Index for HR3962: Affordable Health Care for America Act
DIVISION B — MEDICARE AND MEDICAID IMPROVEMENTS.
TITLE IX — MISCELLANEOUS PROVISIONS.
SEC 1907. — NAIC RECOMMENDATIONS ON THE ESTABLISHMENT OF STANDARDIZED BENEFIT PACKAGES FOR MEDICARE ADVANTAGE PLANS AND PRESCRIPTION DRUG PLANS.
Table Of Contents of the INDEX
Administrative costs of Centers
Sec 1907. -- Naic Recommendations On The Establishment Of Standardized Benefit Packages For Medicare Advantage Plans And Prescription Drug Plans.
(B) MEDICAID.
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (d) (4) (B)
Automated Concept:
Automated Concept:
ADMINISTRATIVE costs of Centers for Medicare and Medicaid Services for administering section with respect to title XIX ;
Index of Sec 1907. ...Avoidable expenditures
Sec 1907. -- Naic Recommendations On The Establishment Of Standardized Benefit Packages For Medicare Advantage Plans And Prescription Drug Plans.
(A) IN GENERAL.
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (b) (2) (A)
Automated Concept:
Automated Concept:
AVOIDABLE expenditures ; Model addressing defined population For which deficits in care leading to poor clinical outcomes or potentially
Index of Sec 1907. ...Clinical and analytical
Sec 1907. -- Naic Recommendations On The Establishment Of Standardized Benefit Packages For Medicare Advantage Plans And Prescription Drug Plans.
(3) CONSULTATION.
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (a) (3)
Automated Concept:
Automated Concept:
HEALTH care management and States ; Cmi consulting representatives of relevant Federal agencies, clinical and analytical experts with expertise in medicine and
Index of Sec 1907. ...Clinical outcomes: poor
Sec 1907. -- Naic Recommendations On The Establishment Of Standardized Benefit Packages For Medicare Advantage Plans And Prescription Drug Plans.
(A) IN GENERAL.
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (b) (2) (A)
Automated Concept:
Automated Concept:
AVOIDABLE expenditures ; Model addressing defined population For which deficits in care leading to poor clinical outcomes or potentially
Index of Sec 1907. ...Expenditure
Expenditures
Sec 1907. -- Naic Recommendations On The Establishment Of Standardized Benefit Packages For Medicare Advantage Plans And Prescription Drug Plans.
(A) INITIAL PERIOD.
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (b) (3) (A)
Automated Concept:
Automated Concept:
EXPENDITURES under applicable title ; Secretary not requiring that design of model ensuring that model being budget neutral initially with respect to
Index of Sec 1907. ...Expenditure: program
Sec 1907. -- Naic Recommendations On The Establishment Of Standardized Benefit Packages For Medicare Advantage Plans And Prescription Drug Plans.
(1) IN GENERAL.
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (b) (1)
Automated Concept:
Automated Concept:
EXPENDITURES under titles and quality of care received by individuals receiving benefits under title ; Cmi testing payment and service delivery models in accordance with selection criteria under paragraph to determine effect of applying models under applicable title on program
Index of Sec 1907. ...Expenditure: total
Sec 1907. -- Naic Recommendations On The Establishment Of Standardized Benefit Packages For Medicare Advantage Plans And Prescription Drug Plans.
(A) ADDITIONAL BENEFITS.
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (d) (4) (A)
Automated Concept:
Automated Concept:
EXPENDITURES under title for subsequent fiscal year as estimated in latest available Annual Report of Board of Trustees as described in section 1841(b)(2) ; Equally divided from Federal Supplementary Hospital Insurance Trust Fund and Federal Supplementary Medical Insurance Trust Fund for payments for additional benefits for items and services under models tested under subsection not otherwise covered under title and applicable to benefits under title and researching, designing, implementing and evaluating models, $350,000,000 for fiscal year 2010, $440,000,000 for fiscal year 2011, $550,000,000 for fiscal year 2012 and amount determined under subparagraph for preceding fiscal year increased by annual percentage rate of increase in total
Index of Sec 1907. ...Fiscal year
Sec 1907. -- Naic Recommendations On The Establishment Of Standardized Benefit Packages For Medicare Advantage Plans And Prescription Drug Plans.
