In this task, you are given text for US Congressional and California state bills, your task is to generate a summary for this bill.

Input: Consider Input: SECTION 1. SHORT TITLE AND TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``California Forest 
Ecosystems Health Act''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title and table of contents.
Sec. 2. Findings.
Sec. 3. Definitions.
Sec. 4. Ecosystem management plans for National Forest System lands in 
                            California.
Sec. 5. Process for full implementation of ecosystem management plans.
Sec. 6. Research and monitoring program.
Sec. 7. Miscellaneous requirements.

SEC. 2. FINDINGS.

    The Congress finds the following:
            (1) Although people have had an active part in the 
        development and maintenance of forest structure and the 
        condition of the National Forest System lands in the State of 
        California for many years, recent forest management policies 
        have often resulted in a degeneration of the forest structure 
        and a loss of forest health and vigor.
            (2) The Forest Service, through the judicious use of 
        ecosystem management, has an opportunity to reverse these 
        forest management policies and restore the health and vigor of 
        National Forest System lands in California.
            (3) Ecosystems are dynamic and in a state of constant 
        change, and it is not possible to preserve a given ecosystem 
        condition in a static state over a period of time.
            (4) The many and varied resources and uses of National 
        Forest System lands provide both tangible and intangible 
        benefits to the people of the United States.
            (5) Although management of National Forest System lands in 
        California has traditionally placed first priority on the need 
        to produce maximum volumes of timber, the other multiple forest 
        resources and services are equally important to the people of 
        California and the United States.
            (6) Ecosystem management must balance the needs of outdoor 
        recreation, range, timber, watershed, fish, and wildlife, as 
        required by the Multiple-Use Sustained-Yield Act of 1960 (16 
        U.S.C. 528 et seq.), as well as protect soil and air quality 
        and provide for forest research.
            (7) National Forest System lands in California include some 
        of the most unique forest ecosystems in the world, including 
        giant sequoias, coastal redwoods, and bristlecone pines.
            (8) Destructive forest fires classified by the Forest 
        Service as ``intense'' have occurred in unprecedented numbers 
        and size on the National Forest System lands in California in 
        recent years, and these fires pose a threat to the very health 
        of the forests and present a danger to human life and property.
            (9) The Forest Service, through the judicious use of 
        ecosystem management, has an opportunity to reduce the 
        likelihood that fires classified as ``intense'' will occur with 
        such frequency and, at the same time, to improve forest vigor 
        and visitor safety.
            (10) Ecosystem management that considers the needs of all 
        species and their ability to interact with the presence of 
        humans can integrate both the conservation needs of the many 
        species of the ecosystems and the multiple use activities of 
        humans.
            (11) Identification of sound management options is both a 
        biological issue and a social issue, and the resulting 
        management policies must be socially acceptable, ecologically 
        sustainable, scientifically sound, legally responsible, and 
        economically viable.
            (12) The results of management practices in local 
        ecosystems can have a profound effect on the levels of demand 
        for commodity outputs from other ecosystems around the world.

SEC. 3. DEFINITIONS.

    For purposes of this Act:
            (1) Adaptive management.--The term ``adaptive management'' 
        means the experimental and monitored application of 
        scientifically derived management decisions to gain knowledge 
        that is then used to improve subsequent management decisions.
            (2) Ecosystem.--The term ``ecosystem'' means a community of 
        organisms and its environment that functions as a unit.
            (3) Ecosystem management.--The term ``ecosystem 
        management'' means the integration of ecological, economic, and 
        social factors to meet the biological needs of all associated 
        organisms and human needs through diverse, healthy, and 
        productive ecosystems, addressing resource supply, 
        conservation, and demand as opposed to a strategy for managing 
        individual species.
            (4) Ecosystem management plans.--The terms ``ecosystem 
        management plans'' and ``plans'' mean the ecosystem management 
        plans for National Forest System lands in the State of 
        California required to be developed by section 4(a).
            (5) National forest system.--The term ``National Forest 
        System'' has the meaning given that term in section 11(a) of 
        the Forest and Rangeland Renewable Resources Planning Act of 
        1974 (16 U.S.C. 1609(a)).
            (6) Seral stages.--The term ``seral stages'' means the 
        various age or life stages of a vegetative community as it 
        progresses from initial establishment toward a climax stage or 
        equilibrium.
            (7) Secretary.--The term ``Secretary'' means the Secretary 
        of Agriculture.
            (8) Stand.--The term ``stand'' means an area within a 
        forest where the trees have similar characteristics with 
        respect to species composition, size, condition, and age.
            (9) Vigor.--The term ``vigor'', with respect to forest 
        ecosystems, means the relative health of stands of trees and 
        related vegetation, including their actual growth rates as 
        compared with potential growth rates and their ability to 
        protect themselves naturally from forest pests, diseases, and 
        the effects of natural disaster.

