PUBLIC LAW 108–173—DEC. 8, 2003
117 STAT. 2329
into contracts with appropriate organizations for the deign, implementation, and evaluation of the demonstration project. (3) In no case may expenditures under this section exceed the aggregate expenditures that would otherwise have been made for the provision of personal care services. SEC.
649.
MEDICARE CARE ONSTRATION.
MANAGEMENT
PERFORMANCE
DEM-
42 USC 1395b–1 note.
(a) ESTABLISHMENT.— (1) IN GENERAL.—The Secretary shall establish a pay-forperformance demonstration program with physicians to meet the needs of eligible beneficiaries through the adoption and use of health information technology and evidence-based outcomes measures for— (A) promoting continuity of care; (B) helping stabilize medical conditions; (C) preventing or minimizing acute exacerbations of chronic conditions; and (D) reducing adverse health outcomes, such as adverse drug interactions related to polypharmacy. (2) SITES.—The Secretary shall designate no more than 4 sites at which to conduct the demonstration program under this section, of which— (A) two shall be in an urban area; (B) one shall be in a rural area; and (C) one shall be in a State with a medical school with a Department of Geriatrics that manages rural outreach sites and is capable of managing patients with multiple chronic conditions, one of which is dementia. (3) DURATION.—The Secretary shall conduct the demonstration program under this section for a 3-year period. (4) CONSULTATION.—In carrying out the demonstration program under this section, the Secretary shall consult with private sector and non-profit groups that are undertaking similar efforts to improve quality and reduce avoidable hospitalizations for chronically ill patients. (b) PARTICIPATION.— (1) IN GENERAL.—A physician who provides care for a minimum number of eligible beneficiaries (as specified by the Secretary) may participate in the demonstration program under this section if such physician agrees, to phase-in over the course of the 3-year demonstration period and with the assistance provided under subsection (d)(2)— (A) the use of health information technology to manage the clinical care of eligible beneficiaries consistent with paragraph (3); and (B) the electronic reporting of clinical quality and outcomes measures in accordance with requirements established by the Secretary under the demonstration program. (2) SPECIAL RULE.—In the case of the sites referred to in subparagraphs (B) and (C) of subsection (a)(2), a physician who provides care for a minimum number of beneficiaries with two or more chronic conditions, including dementia (as specified by the Secretary), may participate in the program under this section if such physician agrees to the requirements in subparagraphs (A) and (B) of paragraph (1).
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