Source: http://www.healthinfolaw.org/federal-law/medicare-title-xviii-social-security-act
Timestamp: 2019-04-25 12:22:50+00:00

Document:
Enacted in 1965, Title XVIII of the Social Security Act established regulations for the Medicare program, which guarantees access to health insurance for all Americans, aged 65 and older, younger people with specific disabilities, and individuals with end stage renal disease. Title XVIII includes provisions regarding the collection, disclosure, and use of Medicare beneficiaries’ health information. The Medicare program has four parts: Part A, Part B, Part C, and Part D.
The Medicare program is administered by the Centers for Medicare and Medicaid Services (CMS), which is a government agency within the U.S. Department of Health and Human Services (HHS).
Note: this is not a complete overview of Medicare, the sections outlined below are those that are related to health information.
Social Security Act § 1848, 42 U.S.C. 1395w-4.
Social Security Act § 1848(g)(7)(A)(i), 42 U.S.C. 1395w-4(g)(7)(A)(i).
Social Security Act § 1848(g)(7)(A)(ii), 42 U.S.C. 1395w-4(g)(7)(A)(ii).
Social Security Act § 1848(g)(7)(B), 42 U.S.C. 1395w-4(g)(7)(B).
Social Security Act § 1848(g)(7)(c)(i), 42 U.S.C. 1395w-4(g)(7)(c)(i).
Social Security Act § 1848(n)(1)(A), 42 U.S.C. 1395w-4(n)(1)(A).
Social Security Act § 1848(n)(9)(B), 42 U.S.C. 1395w-4(n)(9)(B).
Social Security Act § 1848(n)(9)(D)(i), 42 U.S.C. 1395w-4(n)(9)(D)(i).
Social Security Act § 1848(o)(1)(A), 42 U.S.C. 1395w-4(o)(1)(A).
Social Security Act § 1848(o)(2)(A)(ii), 42 U.S.C. 1395w-4(o)(2)(A)(ii).
Social Security Act § 1848(o)(2)(A)(iii), 42 U.S.C. 1395w-4(o)(2)(A)(iii).
Social Security Act § 1848(o)(2)(D), 42 U.S.C. 1395w-4(o)(2)(D).
Definition of eligible professional. Social Security Act § 1848(k)(3)(B), 42 U.S.C. 1395w-4(k)(3)(B).
Social Security Act § 1848(k)(1), 42 U.S.C. 1395w-4(k)(1).
Social Security Act § 1848(m)(1)(A), 42 U.S.C. 1395w-4(m)(1)(A).
Social Security Act § 1848(m), 42 U.S.C. 1395w-4(m).
Social Security Act §1848(m)(5)(G)(i), 42 U.S.C. 1395w-4(m)(5)(G)(i).
Social Security Act §1848(m)(5)(G)(ii), 42 U.S.C. 1395w-4(m)(5)(G)(ii) (See Social Security Act § 1848(m)(3)(B) for standards on a successful electronic prescriber).
Social Security Act § 1848(m)(7), 42 U.S.C. 1395w-4(m)(7).
Social Security Act § 1848(m)(7)(A)(i), 42 U.S.C. 1395w-4(m)(7)(A)(i).
Social Security Act § 1848(m)(7)(A)(ii), 42 U.S.C. 1395w-4(m)(7)(A)(ii).
Social Security Act § 1848(p)(1), 42 U.S.C. 1395w-4(p)(1).
Social Security Act § 1848(p)(2)(B)(i), 42 U.S.C. 1395w-4(p)(2)(B)(i).
Social Security Act §1814, 42 U.S.C. 1395f.
Social Security Act § 1814(a), 42 U.S.C. 1395f(a).
Social Security Act § 1814(a)(2)(B), 42 U.S.C. 1395f(a)(2)(B).
Social Security Act §1819, 42 U.S.C. 1395i-3.
Social Security Act § 1819(b)(1)(B)(i), 42 U.S.C. 1395i-3(b)(1)(B)(i).
Social Security Act § 1819(b)(1)(B)(ii), 42 U.S.C. 1395i-3(b)(1)(B)(ii).
Social Security Act § 1819(c)(3)(E), 42 U.S.C. 1395i-3(c)(3)(E).
Social Security Act § 1819(b)(6)(C), 42 U.S.C. 1395i-3(b)(6)(C).
Social Security Act § 1819(c)(2)(B)(i)(II), 42 U.S.C. 1395i-3(c)(2)(B)(i)(II).
Social Security Act § 1819(b)(3)(C)(i)(I), 42 U.S.C. 1395i-3(b)(3)(C)(i)(I).
Social Security Act § 1819(b)(3)(C)(i)(III), 42 U.S.C. 1395i-3(b)(3)(C)(i)(III).
Social Security Act § 1819(b)(3)(C)(ii), 42 U.S.C. 1395i-3(b)(3)(C)(ii).
Social Security Act § 1819(b)(3)(C)(i)(II), 42 U.S.C. 1395i-3(b)(3)(C)(i)(II).
Social Security Act § 1819(b)(3)(B)(i), 42 U.S.C. 1395i-3(b)(3)(B)(i).
Social Security Act § 1819(b)(3)(A)(i), 42 U.S.C. 1395i-3(b)(3)(A)(i).
Social Security Act § 1819(b)(3)(A)(iv), 42 U.S.C. 1395i-3(b)(3)(A)(iv).
Social Security Act § 1819(b)(2)(B), 42 U.S.C. 1395i-3(b)(2)(B).
Social Security Act § 1819(b)(3)(D), 42 U.S.C. 1395i-3(b)(3)(D).
Social Security Act § 1819(b)(2)(A), 42 U.S.C. 1395i-3(b)(2)(A).
Social Security Act § 1819(b)(2)(C), 42 U.S.C. 1395i-3(b)(2)(C).
Social Security Act § 1819(c)(1)(A)(i), 42 U.S.C. 1395i-3(c)(1)(A)(i).
Social Security Act § 1819(c)(1)(A)(iii), 42 U.S.C. 1395i-3(c)(1)(A)(iii).
Social Security Act § 1819(c)(1)(A)(iv), 42 U.S.C. 1395i-3(c)(1)(A)(iv).
Social Security Act § 1819(c)(1)(A)(vi), 42 U.S.C. 1395i-3(c)(1)(A)(vi).