SEC. 4. ECOSYSTEM MANAGEMENT PLANS FOR NATIONAL FOREST SYSTEM LANDS IN 
              CALIFORNIA.

    (a) Plans Required.--Notwithstanding the planning provisions of 
section 6 of the Forest and Rangeland Renewable Resources Planning Act 
of 1974 (16 U.S.C. 1604), the Secretary of Agriculture shall develop 
and implement ecosystem management plans pursuant to this Act to 
develop and demonstrate ecosystem management, including adaptive 
management techniques, for National Forest System lands described in 
subsection (b).
    (b) Federal Lands Covered by Plans.--The ecosystem management plans 
required by subsection (a) shall apply to all management units of the 
National Forest System located in the State of California. In the case 
of National Forest System lands in California that have been designated 
by law for special management before the date of the enactment of this 
Act, the Secretary shall incorporate into the ecosystem management 
plans applicable to those lands any statutory provisions that are in 
effect on such date and applicable to those lands.
    (c) Principles of Plans.--Ecosystem management plans shall embody 
the following principles:
            (1) Application of management techniques that will enhance 
        the health and vigor of the renewable natural resources on the 
        National Forest System lands covered by the plans and provide 
        for the continued protection of the soil, air, and water 
        resources of these lands.
            (2) Improvement of the forest ecosystems on these lands 
        toward desired forest conditions that--
                    (A) provide a mosaic of forest seral stages--
                            (i) representing a range of wildlife 
                        habitats necessary to meet the needs of the 
                        species indigenous to the ecosystem being 
                        managed; and
                            (ii) designed in such a way as to obviate 
                        the need for corridors or special management 
                        areas to meet the needs of given species or 
                        situations;
                    (B) minimize the danger of stand-destroying 
                uncontrolled wildfire;
                    (C) increase or maintain the health and vigor of 
                stands at a level that will permit the stands to resist 
                naturally, to the greatest degree practicable, insect 
                and disease attacks and the effects of other natural 
                disasters while incorporating the concern that some 
                level of dead-wood, both standing and down, is 
                desirable in healthy ecosystems;
                    (D) maintain the sustainable economic well-being 
                and stability of communities in areas dependent upon 
                national forest resources; and
                    (E) are developed, to the extent possible, with 
                consideration of the conditions that are known to have 
                existed on these lands or on similar lands before the 
                impacts of European settlement.
            (3) Concentration of management activities on the condition 
        of the renewable resources of an ecosystem rather than on 
        producing targeted outputs, with projected outputs based upon 
        attainment of specific stand conditions.
            (4) Emphasis on tangible management results rather than on 
        procedural standards and guidelines, but with development of 
        scientifically credible monitoring standards and guidelines to 
        assess both short- and long-term management results.
            (5) Except for any statutory provisions incorporated under 
        subsection (b) with respect to specific lands, prohibition on 
        requiring the allocation or categorization of tracts of land 
        for specific preselected ecosystem management emphases.
            (6) Consideration of the habitat needs of all species 
        across a broad landscape using management indicator species 
        whose presence will reflect a suitable amount and distribution 
        of particular habitat elements, rather than concentrating on 
        the needs of single species in a limited area.
            (7) Application across the entire unreserved land base in 
        such a manner as to harmonize the various multiple uses.
            (8) Incorporation of maximum flexibility in resource 
        decisionmaking through the use of adaptive management.
    (d) Management to Promote Desired Forest Conditions.--
            (1) In general.--Ecosystem management under the ecosystem 
        management plans shall be planned and practiced in a manner 
        that--
                    (A) considers the entire landscape in a management 
                unit of the National Forest System covered by a plan; 
                and
                    (B) benefits, to the extent practicable, all 
                renewable resources and the human resource in or 
                dependent upon the management unit.
            (2) Individual projects.--Individual management projects in 
        a management unit of the National Forest System covered by the 
        ecosystem management plans shall be designed to provide 
        multiresource benefits, promote the desired forest conditions 
        described in subsection (c)(2), and achieve maximum project 
        operating efficiency.
    (e) Selection of Acres for Ecosystem Management Activities.--
            (1) Minimum acres.--Ecosystem management plans shall 
        specify the minimum number of acres on which ecosystem 
        management activities will be applied annually in any 
        management unit of the National Forest System covered by the 
        plans. Such acreage shall be determined on the basis of the 
        total number of acres in the management unit, the work to be 
        performed across the unit as a whole during the plan period, 
        and the pro rata annual acreage on which ecosystem management 
        activities must be applied in order to establish and maintain 
        the desired forest condition during the specified plan period.
            (2) Effect of natural disasters.--In case of natural 
        disasters, such as wildfire, flood, windthrow, insect or 
        disease attack, a revision of the schedule of acres to be 
        treated may be granted by the Secretary in order to conduct 
        restoration and rehabilitation activities on the acres affected 
        by the natural disaster.
    (f) Participation in Development.--To ensure that the ecosystem 
management plans are economically, scientifically, and socially 
acceptable, the Secretary shall develop the plans through the use of 
public involvement programs that emphasize input from residents of 
local communities to be affected by the plans. The Secretary shall 
continue to consult with all interested persons in evaluating or 
modifying the plans.

