255 
† HR 5297 EAS 
(2) SECOND YEAR IMPLEMENTATION REPORT.— 
Not later than 3 months after the completion of the 
second implementation year under this section, the 
Secretary shall submit to the appropriate committees 
of Congress and make available to the public a report 
that includes, with respect to such year, the items re-
quired under paragraph (1) as well as any other ad-
ditional items determined appropriate by the Sec-
retary with respect to the report for such year. 
(3) THIRD
YEAR
IMPLEMENTATION
REPORT.— 
Not later than 3 months after the completion of the 
third implementation year under this section, the Sec-
retary shall submit to the appropriate committees of 
Congress, and make available to the public, a report 
that includes with respect to such year, the items re-
quired under paragraph (1), as well as any other ad-
ditional items determined appropriate by the Sec-
retary with respect to the report for such year, and 
the following: 
(A) An analysis of the cost-effectiveness and 
feasibility of expanding the use of predictive 
analytics technologies to Medicaid and CHIP. 
(B) An analysis of the effect, if any, the ap-
plication of predictive analytics technologies to
256 
† HR 5297 EAS 
claims under Medicaid and CHIP would have on 
States and the commonwealths and territories. 
(C) Recommendations regarding the extent 
to which technical assistance may be necessary to 
expand the application of predictive analytics 
technologies to claims under Medicaid and 
CHIP, and the type of any such assistance. 
(f) INDEPENDENT EVALUATION AND REPORT.— 
(1) EVALUATION.—Upon completion of the first 
year in which predictive analytics technologies are 
used with respect to claims under Medicaid and 
CHIP, the Secretary shall, by grant, contract, or 
interagency agreement, conduct an independent eval-
uation of the use of predictive analytics technologies 
under the Medicare fee-for-service program and Med-
icaid and CHIP. The evaluation shall include an 
analysis with respect to each such program of the 
items required for the third year implementation re-
port under subsection (e)(3). 
(2) REPORT.—Not later than 18 months after the 
evaluation required under paragraph (1) is initiated, 
the Secretary shall submit a report to Congress on the 
evaluation that shall include the results of the evalua-
tion, the Secretary’s response to such results and, to 
the extent the Secretary determines appropriate, rec-
257 
† HR 5297 EAS 
ommendations for legislation or administrative ac-
tions. 
(g) WAIVER AUTHORITY.—The Secretary may waive 
such provisions of titles XI, XVIII, XIX, and XXI of the 
Social Security Act, including applicable prompt payment 
requirements under titles XVIII and XIX of such Act, as 
the Secretary determines to be appropriate to carry out this 
section. 
(h) FUNDING.— 
(1) APPROPRIATION.—Out of any funds in the 
Treasury not otherwise appropriated, there is appro-
priated to the Secretary to carry out this section, 
$100,000,000 for the period beginning January 1, 
2011, to remain available until expended. 
(2) RESERVATIONS.— 
(A) INDEPENDENT EVALUATION.—The Sec-
retary shall reserve not more than 5 percent of 
the funds appropriated under paragraph (1) for 
purposes of conducting the independent evalua-
tion required under subsection (f). 
(B) 
APPLICATION
TO
MEDICAID
AND 
CHIP.—The Secretary shall reserve such portion 
of the funds appropriated under paragraph (1) 
as the Secretary determines appropriate for pur-
poses of providing assistance to States for ad-
258 
† HR 5297 EAS 
ministrative expenses in the event of the expan-
sion of predictive analytics technologies to claims 
under Medicaid and CHIP. 
(i) DEFINITIONS.—In this section: 
(1) COMMONWEALTHS AND TERRITORIES.—The 
term ‘‘commonwealth and territories’’ includes the 
Commonwealth of Puerto Rico, the Virgin Islands, 
Guam, American Samoa, the Commonwealth of the 
Northern Mariana Islands, and any other territory or 
possession of the United States in which the Medicare 
fee-for-service program, Medicaid, or CHIP operates. 
(2) CHIP.—The term ‘‘CHIP’’ means the Chil-
dren’s Health Insurance Program established under 
title XXI of the Social Security Act (42 U.S.C. 
1397aa et seq.). 
(3) MEDICAID.—The term ‘‘Medicaid’’ means the 
program to provide grants to States for medical as-
sistance programs established under title XIX of the 
Social Security Act (42 U.S.C. 1396 et seq.). 
(4) MEDICARE BENEFICIARY.—The term ‘‘Medi-
care beneficiary’’ means an individual enrolled in the 
Medicare fee-for-service program. 
(5) MEDICARE
FEE-FOR-SERVICE
PROGRAM.— 
The term ‘‘Medicare fee-for-service program’’ means 
the original medicare fee-for-service program under
259 
† HR 5297 EAS 
parts A and B of title XVIII of the Social Security 
Act (42 U.S.C. 1395 et seq.). 
(6) MEDICARE PROVIDER.—The term ‘‘Medicare 
provider’’ means a provider of services (as defined in 
subsection (u) of section 1861 of the Social Security 
Act (42 U.S.C. 1395x)) and a supplier (as defined in 
subsection (d) of such section). 
(7) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Health and Human Services, acting 
through the Administrator of the Centers for Medicare 
& Medicaid Services. 
(8) STATE.—The term ‘‘State’’ means each of the 
50 States and the District of Columbia. 
TITLE V—BUDGETARY 
PROVISIONS 
SEC. 5001. DETERMINATION OF BUDGETARY EFFECTS. 
The budgetary effects of this Act, for the purpose of 
complying with the Statutory Pay-As-You-Go-Act of 2010, 
shall be determined by reference to the latest statement titled 
‘‘Budgetary Effects of PAYGO Legislation’’ for this Act, 
submitted for printing in the Congressional Record by the 
Chairman of the Senate Budget Committee, provided that