Social Security Act § 1819(c)(1)(A)(ix), 42 U.S.C. 1395i-3(c)(1)(A)(ix).
Social Security Act § 1819(c)(1)(D), 42 U.S.C. 1395i-3(c)(1)(D).
Social Security Act § 1819(c)(1)(A)(ii), 42 U.S.C. 1395i-3(c)(1)(A)(ii).
Social Security Act § 1819(c)(2)(B)(ii), 42 U.S.C. 1395i-3(c)(2)(B)(ii).
Social Security Act § 1819(d)(1)(D)(i), 42 U.S.C. 1395i-3(d)(1)(D)(i).
Social Security Act § 1819(d)(1)(D), 42 U.S.C. 1395i-3(d)(1)(D).
Social Security Act § 1819(c)(8), 42 U.S.C. 1395i-3(c)(8).
Social Security Act § 1819(e)(2)(A), 42 U.S.C. 1395i-3(e)(2)(A).
Social Security Act § 1819(e)(2)(B), 42 U.S.C. 1395i-3(e)(2)(B).
Social Security Act § 1861, 42 U.S.C. 1395x.
Social Security Act § 1861(k)(1)(A), 42 U.S.C. 1395x(k)(1)(A).
Social Security Act § 1861(k)(1)(B), 42 U.S.C. 1395x(k)(1)(B).
Social Security Act § 1861(k)(4), 42 U.S.C. 1395x(k)(4).
Social Security Act § 1819(g)(1)(A), 42 U.S.C. 1395i-3(g)(1)(A).
Social Security Act § 1819(g)(1)(C), 42 U.S.C. 1395i-3(g)(1)(C).
Social Security Act § 1819(g)(4)(A), 42 U.S.C. 1395i-3(g)(4)(A).
Social Security Act § 1819(g)(4)(B), 42 U.S.C. 1395i-3(g)(4)(B).
Social Security Act § 1819(g)(2)(A)(i), 42 U.S.C. 1395i-3(g)(2)(A)(i).
Social Security Act § 1819(g)(2)(A)(iii)(I), 42 U.S.C. 1395i-3(g)(2)(A)(iii)(I).
Social Security Act § 1819(g)(2)(A)(i)(I), 42 U.S.C. 1395i-3(g)(2)(A)(i)(I).
Social Security Act § 1819(g)(2)(A)(i)(II), 42 U.S.C. 1395i-3(g)(2)(A)(i)(II).
Social Security Act § 1819(g)(2)(A)(i)(III), 42 U.S.C. 1395i-3(g)(2)(A)(i)(III).
Social Security Act § 1819(g)(2)(B)(i), 42 U.S.C. 1395i-3(g)(2)(B)(i).
Social Security Act § 1819(g)(2)(B)(iii), 42 U.S.C. 1395i-3(g)(2)(B)(iii).
Social Security Act § 1819(g)(3)(A), 42 U.S.C. 1395i-3(g)(3)(A).
Social Security Act § 1819(g)(3)(D), 42 U.S.C. 1395i-3(g)(3)(D).
Social Security Act § 1819(e)(8)(A), 42 U.S.C. 1395i-3(e)(8)(A).
Social Security Act § 1819(e)(8)(B), 42 U.SC.. 1395i-3(e)(8)(B).
Social Security Act § 1819(g)(5)(D), 42 U.S.C. 1395i-3(g)(5)(D).
Social Security Act § 1819(g)(5)(A), 42 U.S.C. 1395i-3(g)(5)(A).
Social Security Act § 1819(g)(5)(B), 42 U.S.C. 1395i-3(g)(5)(B).
Social Security Act § 1819(g)(5)(C)(ii), 42 U.S.C. 1395i-3(g)(5)(C)(ii).
Social Security Act § 1819(g)(5)(E), 42 U.S.C. 1395i-3(g)(5)(E).
Social Security Act § 1819(i)(1)(A), 42 U.S.C. 1395i-3(i)(1)(A).
Social Security Act § 1819(i)(1)(A)(i), 42 U.S.C. 1395i-3(i)(1)(A)(i).
Social Security Act § 1819(i)(1)(A)(ii), 42 U.S.C. 1395i-3(i)(1)(A)(ii).
Social Security Act § 1819(i)(1)(A)(iv), 42 U.S.C. 1395i-3(i)(1)(A)(iv).
Social Security Act § 1819(i)(1)(A)(v)(I), 42 U.S.C. 1395i-3(i)(1)(A)(v)(I).
Social Security Act § 1819(i)(1)(A)(v)(II), 42 U.S.C. 1395(i)(1)(A)(v)(II).
Social Security Act §1814, 42 U.S.C. 1395f ; Social Security Act § 1861, 42 U.S.C. 1395x.
Social Security Act § 1814(i)(6)(A), 42 U.S.C. 1395f(i)(6)(A).
Social Security Act § 1814(i)(6)(B)(ii), 42 U.S.C. 1395f(i)(6)(B)(ii).
Social Security Act § 1814(i)(6)(B)(v), 42 U.S.C. 1395f(i)(6)(B)(v).
Social Security Act § 1814(i)(6)(B)(vii), 42 U.S.C. 1395f(i)(6)(B)(vii).
Social Security Act §1814, 42 U.S.C. 1395f ; Social Security Act § 1861, 42 U.S.C. 1395x; Social Security Act § 1891, 42 U.S.C. 1395bbb; Social Security Act § 1895, 42 U.S.C. 1395fff .
Social Security Act § 1861(o)(3), 42 U.S.C. 1395bbb(a)(1).
Social Security Act § 1891(a)(1), 42 U.S.C. 1395bbb(a)(1).
Social Security Act § 1891(a)(1)(A), 42 U.S.C. 1395bbb(a)(1)(A).
Social Security Act § 1891(a)(1)(B), 42 U.S.C. 1395bbb(a)(1)(B).
Social Security Act § 1891(a)(1)(C), 42 U.S.C. 1395bbb(a)(1)(C).
Social Security Act § 1891(c)(2)(A), 42 U.S.C. 1395bbb(c)(2)(A).
Social Security Act § 1891(c)(1), 42 U.S.C. 1395bbb(c)(1).
