a)( ii of Act 42 USC 1395cc(a)(2)(a)( ii amended by inserting other than Medicare covered

PRIMARY care or principal care physician or nurse practitioner accepting responsibility for providing first contact, continuous and comprehensive care to beneficiary ;   Providing beneficiaries with direct and ongoing access to

HEALTH care provided by physician, nurse practitioner or physician assistant practicing in field of family medicine, general internal medicine, geriatric medicine or pediatric medicine ;   Term primary care meaning

PRIMARY care or principal care physician, nurse practitioner or physician assistant designated by beneficiary ;   Organization providing medical home services under supervision in close collaboration with

PRINCIPAL care physician or nurse practitioner accepting responsibility for providing first contact, continuous and comprehensive care to beneficiary ;   Providing beneficiaries with direct and ongoing access to primary care or

PRINCIPAL care physician, nurse practitioner or physician assistant designated by beneficiary ;   Organization providing medical home services under supervision in close collaboration with primary care or

PROFESSIONAL shortage area ;   Addition to amount otherwise paid under part to be paid to practitioner of section 1842(b)(6)) from Federal Supplementary Medical Insurance Trust Fund amount equal 5 percent as primary care health

PROFESSIONAL shortage area ;   Section 1848(o)(1)(b)( iv of Act 42 USC 1395w-4(o)(1)(b)( iv amended by inserting primary care before health

HOME pursuant to paragraph for targeted high need beneficiaries ;   Secretary making payments for medical home services furnished by independent patient-centered medical

HOME pursuant to paragraph for beneficiaries ;   Secretary making payments for furnishing of medical home services by community-based medical

MEDICAL homes pursuant to criteria established by Secretary ;   Secretary establishing process to provide for review and qualification of community-based

IMPLEMENTATION of section ;   Chapter 35 of title 44, United States Code not applying to manufacturer provision of information pursuant to section 1927(b)(3)(a)( iii or subsection for purposes of

INFORMATION reported pursuant to section ;   Subparagraphs and section 1927(b)(3) applying to information reported pursuant to previous sentence in same manner as subparagraphs applying with respect to

RISK ;   Target to be established on per capita basis or adjusted for

RISK ;   Base amount to be determined on per capita basis or adjusted for

RISK as determined to be appropriate by Secretary ;   Risk physicians' services or items and services under part B Secretary limiting partial capitation model to ACOS highly integrated systems of care and ACOS capable of bearing

PAYMENT under paragraph in manner ensuring that higher payments being made for higher risk beneficiaries ;   Use appropriate risk-adjustment in determining amount of per beneficiary per month

PAYMENT under paragraph ;   Use appropriate risk-adjustment in determining amount of per beneficiary per month

SAVINGS being greater ;   Incentive payment to be made only if

SAVINGS achieved and amount of savings ;   Determinations with respect whether

SAVINGS under demonstration program ;   Nothing in subsection to be construed as preventing independence at home medical practice from including provider of services or participating practitioner described in section 1842(b) affiliated with practice under arrangement structured so that provider of services or practitioner participating in demonstration program and shares in

SAVINGS under subsection ;   Other than payments for items and services furnished under title and shared

TITLE to applicable beneficiaries by qualifying accountable care organizations in order ;   Designing to reduce growth of expenditures and improving health outcomes in provision of items and services under

INCENTIVE payments under pilot program ;   Nothing in subsection to be construed as preventing qualifying ACO from including hospital or other provider of services or supplier furnishing items or services For which payment to be made under title affiliated with ACO under arrangement structured so that provider or supplier participating in pilot program and shares in

TITLE ;   Individual furnishing services For which payment to be made as physicians' services under

TITLE for year estimated below performance target for year as determined by Secretary ;   Qualifying ACO meeting or exceeding annual quality and performance targets for year receiving incentive payment for year equal to portion of amount by which payments under

TITLE not exceeding amount ;   Secretary limiting incentive payments to qualifying ACO under paragraph as necessary to ensure that aggregate expenditures with respect to applicable beneficiaries for ACOS under

CAPITATION model to be established in manner not resulting in spending more for ACO for beneficiaries ;   Payments to qualifying ACO for items and services under title for applicable beneficiaries for year under partial

TITLE after applicable beneficiary discontinuing receiving services under title through qualifying ACO ;   Secretary monitoring data on expenditures and quality of services under

TITLE ;   Secretary evaluating payment incentive model for qualifying ACO under pilot program to assess impacts on beneficiaries, providers of services, suppliers and program under

TITLE ;   Report addressing impact of use of models on expenditures, access and quality under