(A) create and meaningfully use a health 
information network to track patients across 
collaborative providers; 
(B) perform health outreach, such as by 
using 
‘‘promotoras’’—neighborhood 
health 
workers who may inform individuals about the 
availability of safety net and primary care avail-
able through the collaborative care network; 
(C) provide for follow-up outreach to re-
mind patients of appointments or follow-up care 
instructions; 
(D) provide transportation to individuals 
to and from the site of care; 
(E) expand the capacity to provide care at 
any provider participating in the collaborative 
care network, including through hiring new 
staff, opening new clinics or other provider sites 
after-hours, on weekends, or otherwise pro-
viding an urgent care alternative to an emer-
gency department; and 
(F) provide a primary care provider or 
medical home for each network patient. 
Nothing in this section shall be construed as requiring a 
collaborative care network to carry out all such activities. 
(d) COLLABORATIVE CARE NETWORKS.— 
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(1) IN GENERAL.— 
(A) DESCRIPTION.—A collaborative care 
network described in this subsection is a con-
sortium of health care providers with a joint 
governance structure that provides a com-
prehensive range of coordinated and integrated 
health care services for low-income patient pop-
ulations or medically underserved communities 
(whether or not such individuals receive benefits 
under title XVIII, XIX, or XXI of the Social 
Security Act, private or other health insurance 
or are uninsured or underinsured) that complies 
with any applicable minimum eligibility require-
ments that the Secretary may determine appro-
priate. 
(B) REQUIRED
INCLUSION.—Each such 
network shall include— 
(i) at least one eligible DSH program 
participant; and 
(ii) at least one Federally-qualified 
health center (as defined in section 
1905(l)(2)(B) of such Act) unless no such 
a center serves the geographic area pro-
posed to be served by the network; a center 
exists but refuses to participate; or a cen-
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ter places unreasonable conditions on such 
participation. 
(C) ADDITIONAL INCLUSIONS.—Each such 
network may include any of the following addi-
tional providers: 
(i) Another hospital. 
(ii) A county or municipal department 
of health. 
(iii) A rural health clinic. 
(iv) A community clinic, including a 
mental health clinic, substance abuse clin-
ic, or a reproductive health clinic. 
(v) A private practice physician or 
group practice. 
(vi) A nurse or physician assistant or 
group practice. 
(vii) An adult day care center. 
(viii) A home health provider. 
(ix) Any other type of provider speci-
fied by the Secretary, which has a desire to 
serve low-income and uninsured patients. 
(D) CONSTRUCTION.—Nothing in this sec-
tion shall prohibit a single entity from quali-
fying as collaborative care network so long as 
such single entity meets the criteria of a col-
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laborative care network. If the network does not 
include at least one Federally-qualified health 
center (as defined in section 1905(l)(2)(B) of 
the Social Security Act), the application must 
explain the reason pursuant to subparagraph 
(A)(ii). 
(2) COLLABORATIVE CARE NETWORK PAYMENT 
METHODOLOGIES.—The Secretary shall test alter-
native payment methodologies (which the Secretary 
may apply under the Pilot Program in lieu of or in 
addition to the increased payments under subsection 
(a)) to provide reimbursements to members of col-
laborative care networks for services that are pro-
vided by such members under the Pilot Program and 
may adopt alternative payment methodologies pro-
posed by the members of the collaborative care net-
work in the Application submitted under Section 
(b)(2). Such alternative methodologies may be paid 
to the eligible DSH Program participant, to another 
member of the network, or to the network itself, pro-
vided that the initial recipient is able to adequately 
distribute the funds pursuant to assurances in sub-
section (b)(2)(G). Such alternative payment meth-
odologies may include— 
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(A) bundled, capitated, or flat rate pay-
ments to the collaborative care network or a 
member of the network; 
(B) shared savings programs; 
(C) a transition from traditional cost-based 
payments to alternative payment methodologies 
described in this section after an initial period; 
and 
(D) other payment methodologies designed 
to create incentives for the collaborative care 
networks to provide integrated and collaborative 
care and to reward high quality, cost-efficient 
care. 
(3) COMPREHENSIVE RANGE OF COORDINATED 
AND
INTEGRATED
HEALTH
CARE
SERVICES.—The 
Secretary may define criteria for evaluating the serv-
ices offered by a collaborative care network. Such 
criteria may include the following: 
(A) Requiring collaborative care networks 
to include at least the suggested core services 
identified under subsection (b)(4), or whichever 
subset of the suggested core services is applica-
ble to a particular network. 
(B) Requiring such networks to assign 
each patient of the network to a primary care 
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provider responsible for managing that patient’s 
care. 