Social Security Act § 1891(c)(2)(B)(ii), 42 U.S.C. 1395bbb(c)(2)(B)(ii).
Social Security Act § 1891(c)(2)(C)(i)(I), 42 U.S.C. 1395bbb(c)(2)(C)(i)(I).
Social Security Act § 1891(c)(2)(C)(i)(II), 42 U.S.C. 1395bbb(c)(2)(C)(i)(II).
Social Security Act § 1891(c)(2)(D), 42 U.S.C. 1395bbb(c)(2)(D).
Social Security Act § 1894, 42 U.S.C. 1395eee.
Social Security Act § 1894(c)(2), 42 U.S.C. 1395eee(c)(2).
Social Security Act § 1894(c)(3)(A), 42 U.S.C. 1395eee(c)(3)(A).
Social Security Act § 1894(e)(3)(A)(i)(I), 42 U.S.C. 1395eee(e)(3)(A)(i)(I).
Social Security Act § 1894(e)(3)(A)(i)(II), 42 U.S.C. 1395eee(e)(3)(A)(i)(II).
Social Security Act § 1894(e)(3)(A)(i)(III), 42 U.S.C. 1395eee(e)(3)(A)(i)(III).
Social Security Act § 1894(a)(2)(C), 42 U.S.C. 1395eee(a)(2)(C).
Social Security Act § 1894(b)(2)(A), 42 U.S.C. 1395eee(b)(2)(A).
o Furnished items and services.
Defined in Social Security Act § 1834(a)(20)(D), 42 U.S.C. 1395m(a)(20(D).
Social Security Act § 1834(a)(20)(A), 42 U.S.C. 1395m(a)(20)(A).
Social Security Act § 1834(a)(20(F)(i), 42 U.S.C. 1395m(a)(20)(F)(i).
Social Security Act § 1861(aa)(2)(I), 42 U.S.C. 1395x(aa)(2)(I).
Social Security Act § 1861(cc)(2)(G), 42 U.S.C. 1395x(cc)(2)(G).
Social Security Act § 1861(ss)(1)(H)(ii), 42 U.S.C. 1395x(ss)(1)(H)(ii).
Social Security Act § 1861(ss)(1)(H)(i), 42 U.S.C. 1395x(ss)(1)(H)(i).
Social Security Act § 1861(ss)(1)(H)(iii), 42 U.S.C. 1395x(ss)(1)(H)(iii).
Social Security Act § 1861(hhh)(2)(G), 42 U.S.C. 1395x(hhh)(2)(G).
Social Security Act § 1861(hhh)(1)(A), 42 U.S.C. 1395x(hhh)(1)(A) (“Health professional” defined in Social Security Act § 1861(hhh)(3), 42 U.S.C. 1395x(hhh)(3)).
Social Security Act § 1861(hhh)(4)(A)(i), 42 U.S.C. 1395x(hhh)(4)(A)(i).
Social Security Act § 1861(hhh)(2)(A), 42 U.S.C. 1395x(hhh)(2)(A).
Social Security Act § 1861(hhh)(2)(B), 42 U.S.C. 1395x(hhh)(2)(B).
Social Security Act § 1861(hhh)(2)(C), 42 U.S.C. 1395x(hhh)(2)(C).
Social Security Act § 1861(hhh)(2)(D), 42 U.S.C. 1395x(hhh)(2)(D).
Social Security Act § 1861(hhh)(2)(E)(ii), 42 U.S.C. 1395x(hhh)(2)(E)(ii).
Social Security Act § 1861(hhh)(4)(F), 42 U.S.C. 1395x(hhh)(4)(F).
Social Security Act § 1881(c)(2)(B), 42 U.S.C. 1395rr(c)(2)(B).
Social Security Act § 1881(c)(2)(D), 42 U.S.C. 1395rr(c)(2)(D).
Social Security Act § 1881(c)(2)(H), 42 U.S.C. 1395rr(c)(2)(H).
Social Security Act § 1881(c)(2)(F), 42 U.S.C. 1395rr(c)(2)(F).
Social Security Act § 1881(c)(1)(A)(i)(II), 42 U.S.C. 1395rr(c)(1)(A)(i)(II).
Social Security Act § 1881(c)(7), 42 U.S.C. 1395rr(c)(7).
Social Security Act § 1881(c)(7)(B), 42 U.S.C. 1395rr(c)(7)(B).
Social Security Act § 1881(c)(7)(D), 42 U.S.C. 1395rr(c)(7)(D).
Social Security Act § 1881(h)(1)(B), 42 U.S.C. 1395rr(h)(1)(B).
Social Security Act § 1881(h)(2)(A)(ii), 42 U.S.C. 1395rr(h)(2)(A)(ii).
Social Security Act § 1881(h)(6)(A), 42 U.S.C. 1395rr(h)(6)(A).
Social Security Act § 1881(h)(6)(B), 42 U.S.C. 1395rr(h)(6)(B).
Social Security Act §1881(h)(6)(C)(i), 42 U.S.C. 1395rr(h)(6)(C)(i).
Social Security Act § 1881(h)(6)(C)(ii), 42 U.S.C. 1395rr(h)(6)(C)(ii).
Social Security Act §1881(h)(6)(D), 42 U.S.C. 1395rr(h)(6)(D).
Social Security Act § 1805, 42 U.S.C. 1395b-6.
Social Security Act § 1805(b)(2)(A)(iv), 42 U.S.C. 1395b-6(b)(2)(A)(iv).
Social Security Act § 1805(b)(2)(A)(v), 42 U.S.C. 1395b-6(b)(2)(A)(v).
Social Security Act § 1805(b)(2)(B)(iii), 42 U.S.C. 1395b-6(b)(2)(B)(iii).
Social Security Act § 1808, 42 U.S.C. 1395b-9.
Social Security Act § 1808(c)(2)(A), 42 U.S.C. 1395b-9(c)(2)(A).
Social Security Act § 1808(c)(2)(B)(i), 42 U.S.C. 1395b-9(c)(2)(B)(i).
Social Security Act § 1869, 42 U.S.C. 1395ff.
Social Security Act § 1869(c)(3)(B)(i), 42 U.S.C. 1395ff(c)(3)(B)(i).
Social Security Act § 1869(c)(3)(C)(iii)(II), 42 U.S.C. 1395ff(c)(3)(C)(iii)(II).
