Table Of Contents of the INDEX

 

Beneficiary: individual
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(A) IN GENERAL. - paragraph (i)
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (b) (1) (A) (i)
Automated Concept:

BENEFICIARY'S chronic conditions and designed to achieve results in subsection ;   7 days per week to carry out plans of care tailoring to individual

Index of Sec 1312. ...

Beneficiary access: applicable
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(3) BENEFICIARY ACCESS TO SERVICES.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (d) (3)
Automated Concept:

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

Index of Sec 1312. ...

Chronic conditions
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(A) IN GENERAL. - paragraph (i)
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (b) (1) (A) (i)
Automated Concept:

BENEFICIARY'S chronic conditions and designed to achieve results in subsection ;   7 days per week to carry out plans of care tailoring to individual

Index of Sec 1312. ...

Dementias: other
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(1) DEFINITION. - paragraph (C)
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (d) (1) (C)
Automated Concept:

DEMENTIAS designating by Secretary, chronic obstructive pulations disease, ischemic heart disease, stroke, Alzheimer's Disease and neurodegenerative diseases and other diseases and conditions designated by Secretary ;   Congestive heart failure, diabetes, other

Index of Sec 1312. ...

Diabetes
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(1) DEFINITION. - paragraph (C)
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (d) (1) (C)
Automated Concept:

DEMENTIAS designating by Secretary, chronic obstructive pulations disease, ischemic heart disease, stroke, Alzheimer's Disease and neurodegenerative diseases and other diseases and conditions designated by Secretary ;   Congestive heart failure, diabetes, other

Index of Sec 1312. ...

Diagnostic technology: mobile
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(A) IN GENERAL. - paragraph (vi)
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (b) (1) (A) (vi)
Automated Concept:

DIAGNOSTIC technology ;   Uses electronic health information systems, remote monitoring and mobile

Index of Sec 1312. ...

Electronic medical records
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(4) PREFERENCE. - paragraph (C)
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (e) (4) (C)
Automated Concept:

HEALTH information technology and individualized plans of care ;   Use electronic medical records,

Index of Sec 1312. ...

Expenditure
Expenditures
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(1) IN GENERAL.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (a) (1)
Automated Concept:

EXPENDITURES and improving health outcomes in provision of items and services under title to applicable beneficiaries ;   Secretary conducting demonstration program to test payment incentive and service delivery model utilizing physician and nurse practitioner directed home-based primary care teams designed to reduce

Index of Sec 1312. ...

Expenditure: aggregate
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(3) SAVINGS TO THE MEDICARE PROGRAM.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (c) (3)
Automated Concept:

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

Index of Sec 1312. ...

Expenditures and quality of services
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(2) FOLLOWING APPLICABLE BENEFICIARIES.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (f) (2)
Automated Concept:

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

Index of Sec 1312. ...

Fiscal year
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(h) FUNDING.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (h)
Automated Concept:

FISCAL year to be available until expended ;   Amounts transferred under subsection for

Index of Sec 1312. ...

Functional dependencies: more
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(1) DEFINITION. - paragraph (F)
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (d) (1) (F)
Automated Concept:

FUNCTIONAL dependencies requiring assistance of another person ;   2 or more

Index of Sec 1312. ...

Health: other
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(A) IN GENERAL. - paragraph (i)
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (b) (1) (A) (i)
Automated Concept:

HEALTH and social services staffing as appropriate having experience providing home-based primary care to applicable beneficiaries, make in-home visits and available 24 hours per day ;   Comprising of individual physician or nurse practitioner or group of physicians and nurse practitioners providing care as part of team including physicians, nurses, physician assistants, pharmacists and other

Index of Sec 1312. ...

Health care
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(2) REQUIREMENT.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (a) (2)
Automated Concept:

HEALTH care across treatment settings ;   Continuous and accessible care to high-need populations at home and coordinat

Index of Sec 1312. ...

Health care items or services
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(i) ANTIDISCRIMINATION LIMITATION.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (i)
Automated Concept:

HEALTH care items or services under demonstration program unless entity guarantees ;   Secretary not entering into agreement with entity to provide

Index of Sec 1312. ...

Health care service
Health care services
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(4) PREFERENCE. - paragraph (B)
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (e) (4) (B)
Automated Concept:

HEALTH care services to applicable beneficiaries in home ;   Experience in furnishing

Index of Sec 1312. ...

