155 
(2) SITES.—The Secretary shall designate at 
least 2 sites at which to conduct the demonstration 
program under this section, of which— 
(A) 1 shall be in an urban area; and 
(B) 1 shall be in a rural area. 
(3) NUMBER OF ELIGIBLE BENEFICIARIES.— 
Each demonstration project site under this section 
shall consist of at least 1,000 eligible beneficiaries 
representative of the population of individuals enti-
tled to benefits under part A of title XVIII of the 
Social Security Act, and enrolled under part B of 
such title. The Secretary may expand the population 
as needed to measure statistical significance. 
(4) IDENTIFYING ELIGIBLE BENEFICIARIES.— 
The Secretary shall develop a method for identifying 
eligible beneficiaries who may benefit from the dem-
onstration program and communicate with them re-
garding their eligibility. 
(5) VOLUNTARY PARTICIPATION.—Participation 
of health care providers, and individual beneficiaries, 
in the demonstration program shall be voluntary. 
(b) DISEASE PREVENTION PLAN.— 
(1) IN GENERAL.—The disease prevention plan 
described in this subsection is a plan, developed in 
consultation with an eligible beneficiary participating 
VerDate Aug 31 2005 
19:42 Jun 09, 2007
Jkt 059200
PO 00000
Frm 00155
Fmt 6652
Sfmt 6201
E:\BILLS\H2633.IH
H2633
rwilkins on PROD1PC63 with BILLS
156 
in the demonstration program, to mitigate the risk 
factors associated with a particular disease. 
(2) PLAN CONTENTS.—The disease prevention 
plan should include the following: 
(A) POINT OF CONTACT.—The disease pre-
vention plan shall provide for a point of contact 
responsible for communicating with the partici-
pating beneficiary and with other health care 
providers on behalf of such beneficiary. 
(B) PERSONAL HEALTH CARE.—The dis-
ease prevention plan shall provide for instruc-
tion on personal health care. 
(C) PHYSICIAN AND HEALTH CARE PRO-
VIDER TRAINING.—The disease prevention plan 
shall provide for the training of physicians or 
other health care providers in the communica-
tion of relevant clinical information. 
(D) MONITORING TECHNOLOGY.—The dis-
ease prevention plan may provide for necessary 
monitoring technology to facilitate the exchange 
of information, including information such as 
vital signs, symptoms, and health self assess-
ments. 
(c) PROGRAM STANDARDS AND CRITERIA.—The Sec-
retary shall establish performance standards for the dem-
VerDate Aug 31 2005 
19:42 Jun 09, 2007
Jkt 059200
PO 00000
Frm 00156
Fmt 6652
Sfmt 6201
E:\BILLS\H2633.IH
H2633
rwilkins on PROD1PC63 with BILLS
157 
onstration program under this section, including best 
practices for the prevention of chronic diseases. Such prac-
tices shall be standardized to the greatest extent possible. 
The eligibility of entities or individuals to enter into a con-
tract to provide preventive health care under the dem-
onstration program shall be conditioned, at a minimum, 
on performance that meets or exceeds such standards. 
(d) PAYMENT.—The Secretary shall develop a meth-
od and level of payment for entities that participate in 
the program under this section based on best practices, 
as determined by the Secretary. 
(e) WAIVER AUTHORITY.—The Secretary may waive 
such requirements of titles XI and XVIII of the Social 
Security Act as may be necessary to carry out the pur-
poses of the demonstration program under this section. 
(f) EVALUATION AND REPORT.— 
(1) EVALUATION.—The Secretary shall conduct 
evaluations of— 
(A) the benefits due to a reduction, if any, 
in disease incidence for participants in the dem-
onstration projects compared to the medicare 
population as a whole, as determined by the use 
of appropriate statistical techniques; 
(B) the long term cost effectiveness of the 
demonstration projects to the medicare program 
VerDate Aug 31 2005 
19:42 Jun 09, 2007
Jkt 059200
PO 00000
Frm 00157
Fmt 6652
Sfmt 6201
E:\BILLS\H2633.IH
H2633
rwilkins on PROD1PC63 with BILLS
158 
in terms of acute care costs avoided due to dis-
ease prevention; and 
(C) patient satisfaction under the dem-
onstration projects. 
(2) REPORT.—Not later than 6 months after 
the date on which the demonstration program under 
this section ends, the Secretary shall prepare and 
submit to Congress a report on the demonstration 
program together with— 
(A) recommendations on whether the dem-
onstration program should be expanded in 
terms of its success in disease prevention and 
the cost effectiveness of the demonstration pro-
gram; and 
(B) such recommendations for legislation 
or administrative action as the Secretary deter-
mines appropriate. 
(g) FUNDING.—The Secretary shall provide for the 
transfer from the Federal Supplementary Medical Insur-
ance Trust Fund under section 1841 of the Social Secu-
rity Act (42 U.S.C. 1395t) of such funds, not to exceed 
$50,000,000, as are necessary for the costs of carrying 
out the demonstration program under this Act. 
(h) DEFINITIONS.—In this section: 
VerDate Aug 31 2005 
19:42 Jun 09, 2007
Jkt 059200
PO 00000
Frm 00158
Fmt 6652
Sfmt 6201
E:\BILLS\H2633.IH
H2633
rwilkins on PROD1PC63 with BILLS
159 
(1) APPROPRIATE ENTITY.—The term ‘‘appro-
priate entity’’ means— 
(A) a chronic care improvement program; 
(B) a hospital; and 
(C) any other entity that the Secretary de-
termines appropriate based on clinical, finan-
cial, or other requirements appropriate to carry 
out the purposes of the demonstration program 
under this section. 
(2) ELIGIBLE BENEFICIARY.—The term ‘‘eligi-
ble beneficiary’’ means an individual who— 
(A) is entitled to benefits under part A of 
title XVIII of the Social Security Act or en-
rolled under part B of such title; and 
(B) has 2 or more risk factors associated 
with— 
(i) chronic obstructive pulmonary dis-
ease; 
(ii) diabetes; or 
(iii) any other chronic condition that 
the Secretary determines would be appro-
priate for the purpose of providing signifi-
cant potential cost benefits to the medicare 
program through the prevention of such 
condition. 
VerDate Aug 31 2005 
19:42 Jun 09, 2007
Jkt 059200
PO 00000
Frm 00159
Fmt 6652
Sfmt 6201
E:\BILLS\H2633.IH
H2633
rwilkins on PROD1PC63 with BILLS