Section 10306

SEC. 10306. IMPROVEMENTS UNDER THE CENTER FOR MEDICARE AND MEDICAID INNOVATION.

Section 1115A of the Social Security Act, as added by section 3021, is amended--

[1] in subsection [a], by inserting at the end the following new paragraph:

'[5] TESTING WITHIN CERTAIN GEOGRAPHIC AREAS- For purposes of testing payment and service delivery models under this section, the Secretary may elect to limit testing of a model to certain geographic areas.';

[2] in subsection [b][2]--

[A] in subparagraph [A]--

[i] in the second sentence, by striking 'the preceding sentence may include' and inserting 'this subparagraph may include, but are not limited to,'; and

[ii] by inserting after the first sentence the following new sentence: 'The Secretary shall focus on models expected to reduce program costs under the applicable title while preserving or enhancing the quality of care received by individuals receiving benefits under such title.';

[B] in subparagraph [B], by adding at the end the following new clauses:

'[xix] Utilizing, in particular in entities located in medically underserved areas and facilities of the Indian Health Service [whether operated by such Service or by an Indian tribe or tribal organization [as those terms are defined in section 4 of the Indian Health Care Improvement Act]], telehealth services--

'[I] in treating behavioral health issues [such as post-traumatic stress disorder] and stroke; and

'[II] to improve the capacity of non-medical providers and non-specialized medical providers to provide health services for patients with chronic complex conditions.

'[xx] Utilizing a diverse network of providers of services and suppliers to improve care coordination for applicable individuals described in subsection [a][4][A][i] with 2 or more chronic conditions and a history of prior-year hospitalization through interventions developed under the Medicare Coordinated Care Demonstration Project under section 4016 of the Balanced Budget Act of 1997 [42 U.S.C. 1395b-1 note].'; and

[C] in subparagraph [C], by adding at the end the following new clause:

'[viii] Whether the model demonstrates effective linkage with other public sector or private sector payers.';

[3] in subsection [b][4], by adding at the end the following new subparagraph:

'[C] MEASURE SELECTION- To the extent feasible, the Secretary shall select measures under this paragraph that reflect national priorities for quality improvement and patient-centered care consistent with the measures described in 1890[b][7][B].'; and

[4] in subsection [c]--

[A] in paragraph [1][B], by striking 'care and reduce spending; and' and inserting 'patient care without increasing spending;';

[B] in paragraph [2], by striking 'reduce program spending under applicable titles.' and inserting 'reduce [or would not result in any increase in] net program spending under applicable titles; and'; and

[C] by adding at the end the following:

'[3] the Secretary determines that such expansion would not deny or limit the coverage or provision of benefits under the applicable title for applicable individuals.

In determining which models or demonstration projects to expand under the preceding sentence, the Secretary shall focus on models and demonstration projects that improve the quality of patient care and reduce spending.'.