Health care service: cost of
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(2) REQUIREMENT. - paragraph (F)
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (a) (2) (F)
Automated Concept:

HEALTH care services covered under title ;   Reducing cost of

Index of Sec 1312. ...

Health outcomes
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(1) IN GENERAL.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (a) (1)
Automated Concept:

HEALTH outcomes in provision of items and services under title to applicable beneficiaries ;   Secretary conducting demonstration program to test payment incentive and service delivery model utilizing physician and nurse practitioner directed home-based primary care teams designed to reduce expenditures and improving

Index of Sec 1312. ...

Health status: basis of
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(i) ANTIDISCRIMINATION LIMITATION.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (i)
Automated Concept:

HEALTH status if not included in program ;   Entity not denying, limiting or conditioning coverage or provision of benefits to which individual otherwise to be entitled on basis of

Index of Sec 1312. ...

Heart disease: ischemic
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(1) DEFINITION. - paragraph (C)
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (d) (1) (C)
Automated Concept:

HEART disease, stroke, Alzheimer's Disease and neurodegenerative diseases and other diseases and conditions designated by Secretary ;   Congestive heart failure, diabetes, other dementias designating by Secretary, chronic obstructive pulations disease, ischemic

Index of Sec 1312. ...

Heart failure: congestive
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(1) DEFINITION. - paragraph (C)
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (d) (1) (C)
Automated Concept:

DEMENTIAS designating by Secretary, chronic obstructive pulations disease, ischemic heart disease, stroke, Alzheimer's Disease and neurodegenerative diseases and other diseases and conditions designated by Secretary ;   Congestive heart failure, diabetes, other

Index of Sec 1312. ...

Home
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(1) IN GENERAL.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (a) (1)
Automated Concept:

EXPENDITURES and improving health outcomes in provision of items and services under title to applicable beneficiaries ;   Secretary conducting demonstration program to test payment incentive and service delivery model utilizing physician and nurse practitioner directed home-based primary care teams designed to reduce

Index of Sec 1312. ...
(2) REQUIREMENT.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (a) (2)
Automated Concept:

HEALTH care across treatment settings ;   Continuous and accessible care to high-need populations at home and coordinat

Index of Sec 1312. ...
(A) IN GENERAL.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (b) (1) (A)
Automated Concept:

HOME medical practice meaning legal entity ;   Term independence at

Index of Sec 1312. ...
(A) IN GENERAL. - paragraph (i)
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (b) (1) (A) (i)
Automated Concept:

HOME visits and available 24 hours per day ;   Comprising of individual physician or nurse practitioner or group of physicians and nurse practitioners providing care as part of team including physicians, nurses, physician assistants, pharmacists and other health and social services staffing as appropriate having experience providing home-based primary care to applicable beneficiaries, make in-

Index of Sec 1312. ...
(A) IN GENERAL. - paragraph (iii)
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (b) (1) (A) (iii)
Automated Concept:

HOME-based primary care services to high cost chronically ill beneficiaries as determined appropriate by Secretary ;   Documenting experience in providing

Index of Sec 1312. ...
(3) INCLUSION OF PROVIDERS AND PRACTITIONERS.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (b) (3)
Automated Concept:

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 demonstration program ;   Nothing in subsection to be construed as preventing independence at

Index of Sec 1312. ...
(A) IN GENERAL.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (b) (4) (A)
Automated Concept:

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

Index of Sec 1312. ...
(B) DEVELOPMENT OF QUALITY PERFORMANCE STANDARDS.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (b) (4) (B)
Automated Concept:

HOME medical practices participating in demonstration program ;   Secretary developing quality performance standards for independence at

Index of Sec 1312. ...
(B) APPORTIONMENT OF SAVINGS.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (c) (2) (B)
Automated Concept:

HOME medical practices ;   Incentive payment under section to be apportioned among qualifying independence at

Index of Sec 1312. ...
(3) SAVINGS TO THE MEDICARE PROGRAM.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (c) (3)
Automated Concept:

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

Index of Sec 1312. ...
(2) PATIENT ELECTION TO PARTICIPATE.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (d) (2)
Automated Concept:

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

Index of Sec 1312. ...
(3) BENEFICIARY ACCESS TO SERVICES.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (d) (3)
Automated Concept:

HOME medical practice ;   Nothing in section to be construed as encouraging physicians or nurse practitioners to limit applicable 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