SEC. 5. PROCESS FOR FULL IMPLEMENTATION OF ECOSYSTEM MANAGEMENT PLANS.

    (a) Implementation.--Beginning not later than January 1, 1995, the 
Secretary shall begin to implement the ecosystem management plans. The 
Secretary shall develop and implement the plans progressively over a 
five-year period to ensure full application of all plans not later than 
January 1, 2000, to all National Forest System lands described in 
section 4(b). Upon implementation of an ecosystem management plan for 
any portion of the lands described in such section, the plan shall 
replace and supersede any land and resource management plan (or portion 
of such a plan) then in effect for such lands.
    (b) Yearly Expansion.--During each year of the period specified in 
subsection (a), the Secretary shall expand application of the ecosystem 
management plans to contiguous areas required to be covered by such 
plans, as described in section 4(b). To the extent the Secretary 
considers it to be necessary, the Secretary may modify the ecosystem 
management plans for each new addition in order to incorporate the 
lessons gained from experience. Adaptive management shall be used to 
evaluate management decisions and to develop new information to be used 
to keep the plans and subsequent management decisions up-to-date.
    (c) Modification of Ecosystem Management Plans.--The Secretary 
shall modify the ecosystem management plans to incorporate findings 
from research, adaptive management projects, or monitoring to the 
extent such findings indicate changes in the plans are necessary or 
appropriate to achieve the principles described in section 4(c). Before 
the end of the first two years of the period specified in subsection 
(a), the Secretary shall issue regulations that set forth the process 
to be used for any modification of the ecosystem management plans.
    (d) Consistency.--Resource plans and permits and other instruments 
for the use and occupancy of National Forest System lands covered by an 
ecosystem management plan that are executed subsequent to the 
implementation date of the plan with respect to such lands shall be 
consistent with the plan. If the ecosystem management plan is modified, 
resource plans and permits and other instruments that are executed 
subsequent to the date of the modification shall be consistent with the 
modified plan. Appropriate supplemental documents under the National 
Environmental Policy Act of 1969 (42 U.S.C. 4321 et seq.) shall be 
prepared for those resource plans and permits, contracts, and other 
instruments in existence upon adoption of the ecosystem management plan 
or any modification of the plan. Any revisions in existing resource 
plans and permits, contracts, and other instruments shall be consistent 
with the supplemental document findings and subject to the agreement of 
all contractual parties. Any revision in present or future permits, 
contracts, and other instruments made pursuant to this subsection shall 
be subject to valid existing rights.

SEC. 6. RESEARCH AND MONITORING PROGRAM.

    The Secretary shall describe in detail in the ecosystem management 
plans and implement as part of the plans a targeted program of research 
and monitoring aimed at measuring the effects of the management regimes 
adopted under the plans. The Secretary shall ensure that monitoring is 
sufficient to measure the responses of the various resources to 
management practices and to provide a basis for adjustments of 
subsequent management decisions.

SEC. 7. MISCELLANEOUS REQUIREMENTS.

