PUBLIC LAW 108–173—DEC. 8, 2003
117 STAT. 2345
‘‘(C) develop a clinical information database to track and monitor each participant across settings and to evaluate outcomes. ‘‘(4) ADDITIONAL RESPONSIBILITIES.— ‘‘(A) OUTCOMES REPORT.—Each chronic care improvement organization offering a chronic care improvement program shall monitor and report to the Secretary, in a manner specified by the Secretary, on health care quality, cost, and outcomes. ‘‘(B) ADDITIONAL REQUIREMENTS.—Each such organization and program shall comply with such additional requirements as the Secretary may specify. ‘‘(5) ACCREDITATION.—The Secretary may provide that chronic care improvement programs and chronic care improvement organizations that are accredited by qualified organizations (as defined by the Secretary) may be deemed to meet such requirements under this section as the Secretary may specify. ‘‘(f) TERMS OF AGREEMENTS.— ‘‘(1) TERMS AND CONDITIONS.— ‘‘(A) IN GENERAL.—An agreement under this section with a chronic care improvement organization shall contain such terms and conditions as the Secretary may specify consistent with this section. ‘‘(B) CLINICAL, QUALITY IMPROVEMENT, AND FINANCIAL REQUIREMENTS.—The Secretary may not enter into an agreement with such an organization under this section for the operation of a chronic care improvement program unless— ‘‘(i) the program and organization meet the requirements of subsection (e) and such clinical, quality improvement, financial, and other requirements as the Secretary deems to be appropriate for the targeted beneficiaries to be served; and ‘‘(ii) the organization demonstrates to the satisfaction of the Secretary that the organization is able to assume financial risk for performance under the agreement (as applied under paragraph (3)(B)) with respect to payments made to the organization under such agreement through available reserves, reinsurance, withholds, or such other means as the Secretary determines appropriate. ‘‘(2) MANNER OF PAYMENT.—Subject to paragraph (3)(B), the payment under an agreement under— ‘‘(A) subsection (b) shall be computed on a per-member per-month basis; or ‘‘(B) subsection (c) may be on a per-member per-month basis or such other basis as the Secretary and organization may agree. ‘‘(3) APPLICATION OF PERFORMANCE STANDARDS.— ‘‘(A) SPECIFICATION OF PERFORMANCE STANDARDS.— Each agreement under this section with a chronic care improvement organization shall specify performance standards for each of the factors specified in subsection (c)(2), including clinical quality and spending targets under this title, against which the performance of the chronic care
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