Index of Sec 1312. ...
(1) STARTING DATE.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (e) (1)
Automated Concept:

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

Index of Sec 1312. ...
(2) NO PHYSICIAN DUPLICATION IN DEMONSTRATION PARTICIPATION.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (e) (2)
Automated Concept:

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

Index of Sec 1312. ...
(3) NO BENEFICIARY DUPLICATION IN DEMONSTRATION PARTICIPATION.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (e) (3)
Automated Concept:

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

Index of Sec 1312. ...
(4) PREFERENCE. - paragraph (B)
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (e) (4) (B)
Automated Concept:

HOME ;   Experience in furnishing health care services to applicable beneficiaries in

Index of Sec 1312. ...
(A) IN GENERAL.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (e) (5) (A)
Automated Concept:

HOME medial practices as practicable and consistent with subsection to test potential of independence at home medical practice model under section in order to achieve results described in subsection across practices serving varying numbers of applicable beneficiaries ;   Secretary entering into agreements as independence at

Index of Sec 1312. ...
(B) LIMITATION.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (e) (5) (B)
Automated Concept:

HOME medial practices to participate under demonstration program ;   Selecting qualified independence at

Index of Sec 1312. ...
(1) IN GENERAL.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (f) (1)
Automated Concept:

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

Index of Sec 1312. ...
(2) FOLLOWING APPLICABLE BENEFICIARIES.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (f) (2)
Automated Concept:

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

Index of Sec 1312. ...
(j) TERMINATION.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (j)
Automated Concept:

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

Index of Sec 1312. ...

In-home visits: make
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(A) IN GENERAL. - paragraph (i)
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (b) (1) (A) (i)
Automated Concept:

HOME visits and available 24 hours per day ;   Comprising of individual physician or nurse practitioner or group of physicians and nurse practitioners providing care as part of team including physicians, nurses, physician assistants, pharmacists and other health and social services staffing as appropriate having experience providing home-based primary care to applicable beneficiaries, make in-

Index of Sec 1312. ...

Incentive payment
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(B) APPORTIONMENT OF SAVINGS.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (c) (2) (B)
Automated Concept:

HOME medical practices ;   Incentive payment under section to be apportioned among qualifying independence at

Index of Sec 1312. ...

Incentive payments
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(3) SAVINGS TO THE MEDICARE PROGRAM.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (c) (3)
Automated Concept:

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

Index of Sec 1312. ...
(j) TERMINATION.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (j)
Automated Concept:

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

Index of Sec 1312. ...

Information systems: electronic health
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(A) IN GENERAL. - paragraph (vi)
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (b) (1) (A) (vi)
Automated Concept:

DIAGNOSTIC technology ;   Uses electronic health information systems, remote monitoring and mobile

Index of Sec 1312. ...

Information technology: health
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(4) PREFERENCE. - paragraph (C)
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (e) (4) (C)
Automated Concept:

HEALTH information technology and individualized plans of care ;   Use electronic medical records,

Index of Sec 1312. ...

Medical
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(B) PHYSICIAN.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (b) (1) (B)
Automated Concept:

PAYMENT to be made as physicians' services and medical training or experience to fulfill physician's role described in subparagraph ;   Individual furnishing services For which

Index of Sec 1312. ...

Medical practice
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(A) IN GENERAL.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (b) (1) (A)
Automated Concept:

HOME medical practice meaning legal entity ;   Term independence at

Index of Sec 1312. ...
(3) INCLUSION OF PROVIDERS AND PRACTITIONERS.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (b) (3)
Automated Concept:

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

Index of Sec 1312. ...
(A) IN GENERAL.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (b) (4) (A)
Automated Concept:

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

Index of Sec 1312. ...
(3) SAVINGS TO THE MEDICARE PROGRAM.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (c) (3)
Automated Concept:

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

Index of Sec 1312. ...
(2) PATIENT ELECTION TO PARTICIPATE.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (d) (2)
Automated Concept:

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

Index of Sec 1312. ...
(3) BENEFICIARY ACCESS TO SERVICES.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (d) (3)
Automated Concept:

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

Index of Sec 1312. ...
(1) STARTING DATE.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (e) (1)
Automated Concept:

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

Index of Sec 1312. ...
(2) NO PHYSICIAN DUPLICATION IN DEMONSTRATION PARTICIPATION.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (e) (2)
Automated Concept:

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

Index of Sec 1312. ...
(3) NO BENEFICIARY DUPLICATION IN DEMONSTRATION PARTICIPATION.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (e) (3)
Automated Concept:

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

Index of Sec 1312. ...
(1) IN GENERAL.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (f) (1)
Automated Concept:

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

Index of Sec 1312. ...
(2) FOLLOWING APPLICABLE BENEFICIARIES.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (f) (2)
Automated Concept:

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

Index of Sec 1312. ...
(j) TERMINATION.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (j)
Automated Concept:

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

Index of Sec 1312. ...