Social Security Act § 1869(c)(3)(C)(iii)(I), 42 U.S.C. 1395ff(c)(3)(C)(iii)(I).
Social Security Act § 1869(c)(3)(I)(ii), 42 U.S.C. 1395ff(c)(3)(I)(ii).
Social Security Act § 1869(c)(3)(I)(ii)(I), 42 U.S.C. 1395ff(c)(3)(I)(ii)(I).
Social Security Act § 1869(c)(3)(I)(ii)(II), 42 U.S.C. 1395ff(c)(3)(I)(ii)(II).
Social Security Act § 1869(c)(3)(I)(ii)(III), 42 U.S.C. 1395ff(c)(3)(I)(ii)(III).
Social Security Act § 1869(c)(3)(I)(i), 42 U.S.C. 1395ff(c)(3)(I)(i).
Social Security Act § 1869(c)(3)(I)(iii), 42 U.S.C. 1395ff(c)(3)(I)(i).
Social Security Act § 1869(e)(4)(B), 42 U.S.C. 1395ff(e)(4)(B).
Social Security Act § 1882, 42 U.S.C. 1395ss.
Social Security Act § 1882(x)(1)(A), 42 U.S.C. 1395ss(x)(1)(A).
Social Security Act § 1882(x)(1)(C), 42 U.S.C. 1395ss(x)(1)(C).
The research must comply with 45 C.F.R. Part 46 and any other applicable state or federal laws concerning human subject research.
Social Security Act § 1882(x)(1)(D), 42 U.S.C. 1395ss(x)(1)(D).
Social Security Act § 1882(x)(2), 42 U.S.C. 1395ss(x)(2).
Social Security Act § 1893, 42 U.S.C. 1395ddd.
Social Security Act § 1893(a), 42 U.S.C. 1395ddd(a).
Social Security Act § 1893(b)(1), 42 U.S.C. 1395ddd(b)(1).
Social Security Act § 1899A, 42 U.S.C. 1395kkk.
Social Security Act § 1899A(n)(1), 42 U.S.C. 1395kkk(n)(1).
Social Security Act § 1899A(n)(2)(A), 42 U.S.C. 1395kkk(n)(2)(A).
Social Security Act § 1899A(n)(2)(B), 42 U.S.C. 1395kkk(n)(2)(B).
Social Security Act § 1899A(n)(2)(C), 42 U.S.C. 1395kkk(n)(2)(C).
Social Security Act § 1899A(n)(2)(D), 42 U.S.C. 1395kkk(n)(2)(D).
Social Security Act § 1876(c)(5)(A), 42 U.S.C. 1395mm(c)(5)(A).
Social Security Act § 1876(c)(6)(A), 42 U.S.C. 1395mm(c)(6)(A).
Social Security Act § 1876(c)(6)(B), 42 U.S.C. 1395mm(c)(6)(B).
Social Security Act § 1876(i)(3)(A)(i)(I), 42 U.S.C. 1395mm(i)(3)(A)(i)(I).
Social Security Act § 1876(i)(3)(A)(ii)(II), 42 U.S.C. 1395mm(i)(3)(A)(ii)(II).
Social Security Act § 1876(i)(7)(A), 42 U.S.C. 1395mm(i)(7)(A).
Social Security Act § 1876(i)(8)(A)(ii)(II), 42 U.S.C. 1395mm(i)(8)(A)(ii)(II).
The following providers must annually submit data on quality measures to the Secretary. Each provider will have an opportunity to review such data, which will then be made publicly available and reported on CMS’ website.
Social Security Act § 1890, 42 U.S.C. 1395aaa.
Social Security Act § 1890(a)(1), 42 U.S.C. 1395aaa(a)(1).
Social Security Act § 1890(b)(1), 42 U.S.C. 1395aaa(b)(1).
Social Security Act § 1890(b)(2), 42 U.S.C. 1395aaa(b)(2).
Social Security Act § 1890(b)(4), 42 U.S.C. 1395aaa(b)(4).
Social Security Act § 1890(b)(5)(A)(ii), 42 U.S.C. 1395aaa(b)(5)(A)(ii).
Social Security Act § 1890(b)(5)(A)(i), 42 U.S.C. 1395aaa(b)(5)(A)(i).
Social Security Act § 1890(b)(5)(A)(iv), 42 U.S.C. 1395aaa(b)(5)(A)(iv).
Social Security Act § 1890A, 42 U.S.C. 1395aaa-1.
Social Security Act § 1890A(a)(1), 42 U.S.C. 1395aaa-1(a)(1); For provisions using the quality and efficiency measure, see Social Security Act §1890(b)(7)(B), 42 U.S.C. 1395aaa(b)(7)(B).
Social Security Act § 1890A(a)(6)(A), 42 U.S.C. 1395aaa-1(a)(6)(A).
Social Security Act § 1890A(a)(6)(B), 42 U.S.C. 1395aaa-1(a)(6)(B).
Social Security Act § 1814(i)(5), 42 U.S.C. 1395f(i)(5) (requirement applies beginning in 2014).
Social Security Act § 1895(b)(3)(B)(v), 42 U.S.C. 1395fff(b)(3)(B)(v).
Social Security Act § 1886(i)(7), 42 U.S.C. 1395ww(i)(7) (requirement applies beginning in 2014).
Does not include psychiatric hospitals, rehabilitation hospitals, hospitals whose patients are predominantly under 18, long-term care hospitals (average length of stay over 25 days). Social Security Act § 1886(d)(1)(B), 42 U.S.C. 1395ww(d)(1)(B).
Social Security Act §1833(t)(17), 42 U.S.C. 1395l(t)(17).
Social Security Act § 1866(k), 42 U.S.C. 1395cc(k) (requirement applies beginning in 2014).
Social Security Act § 1886(m)(5), 42 U.S.C. 1395ww(m)(5).
Social Security Act § 1886(b)(3)(B)(viii)(VII), 42 U.S.C. 1395ww(b)(3)(B)(viii)(VII).
Social Security Act § 1886(s)(4), 42 U.S.C. 1395ww(s)(4) (requirement applies beginning in 2014).
Social Security Act § 1886(j)(7), 42 U.S.C. 1395ww(j)(7) (requirement applies beginning in 2014).