(B) MEDICAID.
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (d) (4) (B)
Automated Concept:
Automated Concept:
FISCAL year 2010 ; Amounts in Treasury not otherwise appropriated appropriated to Secretary for Centers for Medicare and Medicaid Services programming Management Account $25,000,000 for fiscal year beginning with
Index of Sec 1907. ...Fiscal year: preceding
Sec 1907. -- Naic Recommendations On The Establishment Of Standardized Benefit Packages For Medicare Advantage Plans And Prescription Drug Plans.
(A) ADDITIONAL BENEFITS.
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (d) (4) (A)
Automated Concept:
Automated Concept:
EXPENDITURES under title for subsequent fiscal year as estimated in latest available Annual Report of Board of Trustees as described in section 1841(b)(2) ; Equally divided from Federal Supplementary Hospital Insurance Trust Fund and Federal Supplementary Medical Insurance Trust Fund for payments for additional benefits for items and services under models tested under subsection not otherwise covered under title and applicable to benefits under title and researching, designing, implementing and evaluating models, $350,000,000 for fiscal year 2010, $440,000,000 for fiscal year 2011, $550,000,000 for fiscal year 2012 and amount determined under subparagraph for preceding fiscal year increased by annual percentage rate of increase in total
Index of Sec 1907. ...Fiscal year: subsequent
Sec 1907. -- Naic Recommendations On The Establishment Of Standardized Benefit Packages For Medicare Advantage Plans And Prescription Drug Plans.
(A) ADDITIONAL BENEFITS.
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (d) (4) (A)
Automated Concept:
Automated Concept:
FISCAL year as estimated in latest available Annual Report of Board of Trustees as described in section 1841(b)(2) ; Equally divided from Federal Supplementary Hospital Insurance Trust Fund and Federal Supplementary Medical Insurance Trust Fund for payments for additional benefits for items and services under models tested under subsection not otherwise covered under title and applicable to benefits under title and researching, designing, implementing and evaluating models, $350,000,000 for fiscal year 2010, $440,000,000 for fiscal year 2011, $550,000,000 for fiscal year 2012 and amount determined under subparagraph for preceding fiscal year increased by annual percentage rate of increase in total expenditures under title for subsequent
Index of Sec 1907. ...Fiscal year 2010
Sec 1907. -- Naic Recommendations On The Establishment Of Standardized Benefit Packages For Medicare Advantage Plans And Prescription Drug Plans.
(A) ADDITIONAL BENEFITS.
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (d) (4) (A)
Automated Concept:
Automated Concept:
EXPENDITURES under title for subsequent fiscal year as estimated in latest available Annual Report of Board of Trustees as described in section 1841(b)(2) ; Equally divided from Federal Supplementary Hospital Insurance Trust Fund and Federal Supplementary Medical Insurance Trust Fund for payments for additional benefits for items and services under models tested under subsection not otherwise covered under title and applicable to benefits under title and researching, designing, implementing and evaluating models, $350,000,000 for fiscal year 2010, $440,000,000 for fiscal year 2011, $550,000,000 for fiscal year 2012 and amount determined under subparagraph for preceding fiscal year increased by annual percentage rate of increase in total
Index of Sec 1907. ... (B) MEDICAID.
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (d) (4) (B)
Automated Concept:
Automated Concept:
FISCAL year 2010 ; Amounts in Treasury not otherwise appropriated appropriated to Secretary for Centers for Medicare and Medicaid Services programming Management Account $25,000,000 for fiscal year beginning with
Index of Sec 1907. ...Fiscal year 2011
Sec 1907. -- Naic Recommendations On The Establishment Of Standardized Benefit Packages For Medicare Advantage Plans And Prescription Drug Plans.
(A) ADDITIONAL BENEFITS.