Medical practices
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(B) DEVELOPMENT OF QUALITY PERFORMANCE STANDARDS.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (b) (4) (B)
Automated Concept:

HOME medical practices participating in demonstration program ;   Secretary developing quality performance standards for independence at

Index of Sec 1312. ...
(B) APPORTIONMENT OF SAVINGS.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (c) (2) (B)
Automated Concept:

HOME medical practices ;   Incentive payment under section to be apportioned among qualifying independence at

Index of Sec 1312. ...

Medical practice model
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(A) IN GENERAL.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (e) (5) (A)
Automated Concept:

HOME medial practices as practicable and consistent with subsection to test potential of independence at home medical practice model under section in order to achieve results described in subsection across practices serving varying numbers of applicable beneficiaries ;   Secretary entering into agreements as independence at

Index of Sec 1312. ...

Neurodegenerative diseases
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(1) DEFINITION. - paragraph (C)
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (d) (1) (C)
Automated Concept:

NEURODEGENERATIVE diseases and other diseases and conditions designated by Secretary ;   Congestive heart failure, diabetes, other dementias designating by Secretary, chronic obstructive pulations disease, ischemic heart disease, stroke, Alzheimer's Disease and

Index of Sec 1312. ...

Payment
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(B) PHYSICIAN.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (b) (1) (B)
Automated Concept:

PAYMENT to be made as physicians' services and medical training or experience to fulfill physician's role described in subparagraph ;   Individual furnishing services For which

Index of Sec 1312. ...

Payments
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(h) FUNDING.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (h)
Automated Concept:

PAYMENTS for items and services furnished under title and shared savings under subsection ;   Other than

Index of Sec 1312. ...

Payment incentive and service delivery model
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(1) IN GENERAL.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (a) (1)
Automated Concept:

EXPENDITURES and improving health outcomes in provision of items and services under title to applicable beneficiaries ;   Secretary conducting demonstration program to test payment incentive and service delivery model utilizing physician and nurse practitioner directed home-based primary care teams designed to reduce

Index of Sec 1312. ...

Primary care: based
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(A) IN GENERAL. - paragraph (i)
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (b) (1) (A) (i)
Automated Concept:

HOME visits and available 24 hours per day ;   Comprising of individual physician or nurse practitioner or group of physicians and nurse practitioners providing care as part of team including physicians, nurses, physician assistants, pharmacists and other health and social services staffing as appropriate having experience providing home-based primary care to applicable beneficiaries, make in-

Index of Sec 1312. ...

Primary care services: based
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(A) IN GENERAL. - paragraph (iii)
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (b) (1) (A) (iii)
Automated Concept:

HOME-based primary care services to high cost chronically ill beneficiaries as determined appropriate by Secretary ;   Documenting experience in providing

Index of Sec 1312. ...

Primary care teams: based
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(1) IN GENERAL.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (a) (1)
Automated Concept:

EXPENDITURES and improving health outcomes in provision of items and services under title to applicable beneficiaries ;   Secretary conducting demonstration program to test payment incentive and service delivery model utilizing physician and nurse practitioner directed home-based primary care teams designed to reduce

Index of Sec 1312. ...

Pulations disease: chronic obstructive
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(1) DEFINITION. - paragraph (C)
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (d) (1) (C)
Automated Concept:

HEART disease, stroke, Alzheimer's Disease and neurodegenerative diseases and other diseases and conditions designated by Secretary ;   Congestive heart failure, diabetes, other dementias designating by Secretary, chronic obstructive pulations disease, ischemic

Index of Sec 1312. ...

Rehabilitation services: acute or subacute
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(1) DEFINITION. - paragraph (E)
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (d) (1) (E)
Automated Concept:

REHABILITATION services ;   Past 12 months received acute or subacute

Index of Sec 1312. ...