Social Security Act § 1866(a)(1)(E)(i), 42 U.S.C. 1395cc(a)(1)(E)(i).
Social Security Act § 1866(a)(1)(F)(ii), 42 U.S.C. 1395cc(a)(1)(F)(ii).
Social Security Act § 1866(a)(1)(F)(i), 42 U.S.C. 1395cc(a)(1)(F)(i) (the organization will review).
Social Security Act § 1807, 42 U.S.C. 1395b-8.
Social Security Act § 1807(a)(1), 42 U.S.C. 1395b-8(a)(1).
Social Security Act § 1807(b)(1), 42 U.S.C. 1395b-8(b)(1).
Social Security Act § 1807(b)(5), 42 U.S.C. 1395b-8(b)(5).
Social Security Act § 1807(c)(2), 42 U.S.C. 1395b-8(c)(2).
Social Security Act § 1807(e)(1)(A), 42 U.S.C. 1395b-8(e)(1)(A).
Social Security Act § 1807(e)(1)(B), 42 U.S.C. 1395b-8(e)(1)(B).
Social Security Act § 1807(e)(2)(B), 42 U.S.C. 1395b-8(e)(2)(B).
Social Security Act § 1807(e)(2)(D), 42 U.S.C. 1395b-8(e)(2)(D).
Social Security Act § 1807(e)(3)(A), 42 U.S.C. 1395b-8(e)(3)(A).
Social Security Act § 1807(e)(3)(C), 42 U.S.C. 1395b-8(e)(3)(C).
Social Security Act § 1807(e)(4)(A), 42 U.S.C. 1395b-8(e)(4)(A).
Social Security Act § 1809, 42 U.S.C. 1395b-10.
Social Security Act § 1809(a), 42 U.S.C. 1395b-10(a).
Social Security Act § 1809(a)(1), 42 U.S.C. 1395b-10(a)(1).
Social Security Act § 1809(b)(1)(A), 42 U.S.C. 1395b-10(b)(1)(A).
Social Security Act § 1809(b)(1)(B), 42 U.S.C. 1395b-10(b)(1)(B).
Social Security Act § 1809(c), 42 U.S.C. 1395b-10(c).
Social Security Act § 1809(b)(2), 42 U.S.C. 1395b-10(b)(2).
Social Security Act § 1866A, 42 U.S.C. 1395cc-1.
Social Security Act § 1866A(a)(1)(A), 42 U.S.C. 1395cc-1(a)(1)(A).
Social Security Act § 1866A(a)(1)(B), 42 U.S.C. 1395cc-1(a)(1)(B).
Social Security Act § 1866A(a)(1)(C), 42 U.S.C. 1395cc-1(a)(1)(C).
Social Security Act § 1866B, 42 U.S.C. 1395cc-2.
Social Security Act § 1866B(a)(5), 42 U.S.C. 1395cc-2(a)(5).
Social Security Act § 1866B(b)(9), 42 U.S.C. 1395cc-2(b)(9).
Social Security Act § 1866B(c)(1), 42 U.S.C. 1395cc-2(c)(1).
Social Security Act § 1866B(c)(3), 42 U.S.C. 1395cc-2(c)(3).
Social Security Act § 1866B(f), 42 U.S.C. 1395cc-2(f).
Social Security Act § 1866C, 42 U.S.C. 1395cc-3.
Social Security Act § 1866C(b), 42 U.S.C. 1395cc-3(b).
Social Security Act § 1866C(b)(1), 42 U.S.C. 1395cc-3(b)(1).
Social Security Act § 1866C(b)(3), 42 U.S.C. 1395cc-3(b)(3).
Social Security Act § 1866C(b)(4), 42 U.S.C. 1395cc-3(b)(4).
Social Security Act § 1866C(b)(5), 42 U.S.C. 1395cc-3(b)(5).
Social Security Act § 1866C(b)(6), 42 U.S.C. 1395cc-3(b)(6).
Social Security Act § 1866C(d)(2), 42 U.S.C. 1395cc-3(d)(2).
Social Security Act § 1866C(d)(2)(A), 42 U.S.C. 1395cc-3(d)(2)(A).
Social Security Act § 1866C(d)(2)(B), 42 U.S.C. 1395cc-3(d)(2)(B).
Social Security Act § 1866C(d)(2)(C), 42 U.S.C. 1395cc-3(d)(2)(C).
Social Security Act § 1866C(d)(2)(D), 42 U.S.C. 1395cc-3(d)(2)(D).
Social Security Act § 1866C(h)(1), 42 U.S.C. 1395cc-3(h)(1).
Social Security Act § 1866C(h)(2), 42 U.S.C. 1395cc-3(h)(2).
Social Security Act § 1866C(h)(3), 42 U.S.C. 1395cc-3(h)(3).
Social Security Act § 1866D, 42 U.S.C. 1395cc-4.
Episode of care is defined in Social Security Act § 1866D(a)(2)(D), 42 U.S.C. 1395cc-4(a)(2)(D).
“Applicable beneficiary” is defined as an individual who is admitted to a hospital for an applicable condition and is entitled to, or enrolled for, benefits under part A and enrolled for benefits under part B, but not enrolled under part C or a PACE program. Social Security Act § 1866D(a)(2)(A), 42 U.S.C. 1395cc-4(a)(2)(A). “Applicable condition” means 1 or more of 10 conditions selected by the Secretary. Social Security Act § 1866D(a)(2)(B), 42 U.S.C. 1395cc-4(a)(2)(A).
“Applicable services” is defined in Social Security Act § 1866D(a)(2)(C), 42 U.S.C. 1395cc-4(a)(2)(C).
Social Security Act § 1866D(c)(3)(B), 42 U.S.C. 1395cc-4(c)(3)(B).
Social Security Act § 1866D(c)(4)(A), 42 U.S.C. 1395cc-4(c)(4)(A).
Social Security Act § 1866D(c)(4)(A)(i), 42 U.S.C. 1395cc-4(c)(4)(A)(i).
Social Security Act § 1866D(c)(4)(A)(ii), 42 U.S.C. 1395cc-4(c)(4)(A)(ii).
Social Security Act § 1866D(c)(4)(A)(iv), 42 U.S.C. 1395cc-4(c)(4)(A)(iv).