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (d) (4) (A)
Automated Concept:
Automated Concept:
EXPENDITURES under title for subsequent fiscal year as estimated in latest available Annual Report of Board of Trustees as described in section 1841(b)(2) ; Equally divided from Federal Supplementary Hospital Insurance Trust Fund and Federal Supplementary Medical Insurance Trust Fund for payments for additional benefits for items and services under models tested under subsection not otherwise covered under title and applicable to benefits under title and researching, designing, implementing and evaluating models, $350,000,000 for fiscal year 2010, $440,000,000 for fiscal year 2011, $550,000,000 for fiscal year 2012 and amount determined under subparagraph for preceding fiscal year increased by annual percentage rate of increase in total
Index of Sec 1907. ...Fiscal year 2012 and amount
Sec 1907. -- Naic Recommendations On The Establishment Of Standardized Benefit Packages For Medicare Advantage Plans And Prescription Drug Plans.
(A) ADDITIONAL BENEFITS.
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (d) (4) (A)
Automated Concept:
Automated Concept:
EXPENDITURES under title for subsequent fiscal year as estimated in latest available Annual Report of Board of Trustees as described in section 1841(b)(2) ; Equally divided from Federal Supplementary Hospital Insurance Trust Fund and Federal Supplementary Medical Insurance Trust Fund for payments for additional benefits for items and services under models tested under subsection not otherwise covered under title and applicable to benefits under title and researching, designing, implementing and evaluating models, $350,000,000 for fiscal year 2010, $440,000,000 for fiscal year 2011, $550,000,000 for fiscal year 2012 and amount determined under subparagraph for preceding fiscal year increased by annual percentage rate of increase in total
Index of Sec 1907. ...Health care services: quality and efficiency of
Sec 1907. -- Naic Recommendations On The Establishment Of Standardized Benefit Packages For Medicare Advantage Plans And Prescription Drug Plans.
(1) IN GENERAL.
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (a) (1)
Automated Concept:
Automated Concept:
HEALTH care services provided to applicable individuals defined in paragraph ; Purpose of cmi to test innovative payment and service delivery models to improve coordination, quality and efficiency of
Index of Sec 1907. ...Implementation
Sec 1907. -- Naic Recommendations On The Establishment Of Standardized Benefit Packages For Medicare Advantage Plans And Prescription Drug Plans.
(b) MEDICAID CONFORMING AMENDMENT. - paragraph (3) - paragraph (80)
DIVISION B TITLE IX SEC 1907. (b) (3) Quoted: (80)
Automated Concept:
Automated Concept:
IMPLEMENTATION on nationwide basis unless State demonstrating to satisfaction of Secretary ; Providing for implementation of payment modeling specified by Secretary under section 1115a(c) for
Index of Sec 1907. ...Implementation: design and
Sec 1907. -- Naic Recommendations On The Establishment Of Standardized Benefit Packages For Medicare Advantage Plans And Prescription Drug Plans.
(B) TERMINATION.
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (b) (3) (B)
Automated Concept:
Automated Concept:
IMPLEMENTATION of model unless Secretary determining that model expected ; Secretary terminating or modifying design and
Index of Sec 1907. ...Implementation of payment
Sec 1907. -- Naic Recommendations On The Establishment Of Standardized Benefit Packages For Medicare Advantage Plans And Prescription Drug Plans.
(b) MEDICAID CONFORMING AMENDMENT. - paragraph (3) - paragraph (80)
DIVISION B TITLE IX SEC 1907. (b) (3) Quoted: (80)
Automated Concept:
Automated Concept:
IMPLEMENTATION of payment modeling specified by Secretary under section 1115a(c) for implementation on nationwide basis unless State demonstrating to satisfaction of Secretary ; Providing for
Index of Sec 1907. ...Legislative action
Sec 1907. -- Naic Recommendations On The Establishment Of Standardized Benefit Packages For Medicare Advantage Plans And Prescription Drug Plans.
(e) REPORT TO CONGRESS.
