Social Security Act §1861

(C)(i)Not later than18 months after the date of enactment of this subsection, the Secretaryshall develop and make available to the public a health risk assessmentmodel. Such model shall meet the guidelines under subparagraph (A)and may be used to meet the requirement under paragraph (1)(A).(ii)Any healthrisk assessment that meets the guidelines under subparagraph (A) andis approved by the Secretary may be used to meet the requirement underparagraph (1)(A).(D)The Secretarymay coordinate with community-based entities (including State HealthInsurance Programs, Area Agencies on Aging, Aging and Disability ResourceCenters, and the Administration on Aging) to(i)ensure thathealth risk assessments are accessible to beneficiaries; and(ii)provide appropriatesupport for the completion of health risk assessments by beneficiaries.(E)The Secretaryshall establish procedures to make beneficiaries and providers awareof the requirement that a beneficiary complete a health risk assessmentprior to or at the same time as receiving personalized preventionplan services.(F)To theextent practicable, the Secretary shall encourage the use of, integrationwith, and coordination of health information technology (includinguse of technology that is compatible with electronic medical recordsand personal health records) and may experiment with the use of personalizedtechnology to aid in the development of self-management skills andmanagement of and adherence to provider recommendations in order toimprove the health status of beneficiaries.(G)A beneficiaryshall be eligible to receive only an initial preventive physical examination(as defined under subsection (ww)(1)) during the 12-month period afterthe date that the beneficiarys coverage begins under part Band shall be eligible to receive personalized prevention plan servicesunder this subsection each year thereafter provided that the beneficiaryhas not received either an initial preventive physical examinationor personalized prevention plan services within the preceding 12-monthperiod.(H)The Secretaryshall issue guidance that(i)identifieselements under paragraph (2) that are required to be provided to abeneficiary as part of their first visit for personalized preventionplan services; and(ii)establishesa yearly schedule for appropriate provision of such elements thereafter.(iii)HomeInfusion Therapy(1)The term home infusion therapy means the items and services describedin paragraph (2) furnished by a qualified home infusion therapy supplier(as defined in paragraph (3)(D)) which are furnished in the individual'shome (as defined in paragraph (3)(B)) to an individual(A) who is under the care of an applicableprovider (as defined in paragraph (3)(A)); and(B) with respect to whom a plan prescribingthe type, amount, and duration of infusion therapy services that areto be furnished such individual has been established by a physician(as defined in subsection (r)(1)) and is periodically reviewed bya physician (as so defined) in coordination with the furnishing ofhome infusion drugs (as defined in paragraph (3)(C)) under part B.(2)The items andservices described in this paragraph are the following:(A) Professional services, includingnursing services, furnished in accordance with the plan.(B) Training and education (not otherwisepaid for as durable medical equipment (as defined in subsection (n)),remote monitoring, and monitoring services for the provision of homeinfusion therapy and home infusion drugs furnished by a qualifiedhome infusion therapy supplier.(3)For purposesof this subsection:(A) The term applicable provider means(i) a physician;(ii) a nurse practitioner; and(iii) a physician assistant.(B) The term home meansa place of residence used as the home of an individual (as definedfor purposes of subsection (n)).(C) The term home infusiondrug means a parenteral drug or biological administered intravenously,or subcutaneously for an administration period of 15 minutes or more,in the home of an individual through a pump that is an item of durablemedical equipment (as defined in subsection (n)). Such term does notinclude the following:(i) Insulin pump systems.(ii) A self-administered drug or biologicalon a self- administered drug exclusion list.(D)(i) The term qualified home infusiontherapy supplier means a pharmacy, physician, or other providerof services or supplier licensed by the State in which the pharmacy,physician, or provider or services or supplier furnishes items orservices and that(I) furnishes infusion therapy to individualswith acute or chronic conditions requiring administration of homeinfusion drugs;(II) ensures the safe and effective provisionand administration of home infusion therapy on a 7-day-a-week, 24-hour-a-daybasis;(III) is accredited by an organizationdesignated by the Secretary pursuant to section 1834(u)(5); and(IV) meets such other requirements asthe Secretary determines appropriate, taking into account the standardsof care for home infusion therapy established by Medicare Advantageplans under part C and in the private sector.(ii) A qualified home infusion therapy suppliermay subcontract with a pharmacy, physician, provider of services,or supplier to meet the requirements of this subparagraph.[543]