Savings
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(3) INCLUSION OF PROVIDERS AND PRACTITIONERS.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (b) (3)
Automated Concept:

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

Index of Sec 1312. ...
(h) FUNDING.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (h)
Automated Concept:

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

Index of Sec 1312. ...

Social services
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(A) IN GENERAL. - paragraph (i)
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (b) (1) (A) (i)
Automated Concept:

HOME visits and available 24 hours per day ;   Comprising of individual physician or nurse practitioner or group of physicians and nurse practitioners providing care as part of team including physicians, nurses, physician assistants, pharmacists and other health and social services staffing as appropriate having experience providing home-based primary care to applicable beneficiaries, make in-

Index of Sec 1312. ...

Title
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(1) IN GENERAL.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (a) (1)
Automated Concept:

TITLE to applicable beneficiaries ;   Secretary conducting demonstration program to test payment incentive and service delivery model utilizing physician and nurse practitioner directed home-based primary care teams designed to reduce expenditures and improving health outcomes in provision of items and services under

Index of Sec 1312. ...
(2) REQUIREMENT. - paragraph (F)
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (a) (2) (F)
Automated Concept:

TITLE ;   Reducing cost of health care services covered under

Index of Sec 1312. ...
(3) BENEFICIARY ACCESS TO SERVICES.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (d) (3)
Automated Concept:

HOME medical practice ;   Nothing in section to be construed as encouraging physicians or nurse practitioners to limit applicable 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

Index of Sec 1312. ...
(2) FOLLOWING APPLICABLE BENEFICIARIES.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (f) (2)
Automated Concept:

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

Index of Sec 1312. ...
(h) FUNDING.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (h)
Automated Concept:

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

Index of Sec 1312. ...

Title: provisions of
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
(6) WAIVER.
DIVISION B TITLE III SEC 1312. Quoted: SEC 1866G. (e) (6)
Automated Concept:

TITLE and titling XI as Secretary determining necessary in order to implement demonstration program ;   Secretary waiving provisions of

Index of Sec 1312. ...

Title xviii
Title xviii
Sec 1312. -- Recognition Of Certified Diabetes Educators As Certified Providers For Purposes Of Medicare Diabetes Outpatient Self-Management Training Services.
SEC 1312. -- RECOGNITION OF CERTIFIED DIABETES EDUCATORS AS CERTIFIED PROVIDERS FOR PURPOSES OF MEDICARE DIABETES OUTPATIENT SELF-MANAGEMENT TRAINING SERVICES.
DIVISION B TITLE III SEC 1312.
Automated Concept:

TITLE XVIII of Social Security Act amended by inserting after section 1866f as inserted by section 1302  ;  

Index of Sec 1312. ...


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111th CONGRESS
1st Session


    To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes.


IN THE HOUSE OF REPRESENTATIVES

July 14, 2009

    Mr. Dingell (for himself, Mr. Rangel, Mr. Waxman, Mr. George Miller of California, Mr. Stark, Mr. Pallone, and Mr. Andrews) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Education and Labor, Oversight and Government Reform, and the Budget, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned


A BILL

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SEC. 1312. Independence at home demonstration program.

Title XVIII of the Social Security Act is amended by inserting after section 1866F, as inserted by section 1302, the following new section:

    Independence at home medical practice demonstration program

“Sec. 1866G. (a) Establishment.—

“(1) IN GENERAL.—The Secretary shall conduct a demonstration program (in this section referred to as the ‘demonstration program’) to test a payment incentive and service delivery model that utilizes physician and nurse practitioner directed home-based primary care teams designed to reduce expenditures and improve health outcomes in the provision of items and services under this title to applicable beneficiaries (as defined in subsection (d)).

“(2) REQUIREMENT.—The demonstration program shall test whether a model described in paragraph (1), which is accountable for providing comprehensive, coordinated, continuous, and accessible care to high-need populations at home and coordinating health care across all treatment settings, results in—

“(A) reducing preventable hospitalizations;

“(B) preventing hospital readmissions;

“(C) reducing emergency room visits;

“(D) improving health outcomes commensurate with the beneficiaries’ stage of chronic illness;

“(E) improving the efficiency of care, such as by reducing duplicative diagnostic and laboratory tests;

“(F) reducing the cost of health care services covered under this title; and

“(G) achieving beneficiary and family caregiver satisfaction.


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