    (a) Increased Use of Certified Professional Practitioners.--With 
respect to National Forest System lands covered by the ecosystem 
management plans, the Secretary shall endeavor to increase the amount 
of field work to be done by professional practitioners certified by the 
Forest Service.
    (b) Accountability Procedures.--The Secretary shall develop 
accountability procedures to annually measure and inform the Congress 
concerning the work (as described in section 4(e)) achieved through the 
use of funds appropriated each year for National Forest System lands 
covered by the ecosystem management plans. The selection of acres upon 
which such work will be performed shall be controlled through the 
planning process. The accountability procedures required by this 
subsection shall be established and in operation before the end of the 
first two years of the period specified in section 5(a) and shall be 
designed to ensure the accomplishment of the work in accordance with 
plan direction.
    (c) Budgetary Considerations.--The Secretary shall develop budgets 
for each management unit of the National Forest System covered by 
ecosystem management plans on the basis of estimated benefits to the 
various resources affected by the ecosystem management activities, and 
such budgets will be justified on such basis. The Secretary shall 
provide the managers of these units the flexibility to accomplish over-
all objectives within over-all budgets in lieu of requiring and 
preparing detailed line-item budgets for each unit of work, except that 
accountability procedures developed under subsection (b) shall include 
requirements for detailed explanations of expenditures and estimates of 
benefits for each resource.

Output: California Forest Ecosystems Health Act - Directs the Secretary of Agriculture to develop and implement ecosystem management plans for National Forest System lands in California.


Input: Consider Input: SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Federal Law Enforcement Officers Pay 
Equity and Reform Act''.

SEC. 2. LIMITATION ON PREMIUM PAY.

    (a) In General.--Section 5547 of title 5, United States Code, is 
amended--
            (1) in subsection (a), by striking ``5545a,'';
            (2) in subsection (c), by striking ``or 5545a''; and
            (3) in subsection (d), by striking the period and inserting 
        ``or a criminal investigator who is paid availability pay under 
        section 5545a.''.
    (b) Effective Date.--The amendments made by this section shall take 
effect as if included in the enactment of section 1114 of the National 
Defense Authorization Act for Fiscal Year 2002 (Public Law 107-107; 115 
Stat. 1239).

SEC. 3. SPECIAL PAY ADJUSTMENTS FOR FEDERAL LAW ENFORCEMENT OFFICERS IN 
              CERTAIN AREAS.

    (a) In General.--Section 404(b)(1) of the Federal Law Enforcement 
Pay Reform Act of 1990 (5 U.S.C. 5305 note) is amended by striking the 
matter after the semicolon and inserting the following:

          ``Area                                           Differential
        Boston-Lawrence-Salem, MA-NH Consolidated                24.4% 
            Metropolitan Statistical Area.
        Chicago-Gary-Lake County, IL-IN-WI Consolidated          24.5% 
            Metropolitan Statistical Area.
        Detroit-Ann Arbor-Flint, MI........................      18.5% 
        Hartford, CT.......................................      20.3% 
        Los Angeles-Anaheim-Riverside, CA Consolidated           27.1% 
            Metropolitan Statistical Area.
        New York-Northern New Jersey-Long Island, NY-NJ-CT       26.1% 
            Consolidated Metropolitan Statistical Area.
        Philadelphia-Wilmington-Trenton PA-NJ-DE-MD              20.3% 
            Consolidated Metropolitan Statistical Area.
        Portland-Salem, OR-WA..............................      18.5% 
        Sacramento-Yolo, CA................................        21% 
        San Diego, CA Metropolitan Statistical Area........      27.1% 
        San Francisco-Oakland-San Jose, CA Consolidated         32.03% 
            Metropolitan Statistical Area.
        Seattle-Tacoma-Bremerton, WA.......................      27.5% 
        Washington-Baltimore, DC-MD-VA-WV Consolidated         24.3%''.
            Metropolitan Statistical Area.
    (b) Effective Date.--The amendment made by this section shall apply 
with respect to pay for service performed in pay periods beginning on 
or after the date of the enactment of this Act.

SEC. 4. SEPARATE PAY, EVALUATION, AND PROMOTION SYSTEM FOR FEDERAL LAW 
              ENFORCEMENT OFFICERS.

