Page:United States Statutes at Large Volume 117.djvu/2361

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[117 STAT. 2342]
PUBLIC LAW 107-000—MMMM. DD, 2003
[117 STAT. 2342]

117 STAT. 2342

by the Secretary as appropriate for the establishment of a chronic care improvement program. ‘‘(E) TARGETED BENEFICIARY.—The term ‘targeted beneficiary’ means, with respect to a chronic care improvement program, an individual who— ‘‘(i) is entitled to benefits under part A and enrolled under part B, but not enrolled in a plan under part C; ‘‘(ii) has one or more threshold conditions covered under such program; and ‘‘(iii) has been identified under subsection (d)(1) as a potential participant in such program. ‘‘(3) CONSTRUCTION.—Nothing in this section shall be construed as— ‘‘(A) expanding the amount, duration, or scope of benefits under this title; ‘‘(B) providing an entitlement to participate in a chronic care improvement program under this section; ‘‘(C) providing for any hearing or appeal rights under section 1869, 1878, or otherwise, with respect to a chronic care improvement program under this section; or ‘‘(D) providing benefits under a chronic care improvement program for which a claim may be submitted to the Secretary by any provider of services or supplier (as defined in section 1861(d)). ‘‘(b) DEVELOPMENTAL PHASE (PHASE I).— ‘‘(1) IN GENERAL.—In carrying out this section, the Secretary shall enter into agreements consistent with subsection (f) with chronic care improvement organizations for the development, testing, and evaluation of chronic care improvement programs using randomized controlled trials. The first such agreement shall be entered into not later than 12 months after the date of the enactment of this section. ‘‘(2) AGREEMENT PERIOD.—The period of an agreement under this subsection shall be for 3 years. ‘‘(3) MINIMUM PARTICIPATION.— ‘‘(A) IN GENERAL.—The Secretary shall enter into agreements under this subsection in a manner so that chronic care improvement programs offered under this section are offered in geographic areas that, in the aggregate, consist of areas in which at least 10 percent of the aggregate number of medicare beneficiaries reside. ‘‘(B) MEDICARE BENEFICIARY DEFINED.—In this paragraph, the term ‘medicare beneficiary’ means an individual who is entitled to benefits under part A, enrolled under part B, or both, and who resides in the United States. ‘‘(4) SITE SELECTION.—In selecting geographic areas in which agreements are entered into under this subsection, the Secretary shall ensure that each chronic care improvement program is conducted in a geographic area in which at least 10,000 targeted beneficiaries reside among other individuals entitled to benefits under part A, enrolled under part B, or both to serve as a control population. ‘‘(5) INDEPENDENT EVALUATIONS OF PHASE I PROGRAMS.— The Secretary shall contract for an independent evaluation of the programs conducted under this subsection. Such evaluation shall be done by a contractor with knowledge of chronic

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