Social Security Act § 1866D(c)(4)(A)(v), 42 U.S.C. 1395cc-4(c)(4)(A)(v).
Social Security Act § 1866D(c)(4)(A)(vii), 42 U.S.C. 1395cc-4(c)(4)(A)(vii).
Social Security Act § 1866D(c)(4)(A)(viii), 42 U.S.C. 1395cc-4(c)(4)(A)(viii).
Social Security Act § 1866D(c)(4)(B)(i), 42 U.S.C. 1395cc-4(c)(4)(B)(i).
Social Security Act s 1866D(c)(4)(B)(ii), 42 U.S.C. 1395cc-4(c)(4)(B)(ii).
Social Security Act § 1866D(e)(1), 42 U.S.C. 1395cc-4(e)(1).
Social Security Act § 1866D(e)(1)(A), 42 U.S.C. 1395cc-4(e)(1)(A).
Social Security Act § 1866D(e)(1)(B), 42 U.S.C. 1395cc-4(e)(1)(B).
Social Security Act § 1866D(e)(1)(C), 42 U.S.C. 1395cc-4(e)(1)(C).
Social Security Act § 1866D(e)(2)(A), 42 U.S.C. 1395cc-4(e)(2)(A).
Social Security Act § 1866D(e)(2)(B), 42 U.S.C. 1395cc-4(e)(2)(B).
Social Security Act § 1866E, 42 U.S.C. 1395cc-5.
“Applicable beneficiary” is defined in Social Security Act § 1866E(d)(1), 42 U.S.C. 1395cc-5(d)(1).
Social Security Act § 1866E(a)(1), 42 U.S.C. 1395cc-5(a)(1).
Social Security Act § 1866E(a)(2), 42 U.S.C. 1395cc-5(a)(2).
Social Security Act § 1866E(a)(2)(A), 42 U.S.C. 1395cc-5(a)(2)(A).
Social Security Act § 1866E(a)(2)(B), 42 U.S.C. 1395cc-5(a)(2)(B).
Social Security Act § 1866E(a)(2)(C), 42 U.S.C. 1395cc-5(a)(2)(C).
Social Security Act § 1866E(a)(2)(D), 42 U.S.C. 1395cc-5(a)(2)(D).
Social Security Act § 1866E(a)(2)(E), 42 U.S.C. 1395cc-5(a)(2)(E).
Social Security Act § 1866E(a)(2)(G), 42 U.S.C. 1395cc-5(a)(2)(G).
“Independence at home medical practice” is defined in Social Security Act § 1866E(b)(1)(A), 42 U.S.C. 1395cc-5(b)(1)(A).
Social Security Act § 1866E(b)(1)(A)(vi), 42 U.S.C. 1395cc-5(b)(1)(A)(vi).
Social Security Act § 1866E(b), 42 U.S.C. 1395cc-5(b).
Social Security Act § 1866E(f)(1), 42 U.S.C. 1395cc-5(f)(1).
Social Security Act §1866E(f)(2), 42 U.S.C. 1395cc-5(f)(2).
Social Security Act § 1866E(g), 42 U.S.C. 1395cc-5(g).
Social Security Act § 1899, 42 U.S.C. 1395jjj.
Social Security Act § 1899(a)(1), 42 U.S.C. 1395jjj(a)(1).
Social Security Act § 1899(a)(1)(A), 42 U.S.C. 1395jjj(a)(1)(A).
Social Security Act § 1899(a)(1)(B), 42 U.S.C. 1395jjj(a)(1)(B).
Social Security Act § 1899(b)(2)(A), 42 U.S.C. 1395jjj(b)(2)(A).
Social Security Act § 1899(b)(2)(G), 42 U.S.C. 1395jjj(b)(2)(G).
Social Security Act § 1899(b)(2)(H), 42 U.S.C. 1395jjj(b)(2)(H).
Social Security Act § 1899(b)(3)(A), 42 U.S.C. 1395jjj(b)(3)(A).
Social Security Act § 1899(b)(3)(A)(i), 42 U.S.C. 1395jjj(b)(3)(A)(i).
Social Security Act § 1899(b)(3)(A)(ii), 42 U.S.C. 1395jjj(b)(3)(A)(ii).
Social Security Act § 1899(b)(3)(A)(iii), 42 U.S.C. 1395jjj(b)(3)(A)(iii).
Social Security Act § 1899(b)(3)(B), 42 U.S.C. 1395jjj(b)(3)(B).
Social Security Act § 1899(b)(3)(C), 42 U.S.C. 1395jjj(b)(3)(C).
Social Security Act § 1899(b)(3)(D), 42 U.S.C. 1395jjj(b)(3)(D).
“Medicare Advantage,” Available at: .
Social Security Act § 1851, 42 U.S.C. 1395w-21.
Social Security Act § 1851(d)(1), 42 U.S.C. 1395w-21(d)(1).
Social Security Act § 1851(d)(4)(D), 42 U.S.C. 1395w-21(d)(4)(D).
Social Security Act § 1852, 42 U.S.C. 1395w-22.
Social Security Act § 1852(b)(1)(A), 42 U.S.C. 1395w-22(b)(1)(A).
Social Security Act § 1852(e)(1), 42 U.S.C. 1395w-22(e)(1).
Social Security Act § 1852(e)(2), 42 U.S.C. 1395w-22(e)(2).
Social Security Act § 1852(e)(3), 42 U.S.C. 1395w-22(e)(3).
Social Security Act § 1852(e)(5)(A), 42 U.S.C. 1395w-22(e)(5)(A).
Social Security Act § 1852(e)(5)(B)(ii), 42 U.S.C. 1395w-22(e)(5)(B)(ii).
Social Security Act §1852(e)(5)(B)(iii), 42 U.S.C. 1395w-22(e)(5)(B)(iii).
Social Security Act § 1852(f), 42 U.S.C. 1395w-22(f).
Social Security Act § 1852(h)(1), 42 U.S.C. 1395w-22(h)(1).
Social Security Act § 1852(h)(3), 42 U.S.C. 1395w-22(h)(3).
Social Security Act § 1853, 42 U.S.C. 1395w-23.
Social Security Act §1853(a)(1)(C)(i), 42 U.S.C. 1395w-23(a)(1)(C)(i).