    (a) Study.--Not later than 6 months after the date of the enactment 
of this Act, the Office of Personnel Management shall study and submit 
to Congress a report which shall contain its findings and 
recommendations regarding the need for, and the potential benefits to 
be derived from, the establishment of a separate pay, evaluation, and 
promotion system for Federal law enforcement officers. In carrying out 
this subsection, the Office of Personnel Management shall take into 
account the findings and recommendations contained in the September 
1993 report of the Office entitled ``A Plan to Establish a New Pay and 
Job Evaluation System for Federal Law Enforcement Officers''.
    (b) Demonstration Project.--
            (1) In general.--If, after completing its report under 
        subsection (a), the Office of Personnel Management considers it 
        to be appropriate, the Office shall implement, within 12 months 
        after the date of the enactment of this Act, a demonstration 
        project to determine whether a separate system for Federal law 
        enforcement officers (as described in subsection (a)) would 
        result in improved Federal personnel management.
            (2) Applicable provisions.--Any demonstration project under 
        this subsection shall be conducted in accordance with the 
        provisions of chapter 47 of title 5, United States Code, except 
        that a project under this subsection shall not be taken into 
        account for purposes of the numerical limitation under section 
        4703(d)(2) of such title.
            (3) Permanent changes.--Not later than 6 months before the 
        demonstration project's scheduled termination date, the Office 
        of Personnel Management shall submit to Congress--
                    (A) its evaluation of the system tested under the 
                demonstration project; and
                    (B) recommendations as to whether or not that 
                system (or any aspects of that system) should be 
                continued or extended to other Federal law enforcement 
                officers.
    (c) Federal Law Enforcement Officer Defined.--For purposes of this 
section, the term ``Federal law enforcement officer'' means a law 
enforcement officer as defined by section 8331 or 8401 of title 5, 
United States Code, and, subsection (b)(2) notwithstanding, includes 
any such officer serving in or under the Federal Bureau of 
Investigation.

Output: Federal Law Enforcement Officers Pay Equity and Reform Act - Excludes availability pay for Federal criminal investigators from premium pay limitations.Amends the Federal Law Enforcement Pay Reform Act of 1990 to increase the Federal special pay differential for Federal law enforcement officers employed in specified metropolitan statistical areas.Requires a study by the Office of Personnel Management (OPM) regarding the need for, and potential benefits of, the establishment of a separate pay, evaluation, and promotion system for Federal law enforcement officers (including officers serving in or under the Federal Bureau of Investigation). Authorizes OPM to implement a demonstration project for such a system.


Input: Consider Input: SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicare's Elderly Receiving 
Innovative Treatments (MERIT) Act of 1999''.

SEC. 2. MODIFICATION OF PAYMENT RULES.

    Section 1853 of the Social Security Act (42 U.S.C. 1395w-23) is 
amended--
            (1) in subsection (a)(1)(A), by striking ``subsections (e) 
        and (f)'' and inserting ``subsections (e) through (i)'';
            (2) in subsection (a)(3)(D), by inserting ``and paragraph 
        (4)'' after ``section 1859(e)(4)''; and
            (3) by adding at the end of subsection (a) the following 
        new paragraph:
            ``(4) Exemption from risk-adjustment system for frail 
        elderly beneficiaries enrolled in specialized programs for the 
        frail elderly.--
                    ``(A) In general.--During the period described in 
                subparagraph (B), the risk-adjustment described in 
                paragraph (3) shall not apply to a frail elderly 
                Medicare+Choice beneficiary (as defined in subsection 
                (i)(3)) who is enrolled in a Medicare+Choice plan under 
                a specialized program for the frail elderly (as defined 
                in subsection (i)(2)).
                    ``(B) Period of application.--The period described 
                in this subparagraph begins with January 2000 and ends 
                with the first month for which the Secretary certifies 
                to Congress that a comprehensive risk adjustment 
                methodology under paragraph (3)(C) (that takes into 
                account the types of factors described in subsection 
                (i)(1)) is being fully implemented.''; and
            (4) by adding at the end the following new subsection:
    ``(i) Special Rules for Frail Elderly Enrolled in Specialized 
Programs for the Frail Elderly.--
            ``(1) Development and implementation of new payment 
        system.--The Secretary shall develop and implement (as soon as 
        possible after the date of the enactment of this subsection), 
        during the period described in subsection (a)(4)(B), a payment 
        methodology for frail elderly Medicare+Choice beneficiaries 
        enrolled in a Medicare+Choice plan under a specialized program 
        for the frail elderly (as defined in paragraph (2)(A)). Such 
        methodology shall account for the prevalence, mix, and severity 
        of chronic conditions among such beneficiaries and shall 
        include medical diagnostic factors from all provider settings 
        (including hospital and nursing facility settings). It shall 
        include functional indicators of health status and such other 
        factors as may be necessary to achieve appropriate payments for 
        plans serving such beneficiaries.
            ``(2) Specialized program for the frail elderly 
        described.--
                    ``(A) In general.--For purposes of this part, the 
                term `specialized program for the frail elderly' means 
                a program which the Secretary determines--
                            ``(i) if offered under this part as a 
                        distinct part of a Medicare+Choice plan;
                            ``(ii) primarily enrolls frail elderly 
                        Medicare+Choice beneficiaries; and
                            ``(iii) has a clinical delivery system that 
                        is specifically designed to serve the special 
                        needs of such beneficiaries and to coordinate 
                        short-term and long-term care for such 
                        beneficiaries through the use of a team 
                        described in subparagraph (B) and through the 
                        provision of primary care services to such 
                        beneficiaries by means of such a team at the 
                        nursing facility involved.
                    ``(B) Specialized team.--A team described in this 
                subparagraph--
                            ``(i) includes--
                                    ``(I) a physician, and
                                    ``(II) a nurse practitioner or 
                                geriatric care manager, or both; and
                            ``(ii) has as members individuals who have 
                        special training and specialize in the care and 
                        management of the frail elderly beneficiaries.
            ``(3) Frail elderly medicare+choice beneficiary 
        described.--For purposes of this part, the term `frail elderly 
        Medicare+Choice beneficiary' means a Medicare+Choice eligible 
        individual who--
                    ``(A) is residing in a skilled nursing facility or 
                a nursing facility (as defined for purposes of title 
                XIX) for an indefinite period and without any intention 
                of residing outside the facility; and
                    ``(B) has a severity of condition that makes the 
                individual frail (as determined under guidelines 
                approved by the Secretary).''.

