124 STAT. 405 PUBLIC LAW 111–148—MAR. 23, 2010 ‘‘(iv) furnishes services to at least 200 applicable beneficiaries (as defined in subsection (d)) during each year of the demonstration program; ‘‘(v) has entered into an agreement with the Sec- retary; ‘‘(vi) uses electronic health information systems, remote monitoring, and mobile diagnostic technology; and ‘‘(vii) meets such other criteria as the Secretary determines to be appropriate to participate in the dem- onstration program. The entity shall report on quality measures (in such form, manner, and frequency as specified by the Secretary, which may be for the group, for providers of services and sup- pliers, or both) and report to the Secretary (in a form, manner, and frequency as specified by the Secretary) such data as the Secretary determines appropriate to monitor and evaluate the demonstration program. ‘‘(B) PHYSICIAN.—The term ‘physician’ includes, except as the Secretary may otherwise provide, any individual who furnishes services for which payment may be made as physicians’ services and has the medical training or experience to fulfill the physician’s role described in subparagraph (A)(i). ‘‘(2) PARTICIPATION OF NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS.—Nothing in this section shall be construed to pre- vent a nurse practitioner or physician assistant from partici- pating in, or leading, a home-based primary care team as part of an independence at home medical practice if— ‘‘(A) all the requirements of this section are met; ‘‘(B) the nurse practitioner or physician assistant, as the case may be, is acting consistent with State law; and ‘‘(C) the nurse practitioner or physician assistant has the medical training or experience to fulfill the nurse practitioner or physician assistant role described in para- graph (1)(A)(i). ‘‘(3) INCLUSION OF PROVIDERS AND PRACTITIONERS.— Nothing in this subsection shall be construed as preventing an independence at home medical practice from including a provider of services or a participating practitioner described in section 1842(b)(18)(C) that is affiliated with the practice under an arrangement structured so that such provider of services or practitioner participates in the demonstration pro- gram and shares in any savings under the demonstration pro- gram. ‘‘(4) QUALITY AND PERFORMANCE STANDARDS.—The Sec- retary shall develop quality performance standards for independence at home medical practices participating in the demonstration program. ‘‘(c) PAYMENT METHODOLOGY.— ‘‘(1) ESTABLISHMENT OF TARGET SPENDING LEVEL.—The Sec- retary shall establish an estimated annual spending target, for the amount the Secretary estimates would have been spent in the absence of the demonstration, for items and services Reports. Determination.