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (e)
Automated Concept:
Automated Concept:
LEGISLATIVE action to facilitate development and expansion of successful payment models ; Report providing recommendations as Secretary believing being appropriate for
Index of Sec 1907. ...Medicaid
Sec 1907. -- Naic Recommendations On The Establishment Of Standardized Benefit Packages For Medicare Advantage Plans And Prescription Drug Plans.
(b) MEDICAID CONFORMING AMENDMENT.
DIVISION B TITLE IX SEC 1907. (b)
Automated Concept:
Automated Concept:
MEDICAID conforming amendment ;
Index of Sec 1907. ...Medicine and health care management
Sec 1907. -- Naic Recommendations On The Establishment Of Standardized Benefit Packages For Medicare Advantage Plans And Prescription Drug Plans.
(3) CONSULTATION.
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (a) (3)
Automated Concept:
Automated Concept:
HEALTH care management and States ; Cmi consulting representatives of relevant Federal agencies, clinical and analytical experts with expertise in medicine and
Index of Sec 1907. ...Payment
Sec 1907. -- Naic Recommendations On The Establishment Of Standardized Benefit Packages For Medicare Advantage Plans And Prescription Drug Plans.
(e) REPORT TO CONGRESS.
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (e)
Automated Concept:
Automated Concept:
PAYMENT modeling tested under subsection ; Report describing
Index of Sec 1907. ...Payment and service delivery models
Sec 1907. -- Naic Recommendations On The Establishment Of Standardized Benefit Packages For Medicare Advantage Plans And Prescription Drug Plans.
(1) IN GENERAL.
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (b) (1)
Automated Concept:
Automated Concept:
EXPENDITURES under titles and quality of care received by individuals receiving benefits under title ; Cmi testing payment and service delivery models in accordance with selection criteria under paragraph to determine effect of applying models under applicable title on program
Index of Sec 1907. ...Payment: innovative
Sec 1907. -- Naic Recommendations On The Establishment Of Standardized Benefit Packages For Medicare Advantage Plans And Prescription Drug Plans.
(1) IN GENERAL.
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (a) (1)
Automated Concept:
Automated Concept:
HEALTH care services provided to applicable individuals defined in paragraph ; Purpose of cmi to test innovative payment and service delivery models to improve coordination, quality and efficiency of
Index of Sec 1907. ...Payments
Sec 1907. -- Naic Recommendations On The Establishment Of Standardized Benefit Packages For Medicare Advantage Plans And Prescription Drug Plans.
(A) ADDITIONAL BENEFITS.
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (d) (4) (A)
Automated Concept:
Automated Concept:
EXPENDITURES under title for subsequent fiscal year as estimated in latest available Annual Report of Board of Trustees as described in section 1841(b)(2) ; Equally divided from Federal Supplementary Hospital Insurance Trust Fund and Federal Supplementary Medical Insurance Trust Fund for payments for additional benefits for items and services under models tested under subsection not otherwise covered under title and applicable to benefits under title and researching, designing, implementing and evaluating models, $350,000,000 for fiscal year 2010, $440,000,000 for fiscal year 2011, $550,000,000 for fiscal year 2012 and amount determined under subparagraph for preceding fiscal year increased by annual percentage rate of increase in total
Index of Sec 1907. ...Payment: models and
Sec 1907. -- Naic Recommendations On The Establishment Of Standardized Benefit Packages For Medicare Advantage Plans And Prescription Drug Plans.
(e) REPORT TO CONGRESS.
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (e)
Automated Concept:
Automated Concept:
PAYMENTS making under applicable titles for services on behalf of individuals ; Including number of individuals described in subsection and individuals described in subsection participating in models and
Index of Sec 1907. ...Payment models: successful
Sec 1907. -- Naic Recommendations On The Establishment Of Standardized Benefit Packages For Medicare Advantage Plans And Prescription Drug Plans.
(e) REPORT TO CONGRESS.