Social Security Act § 1853(a)(1)(C)(iii)(I), 42 U.S.C. 1395w-23(a)(1)(C)(iii)(I).
Social Security Act § 1853(a)(1)(C)(iii)(III), 42 U.S.C. 1395w-23(a)(1)(C)(iii)(III).
Social Security Act § 1853(a)(3)(B), 42 U.S.C. 1395w-23(a)(3)(B).
Social Security Act § 1853(a)(3)(A), 42 U.S.C. 1395w-23(a)(3)(A).
Social Security Act § 1857, 42 U.S.C. 1395w-27.
Social Security Act § 1857(d)(2)(A), 42 U.S.C. 1395w-27(d)(2)(A).
Social Security Act § 1857(d)(6), 42 U.S.C. 1395w-27(d)(6).
Social Security Act § 1859, 42 U.S.C. 1395w-28.
Social Security Act § 1859(f)(5)(B)(i), 42 U.S.C. 1395w-28(f)(5)(B)(i).
Social Security Act § 1859(f)(5)(B)(ii), 42 U.S.C. 1395w-28(f)(5)(B)(ii).
Social Security Act § 1859(f)(5)(B)(iii), 42 U.S.C. 1395w-28(f)(5)(B)(iii).
“Medicare Prescription Drug Coverage,” Available at: .
Social Security Act § 1860D-1, 42 U.S.C. 1395w-101.
Social Security Act § 1860D-1(b)(4)(A), 42 U.S.C. 1395w-101(b)(4)(A).
Social Security Act § 1860D-4, 42 U.S.C. 1395w-104.
Social Security Act § 1860D-4(c)(1)(A), 42 U.S.C. 1395w-104(c)(1)(A).
Social Security Act § 1860D-4(c)(1)(B), 42 U.S.C. 1395w-104(c)(1)(B).
Social Security Act § 1860D-4(c)(1)(C), 42 U.S.C. 1395w-104(c)(1)(C).
Social Security Act § 1860D-4(c)(1)(D), 42 U.S.C. 1395w-104(c)(1)(D).
A targeted beneficiary is one who has multiple chronic diseases, is taking multiple covered part D drugs and is identified as likely to incur annual costs that exceed a level specified by the Secretary (Social Security Act § 1860D-4(c)(2)(A)(ii), 42 U.S.C. 1395w-104(c)(2)(A)(ii)).
Social Security Act § 1860D-4(c)(2)(A)(i), 42 U.SC. 1395w-104(c)(2)(A)(i).
Social Security Act § 1860D-4(c)(2)(B)(iii), 42 U.S.C. 1395w-104(c)(2)(B)(iii).
Social Security Act § 1860D-4(c)(2)(C)(i), 42 U.S.C. 1395w-104(c)(2)(C)(i).
Social Security Act § 1860D-4(c)(2)(C)(ii), 42 U.S.C. 1395w-104(c)(2)(C)(ii).
Social Security Act § 1860D-4(c)(2)(D), 42 U.S.C. 1395w-104(c)(2)(D).
Social Security Act § 1860D-4(c)(2)(F), 42 U.S.C. 1395w-104(c)(2)(F).
Social Security Act § 1860D-4(e)(1), 42 U.S.C. 1395w-104(e)(1).
Social Security Act § 1860D-4(e)(2)(B), 42 U.S.C. 1395w-104(e)(2)(B).
Social Security Act § 1860D-4(e)(3)(A), 42 U.S.C. 1395w-104(e)(3)(A).
Social Security Act § 1860D-4(e)(3)(B)(i), 42 U.S.C. 1395w-104(e)(3)(B)(i).
Social Security Act § 1860D-4(e)(3)(B)(ii), 42 U.S.C. 1395w-104(e)(3)(B)(ii).
Social Security Act §1860D-4(e)(3)(B)(iii), 42 U.S.C. 1395w-104(e)(3)(B)(iii).
Social Security Act § 1860D-4(f), 42 U.S.C. 1395w-104(f).
Social Security Act § 1860D-4(i), 42 U.S.C. 1395w-104(i).
Social Security Act § 1860D-11, 42 U.S.C. 1395w-111.
Social Security Act § 1860D-11(g)(5)(A)(ii), 42 U.S.C. 1395w-111(g)(5)(A)(ii).
Social Security Act §1860D-11(g)(5)(B)(ii), 42 U.S.C. 1395w-11(g)(5)(B)(ii).
1. “Medicare Prescription Drug Coverage,” Available at: http://www.medicare.gov/navigation/medicare-basics/medicare-benefits/part-d.aspx.
2. Social Security Act § 1860D-1, 42 U.S.C. 1395w-101.
3. “Medicare Prescription Drug Coverage,” Available at: http://www.medicare.gov/navigation/medicare-basics/medicare-benefits/part-d.aspx.
4. “Medicare Prescription Drug Coverage,” Available at: http://www.medicare.gov/navigation/medicare-basics/medicare-benefits/part-d.aspx.
5. Social Security Act § 1860D-1, 42 U.S.C. 1395w-101.
6. Social Security Act § 1860D-1(b)(4)(A), 42 U.S.C. 1395w-101(b)(4)(A).
7. Social Security Act § 1860D-4, 42 U.S.C. 1395w-104.
8. Social Security Act § 1860D-4(c)(1)(A), 42 U.S.C. 1395w-104(c)(1)(A).
9. Social Security Act § 1860D-4(c)(1)(B), 42 U.S.C. 1395w-104(c)(1)(B).
10. Social Security Act § 1860D-4(c)(1)(C), 42 U.S.C. 1395w-104(c)(1)(C).
11. Social Security Act § 1860D-4(c)(1)(D), 42 U.S.C. 1395w-104(c)(1)(D).
12. A targeted beneficiary is one who has multiple chronic diseases, is taking multiple covered part D drugs and is identified as likely to incur annual costs that exceed a level specified by the Secretary (Social Security Act § 1860D-4(c)(2)(A)(ii), 42 U.S.C. 1395w-104(c)(2)(A)(ii)).
13. “Medicare Prescription Drug Coverage,” Available at: http://www.medicare.gov/navigation/medicare-basics/medicare-benefits/part-d.aspx.