SEC. 3. CONTINUOUS OPEN ENROLLMENT FOR QUALIFIED INDIVIDUALS.

    (a) In General.--Section 1851(e) of the Social Security Act (42 
U.S.C. 1395w-21(e)) is amended by adding at the end the following new 
paragraph:
            ``(7) Special rules for frail elderly medicare+choice 
        beneficiaries enrolling in specialized programs for the frail 
        elderly.--There shall be a continuous open enrollment period 
        for any frail elderly Medicare+Choice beneficiary (as defined 
        in section 1853(i)(3)) who is seeking to enroll in a 
        Medicare+Choice plan under a specialized program for the frail 
        elderly (as defined in section 1853(i)(2)).''.
    (b) Effective Date.--The amendment made by subsection (a) takes 
effect on the date of the enactment of this Act.

SEC. 4. DEVELOPMENT OF QUALITY MEASUREMENT PROGRAM.

    (a) In General.--Section 1852(e) of the Social Security Act (42 
U.S.C. 1395w-22(e)) is amended by adding at the end the following new 
paragraph:
            ``(5) Quality measurement program for specialized programs 
        for the frail elderly as part of medicare+choice plans.--The 
        Secretary shall develop and implement a program to measure the 
        quality of care provided in specialized programs for the frail 
        elderly (as defined in section 1853(i)(2)) in order to reflect 
        the unique health aspects and needs of frail elderly 
        Medicare+Choice beneficiaries (as defined in section 
        1853(i)(3)). Such quality measurements may include indicators 
        of the prevalence of pressure sores, reduction of iatrogenic 
        disease, use of urinary catheters, use of anti-anxiety 
        medications, use of advance directives, incidence of pneumonia, 
        and incidence of congestive heart failure.''.
    (b) Effective Date.--The Secretary of Health and Human Services 
shall first provide for the implementation of the quality measurement 
program for specialized programs for the frail elderly under the 
amendment made by subsection (a) by not later than July 1, 2000.


Output: Medicare's Elderly Receiving Innovative Treatments (MERIT) Act of 1999 - Amends part C (Medicare+Choice) of title XVIII (Medicare) of the Social Security Act with regard to the frail elderly, modifying: (1) payment rules (including requiring the Secretary of Health and Human Services to develop and implement a new payment system); (2) eligibility, election, and enrollment provisions (adding special rules for frail elderly Medicare+Choice beneficiaries enrolling in specialized programs for the frail elderly that establish a continuous open enrollment period for such individuals); and (3) benefits and beneficiary protections provisions (requiring the Secretary to develop and implement a program to measure the quality of care provided in specialized programs for the frail elderly).  Exempts Medicare+Choice beneficiaries in a specialized program for the frail elderly from any risk adjustment system until the Secretary certifies to Congress that a comprehensive risk adjustment methodology taking certain factors into account is being fully implemented.