228 
ENTITY.—Procedures that encourage a State to in-
clude in any contract entered into with a managed 
care entity (as defined in section 1932(a)(1)(B)) 
under this title or title XXI provisions which ensure 
that the entity will make prompt payment to a 
school-based health center for furnishing physical or 
mental health services to a child who is eligible for 
medical assistance under this title or child health as-
sistance under title XXI that are within the scope of 
items and services for which benefits are available 
with respect to the child under the contract between 
the entity and the State (or to a provider who fur-
nishes such services to such a child through a 
school-based health center), regardless of whether 
the center (or provider) is a participating provider 
with respect to such entity, at a rate established by 
the entity for such services that is not less than the 
level and amount of payment which the entity would 
make for the services if the services were furnished 
by a participating provider.’’. 
(b) REPORT
TO CONGRESS.—Not later than 36 
months after the date of enactment of this section, the 
Secretary of Health and Human Services shall submit a 
report to Congress on the effectiveness of the procedures 
established in accordance with section 1911A of the Social 
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229 
Security Act (as added by subsection (a)) in encouraging 
the use of school-based health centers for the delivery of 
primary care physical and mental health services to chil-
dren who are eligible for medical assistance under title 
XIX of the Social Security Act (42 U.S.C. 1396 et seq.) 
or child health assistance under title XXI of such Act (42 
U.S.C. 1397aa et seq.), together with such recommenda-
tions for administrative or legislative action as the Sec-
retary determines to be appropriate. 
SEC. 404. PREVENTIVE HEALTH CARE DEMONSTRATION 
PROGRAM. 
(a) ESTABLISHMENT.— 
(1) IN GENERAL.—Not later than 18 months 
after the date of enactment of this Act, the Sec-
retary of Health and Human Services (in this sec-
tion referred to as the ‘‘Secretary’’) shall conduct a 
5-year demonstration program under part B of title 
XVIII of the Social Security Act under which the 
Secretary establishes demonstration projects to con-
tract with appropriate entities to provide preventive 
health care to eligible beneficiaries through the de-
velopment and implementation of a disease preven-
tion plan (as described in subsection (b)). 
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230 
(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 
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231 
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-
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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 
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