SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Medicare Care Coordi-
nation Improvement Act of 2017’’. 
SEC. 2. MODERNIZATION OF LIMITATIONS ON PHYSICIAN 
SELF-REFERRAL. 
(a) WAIVERS TO PROMOTE CARE COORDINATION BY 
FACILITATING PARTICIPATION
IN ALTERNATIVE PAY-
MENT MODELS.— 
(1) IN GENERAL.—Section 1833 of the Social 
Security Act (42 U.S.C. 1395l) is amended— 
(A) in subsection (z), as added by section 
101(e)(2) of the Medicare Access and CHIP 
Reauthorization Act of 2015 (Public Law 114– 
10), by adding at the end the following new 
paragraph: 
‘‘(5) WAIVER AUTHORITY.— 
‘‘(A) IN GENERAL.—The provisions of sub-
section (f) of section 1899 shall apply with re-
spect to covered APM entities to the same ex-
tent and in the same manner as such provisions 
apply with respect to accountable care organiza-
tions under such section. 
‘‘(B) COVERED APM ENTITIES.—For pur-
poses of subparagraph (A), the term ‘covered 
APM entity’ means, subject to subparagraph 
(C), each of the following: 
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‘‘(i) An eligible alternative payment 
entity as defined in paragraph (3)(D). 
‘‘(ii) An entity participating in an al-
ternative payment model as defined in 
paragraph (3)(C), including such participa-
tion that qualifies as a clinical practice im-
provement 
activity 
under 
section 
1848(q)(2)(B)(iii)(VI). 
‘‘(iii) An entity participating in a phy-
sician-focused payment model for which 
comments and recommendations have, 
under 
subparagraph 
(C) 
of 
section 
1868(c)(2), been submitted indicating that 
such model meets the criteria described in 
subparagraph (A) of such section. 
‘‘(iv) An entity participating in any 
other model that the Secretary determines 
is a covered APM for purposes of subpara-
graph (A), including such a determination 
made pursuant to physicians submitting a 
proposal to the Secretary for an alternative 
payment model. 
‘‘(v) An entity engaging in activities 
that the Secretary has determined con-
stitute significant progress toward estab-
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lishing a model referred to in any of 
clauses (i) through (iv). 
‘‘(C) CERTAIN REQUIREMENTS.—A model 
referred to in any of clauses (i) through (iv) of 
subparagraph (B) may not be considered a cov-
ered APM entity for purposes of subparagraph 
(A) unless the model meets the requirements 
described in section 1877(b)(6)(B).’’; and 
(B) by redesignating subsection (z), as 
added by section 514(a) of the Medicare Access 
and CHIP Reauthorization Act of 2015 (Public 
Law 114–10), as subsection (aa). 
(2) 
CONFORMING
AMENDMENT.—Section 
514(c)(1) of the Medicare Access and CHIP Reau-
thorization Act of 2015 (Public Law 114–10) is 
amended by striking ‘‘subsection (z)’’ and inserting 
‘‘subsection (aa)’’. 
(b) EXPANSION OF ADMINISTRATIVE AUTHORITY TO 
PROVIDE EXCEPTIONS TO PHYSICIAN OWNERSHIP AND 
COMPENSATION ARRANGEMENT PROHIBITIONS TO PRO-
MOTE CARE COORDINATION.— 
(1) PROMOTING CARE COORDINATION.—Section 
1877(b)(4) of the Social Security Act (U.S.C. 
1395nn(b)(4)) is amended by striking ‘‘risk of pro-
gram or patient abuse’’ and inserting the following: 
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‘‘significant risk of program or patient abuse, in-
cluding those that would promote care coordination, 
quality improvement, or resource conservation by 
physician practices under part B’’. 
(2) CARE COORDINATION IN MIPS AND PARTICI-
PATION IN APMS.—Section 1877(a) of the Social Se-
curity Act (U.S.C. 1395nn(a)) is amended by adding 
at the end the following new paragraph: 
‘‘(3) LIMITATION.—The Secretary may not im-
pose requirements under this section that could ad-
versely affect— 
‘‘(A) physician care coordination in the 
merit-based incentive payment system under 
section 1848(q); or 
‘‘(B) physician participation in an alter-
native payment model under 1833(z).’’. 
(c) EXCEPTION FACILITATING THE DEVELOPMENT 
AND OPERATION OF ALTERNATIVE PAYMENT MODELS.— 
Section 1877(b) of the Social Security Act (42 U.S.C. 
1395nn(b)) is amended by adding at the end the following 
new paragraph: 
‘‘(6) DEVELOPMENT AND OPERATION OF AL-
TERNATIVE PAYMENT MODELS.— 
‘‘(A) IN GENERAL.—In the case of services 
furnished pursuant to an arrangement that 
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meets the requirements described in subpara-
graph (B) entered into for the purpose of devel-
oping or operating an alternative payment 
model, including— 
‘‘(i) advanced alternative payment 
models described in section 1833(z) (in-
cluding physician-focused payment models 
referred to in section 1868(c)); 
‘‘(ii) MIPS APMs (as defined by the 
Secretary); and 
‘‘(iii) any other alternative payment 
model that the Secretary may, by regula-
tion, specify. 
‘‘(B) REQUIREMENTS.—The requirements 
described in this subparagraph with respect to 
an arrangement relating to an alternative pay-
ment model are as follows: 
‘‘(i) The arrangement is in writing, 
identifies the services, items, or actions 
subject to the arrangement and is signed 
by the parties to the arrangement. 
‘‘(ii) Items and services furnished sub-
ject to the arrangement are furnished at 
fair market value. In this clause, the term 
‘fair market value’ has the meaning given 
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such term in subsection (h)(3), except that 
the Secretary may not take into account 
the volume or value of referrals in deter-
mining such value for purposes of this 
clause. 
‘‘(iii) The arrangement includes a de-
scription of the alternative payment model. 
‘‘(iv) Under the arrangement written 
reports are submitted to the Secretary on 
a semi-annual basis on the progress 
achieved in the development and operation 
of the alternative payment model 
‘‘(v) The arrangement meets such 
other requirements as the Secretary may 
impose by regulation as needed to protect 
against a significant risk of program pa-
tient abuse’’. 
Æ 
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