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (e)
Automated Concept:
Automated Concept:
PAYMENT models ; Report providing recommendations as Secretary believing being appropriate for legislative action to facilitate development and expansion of successful
Index of Sec 1907. ...Population: defined
Sec 1907. -- Naic Recommendations On The Establishment Of Standardized Benefit Packages For Medicare Advantage Plans And Prescription Drug Plans.
(A) IN GENERAL.
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (b) (2) (A)
Automated Concept:
Automated Concept:
AVOIDABLE expenditures ; Model addressing defined population For which deficits in care leading to poor clinical outcomes or potentially
Index of Sec 1907. ...Title
Sec 1907. -- Naic Recommendations On The Establishment Of Standardized Benefit Packages For Medicare Advantage Plans And Prescription Drug Plans.
(1) IN GENERAL.
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (b) (1)
Automated Concept:
Automated Concept:
TITLE ; Cmi testing payment and service delivery models in accordance with selection criteria under paragraph to determine effect of applying models under applicable title on program expenditures under titles and quality of care received by individuals receiving benefits under
Index of Sec 1907. ... (A) IN GENERAL.
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (b) (2) (A)
Automated Concept:
Automated Concept:
TITLE ; Administrator focusing on models expected to reduce program costs under applicable title when preserving or enhancing quality of care received by individuals receiving benefits under
Index of Sec 1907. ... (B) TERMINATION. - paragraph (i)
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (b) (3) (B) (i)
Automated Concept:
Automated Concept:
TITLE ; Improving quality of care without increasing spending under
Index of Sec 1907. ... (A) ADDITIONAL BENEFITS.
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (d) (4) (A)
Automated Concept:
Automated Concept:
EXPENDITURES under title for subsequent fiscal year as estimated in latest available Annual Report of Board of Trustees as described in section 1841(b)(2) ; Equally divided from Federal Supplementary Hospital Insurance Trust Fund and Federal Supplementary Medical Insurance Trust Fund for payments for additional benefits for items and services under models tested under subsection not otherwise covered under title and applicable to benefits under title and researching, designing, implementing and evaluating models, $350,000,000 for fiscal year 2010, $440,000,000 for fiscal year 2011, $550,000,000 for fiscal year 2012 and amount determined under subparagraph for preceding fiscal year increased by annual percentage rate of increase in total
Index of Sec 1907. ...Title: applicable
Sec 1907. -- Naic Recommendations On The Establishment Of Standardized Benefit Packages For Medicare Advantage Plans And Prescription Drug Plans.
(1) IN GENERAL.
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (b) (1)
Automated Concept:
Automated Concept:
EXPENDITURES under titles and quality of care received by individuals receiving benefits under title ; Cmi testing payment and service delivery models in accordance with selection criteria under paragraph to determine effect of applying models under applicable title on program
Index of Sec 1907. ... (A) IN GENERAL.
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (b) (2) (A)
Automated Concept:
Automated Concept:
TITLE when preserving or enhancing quality of care received by individuals receiving benefits under title ; Administrator focusing on models expected to reduce program costs under applicable
Index of Sec 1907. ... (A) INITIAL PERIOD.
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (b) (3) (A)
Automated Concept:
Automated Concept:
TITLE ; Secretary not requiring that design of model ensuring that model being budget neutral initially with respect to expenditures under applicable
Index of Sec 1907. ... (c) EXPANSION OF MODELS (PHASE II). - paragraph (3)
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (c) (3)
Automated Concept:
Automated Concept:
TITLE for applicable individuals ; Secretary determining that expansion not denying or limiting coverage or provision of benefits under applicable
Index of Sec 1907. ...Title 44: chapter 35 of
Sec 1907. -- Naic Recommendations On The Establishment Of Standardized Benefit Packages For Medicare Advantage Plans And Prescription Drug Plans.
(3) ADMINISTRATION.
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (d) (3)
Automated Concept:
Automated Concept:
TITLE 44, United States Code not applying to testing and evaluation of models or expansion of models under section ; Chapter 35 of
Index of Sec 1907. ...Title means: applicable
Sec 1907. -- Naic Recommendations On The Establishment Of Standardized Benefit Packages For Medicare Advantage Plans And Prescription Drug Plans.