(C) Requiring the services provided by a 
collaborative care network to include support 
services appropriate to meet the health needs of 
low-income populations in the network’s com-
munity, which may include chronic care man-
agement, nutritional counseling, transportation, 
language services, enrollment counselors, social 
services and other services as proposed by the 
network. 
(D) Providing that the services provided by 
a collaborative care network may also include 
long term care services and other services not 
specified in this subsection. 
(E) Providing for the approval by the Sec-
retary of a scope of collaborative care network 
services for each network that addresses an ap-
propriate minimum scope of work consistent 
with the setting of the network and the health 
professionals available in the community the 
network serves. 
(4) CLARIFICATION.—Participation in a collabo-
rative care network under the Pilot Program shall 
not disqualify a health care provider from reimburse-
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ment under title XVIII, XIX, or XXI of the Social 
Security Act with respect to services otherwise reim-
bursable under such title. Nothing in this section 
shall prevent a collaborative care network that is 
otherwise eligible to contract with Medicare, a pri-
vate health insurer, or any other appropriate entity 
to provide care under Medicare, under health insur-
ance coverage offered by the insurer, or otherwise. 
(e) EVALUATIONS.— 
(1) 
PARTICIPANT
REPORTS.—Each 
eligible 
DSH Program participant shall submit to the Sec-
retary, for each year of the participant’s participa-
tion in the Pilot Program beginning in the third 
year following the date of implementation of the 
Pilot Program, an evaluation on the activities car-
ried out by the collaborative care network of such 
participant under the Pilot Program and shall in-
clude— 
(A) the number of people served; 
(B) the most common health problems 
treated; 
(C) any reductions in emergency depart-
ment use; 
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(D) an accounting of how amounts re-
ceived pursuant to the Pilot Program were 
used; and 
(E) to the extent requested by the Sec-
retary, any quality measures or any other meas-
ures specified by the Secretary. 
(2) PROGRAM REPORTS.—The Secretary shall 
submit to Congress an annual evaluation (beginning 
not later than 6 months after the first reports under 
paragraph (1) are submitted) on the extent to which 
emergency department use was reduced as a result 
of the activities carried out by the participant under 
the Pilot Program. Each such evaluation shall also 
include information on— 
(A) the prevalence of certain chronic condi-
tions in various populations, including a com-
parison of such prevalence in the general popu-
lation versus in the population of individuals 
with inadequate health insurance coverage; 
(B) demographic characteristics of the 
population of uninsured and underinsured indi-
viduals served by the collaborative care network 
involved; and 
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(C) the conditions of such individuals for 
whom services were requested at such emer-
gency departments of participating hospitals. 
(3) AUDIT
AUTHORITY.—The Secretary may 
conduct periodic audits and request periodic spend-
ing reports of participants under the Pilot Program. 
(4) MEDPAC EVALUATION.—In its annual re-
ports to Congress, the Medicare Payment Advisory 
Commission shall include its evaluation of the Pilot 
Program. 
(f) CLARIFICATION.—Nothing in this section or sec-
tion 3 requires a provider to report individually identifi-
able information of an individual to government agencies, 
unless the individual consents, consistent with HIPAA pri-
vacy and security law, as defined in section 3009(a)(2) 
of the Public Health Service Act. 
SEC. 3. CREATION OF A COLLABORATIVE CARE NETWORK 
CENTER WITHIN HHS. 
(a) IN GENERAL.—The Secretary shall create within 
the Department of Health and Human Services a Collabo-
rative Care Network Center (in this section referred to 
as the ‘‘Center’’). 
(b) DUTIES.—The Center shall carry out the fol-
lowing duties: 
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(1) Provide technical assistance and other im-
plementation support to collaborative care networks. 
(2) Develop and disseminate collaborative care 
network best practice models and facilitate net-
working and information sharing among collabo-
rative care networks. 
(3) Develop and assist in the development of 
pilot programs under title XVIII, XIX, or XXI of 
the Social Security Act to test new payment models 
and delivery system innovations, such as bundling, 
shared savings models, capitated payments, and in-
centive payment structures. 
(4) Evaluate the effectiveness of such pilots 
programs. 
(5) Evaluate the performance of collaborative 
care networks based on an aggregation of the quality 
measures the network’s providers are to report 
under section 2(e)(1)(E). 
(6) Advise Congress, the Secretary, and other 
relevant agencies regarding proposed changes to 
statutory or regulatory barriers to collaborative care 
network success. 
(7) Carry out other activities as determined by 
the Secretary to be necessary for the development or 
improvement of collaborative care networks. 
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(c) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated such sums as are nec-
essary to carry out this section. 
Æ 
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