(B) APPLICABLE TITLE.
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (a) (4) (B)
Automated Concept:
Automated Concept:
TITLE means titling XVIII, title XIX ; Term applicable
Index of Sec 1907. ...Title XI
Sec 1907. -- Naic Recommendations On The Establishment Of Standardized Benefit Packages For Medicare Advantage Plans And Prescription Drug Plans.
(a) IN GENERAL.
DIVISION B TITLE IX SEC 1907. (a)
Automated Concept:
Automated Concept:
TITLE XI of Social Security Act amended by inserting after section 1115 following new section ;
Index of Sec 1907. ...Title XIX
Sec 1907. -- Naic Recommendations On The Establishment Of Standardized Benefit Packages For Medicare Advantage Plans And Prescription Drug Plans.
(B) APPLICABLE TITLE.
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (a) (4) (B)
Automated Concept:
Automated Concept:
TITLE XIX ; Term applicable title means titling XVIII,
Index of Sec 1907. ...Title xviii
Title xviii: part A of
Sec 1907. -- Naic Recommendations On The Establishment Of Standardized Benefit Packages For Medicare Advantage Plans And Prescription Drug Plans.
(A) APPLICABLE INDIVIDUAL. - paragraph (i)
DIVISION B TITLE IX SEC 1907. (a) Quoted: SEC 1115A. (a) (4) (A) (i)
Automated Concept:
Automated Concept:
TITLE XVIII ; Individual enrolled under part B and entitled to benefits under part A of
Index of Sec 1907. ...The Index is © 2009 healthcarebillindex.com
1st Session |
To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes.
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
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
SEC. 1907. Establishment of Center for Medicare and Medicaid Innovation within CMS.
(a) In general.—Title XI of the Social Security Act is amended by inserting after section 1115 the following new section:
“Center For Medicare and Medicaid Innovation
“Sec. 1115A. (a) Center for Medicare and Medicaid Innovation established.—
“(1) IN GENERAL.—There is created within the Centers for Medicare & Medicaid Services a Center for Medicare and Medicaid Innovation (in this section referred to as the ‘CMI’) to carry out the duties described in this section. The purpose of the CMI is to test innovative payment and service delivery models to improve the coordination, quality, and efficiency of health care services provided to applicable individuals defined in paragraph (4)(A).
“(2) DEADLINE.—The Secretary shall ensure that the CMI is carrying out the duties described in this section by not later than January 1, 2011.
“(3) CONSULTATION.—In carrying out the duties under this section, the CMI shall consult representatives of relevant Federal agencies, clinical and analytical experts with expertise in medicine and health care management, and States. The CMI shall use open door forums or other mechanisms to seek input from interested parties.
“(4) DEFINITIONS.—In this section:
“(A) APPLICABLE INDIVIDUAL.—The term ‘applicable individual’ means—
“(i) an individual who is enrolled under part B and entitled to benefits under part A of title XVIII;
“(ii) an individual who is eligible for medical assistance under title XIX; or
“(iii) an individual who meets the criteria of both clauses (i) and (ii).
“(B) APPLICABLE TITLE.—The term ‘applicable title’ means title XVIII, title XIX, or both.
(b) Medicaid conforming amendment.—Section 1902(a) of the Social Security Act (42 U.S.C. 1396a(a)), as amended by sections 1631(b), 1703(a), 1729, 1753, 1757(a), and 1759(a), is amended—
(1) in paragraph (78), by striking “and” at the end;
(2) in paragraph (79), by striking the period at the end and inserting “; and”; and
(3) by inserting after paragraph (79) the following new paragraph:
“(80) provide for implementation of the payment models specified by the Secretary under section 1115A(c) for implementation on a nationwide basis unless the State demonstrates to the satisfaction of the Secretary that implementation would not be administratively feasible or appropriate to the health care delivery system of the State.”.
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