14. Social Security Act § 1860D-1, 42 U.S.C. 1395w-101.
15. Social Security Act § 1860D-1(b)(4)(A), 42 U.S.C. 1395w-101(b)(4)(A).
16. Social Security Act § 1860D-4, 42 U.S.C. 1395w-104.
17. Social Security Act § 1860D-4(c)(1)(A), 42 U.S.C. 1395w-104(c)(1)(A).
18. Social Security Act § 1860D-4(c)(1)(B), 42 U.S.C. 1395w-104(c)(1)(B).
19. Social Security Act § 1860D-4(c)(1)(C), 42 U.S.C. 1395w-104(c)(1)(C).
20. Social Security Act § 1860D-4(c)(1)(D), 42 U.S.C. 1395w-104(c)(1)(D).
21. A targeted beneficiary is one who has multiple chronic diseases, is taking multiple covered part D drugs and is identified as likely to incur annual costs that exceed a level specified by the Secretary (Social Security Act § 1860D-4(c)(2)(A)(ii), 42 U.S.C. 1395w-104(c)(2)(A)(ii)).
22. Social Security Act § 1860D-4(c)(2)(A)(i), 42 U.SC. 1395w-104(c)(2)(A)(i).
23. Social Security Act § 1860D-4(c)(2)(B)(iii), 42 U.S.C. 1395w-104(c)(2)(B)(iii).
24. Social Security Act § 1860D-4(c)(2)(C)(i), 42 U.S.C. 1395w-104(c)(2)(C)(i).
25. Social Security Act § 1860D-4(c)(2)(C)(ii), 42 U.S.C. 1395w-104(c)(2)(C)(ii).
26. Social Security Act § 1860D-4(c)(2)(D), 42 U.S.C. 1395w-104(c)(2)(D).
27. Social Security Act § 1860D-4(c)(2)(F), 42 U.S.C. 1395w-104(c)(2)(F).
28. Social Security Act § 1860D-4(e)(1), 42 U.S.C. 1395w-104(e)(1).
29. Social Security Act § 1860D-4(e)(2)(B), 42 U.S.C. 1395w-104(e)(2)(B).
30. Social Security Act § 1860D-4(e)(3)(A), 42 U.S.C. 1395w-104(e)(3)(A).
31. Social Security Act § 1860D-4(e)(3)(B)(i), 42 U.S.C. 1395w-104(e)(3)(B)(i).
32. Social Security Act § 1860D-4(e)(3)(B)(ii), 42 U.S.C. 1395w-104(e)(3)(B)(ii).
33. Social Security Act §1860D-4(e)(3)(B)(iii), 42 U.S.C. 1395w-104(e)(3)(B)(iii).
34. Social Security Act § 1860D-4(f), 42 U.S.C. 1395w-104(f).
35. Social Security Act § 1860D-4(i), 42 U.S.C. 1395w-104(i).
36. Social Security Act § 1852(h)(3), 42 U.S.C. 1395w-22(h)(3).
37. Social Security Act § 1860D-11, 42 U.S.C. 1395w-111.
38. Social Security Act § 1860D-11(g)(5)(A)(ii), 42 U.S.C. 1395w-111(g)(5)(A)(ii).
39. Social Security Act §1860D-11(g)(5)(B)(ii), 42 U.S.C. 1395w-11(g)(5)(B)(ii).
40. Social Security Act § 1859(f)(5)(B)(iii), 42 U.S.C. 1395w-28(f)(5)(B)(iii).
41. Social Security Act § 1866B(f), 42 U.S.C. 1395cc-2(f).
42. Social Security Act § 1866C, 42 U.S.C. 1395cc-3.
43. Social Security Act § 1866C(b), 42 U.S.C. 1395cc-3(b).
44. Social Security Act § 1866C(b)(1), 42 U.S.C. 1395cc-3(b)(1).
45. Social Security Act § 1866C(b)(3), 42 U.S.C. 1395cc-3(b)(3).
46. Social Security Act § 1866C(b)(4), 42 U.S.C. 1395cc-3(b)(4).
47. Social Security Act § 1866C(b)(5), 42 U.S.C. 1395cc-3(b)(5).
48. Social Security Act § 1866C(b)(6), 42 U.S.C. 1395cc-3(b)(6).
49. Social Security Act § 1866C(d)(2), 42 U.S.C. 1395cc-3(d)(2).
50. Social Security Act § 1866C(d)(2)(A), 42 U.S.C. 1395cc-3(d)(2)(A).
51. Social Security Act § 1866C(d)(2)(B), 42 U.S.C. 1395cc-3(d)(2)(B).
52. Social Security Act § 1866C(d)(2)(C), 42 U.S.C. 1395cc-3(d)(2)(C).
53. Social Security Act § 1866C(d)(2)(D), 42 U.S.C. 1395cc-3(d)(2)(D).
54. Social Security Act § 1866C(h)(1), 42 U.S.C. 1395cc-3(h)(1).
55. Social Security Act § 1866C(h)(2), 42 U.S.C. 1395cc-3(h)(2).
56. Social Security Act § 1866C(h)(3), 42 U.S.C. 1395cc-3(h)(3).
57. Social Security Act § 1866D, 42 U.S.C. 1395cc-4.
58. Episode of care is defined in Social Security Act § 1866D(a)(2)(D), 42 U.S.C. 1395cc-4(a)(2)(D).
59. “Applicable beneficiary” is defined as an individual who is admitted to a hospital for an applicable condition and is entitled to, or enrolled for, benefits under part A and enrolled for benefits under part B, but not enrolled under part C or a PACE program. Social Security Act § 1866D(a)(2)(A), 42 U.S.C. 1395cc-4(a)(2)(A). “Applicable condition” means 1 or more of 10 conditions selected by the Secretary. Social Security Act § 1866D(a)(2)(B), 42 U.S.C. 1395cc-4(a)(2)(A).
60. “Applicable services” is defined in Social Security Act § 1866D(a)(2)(C), 42 U.S.C. 1395cc-4(a)(2)(C).
61. Social Security Act § 1866D(c)(3)(B), 42 U.S.C. 1395cc-4(c)(3)(B).
62. Social Security Act § 1866D(c)(4)(A), 42 U.S.C. 1395cc-4(c)(4)(A).
63. Social Security Act § 1866D(c)(4)(A)(i), 42 U.S.C. 1395cc-4(c)(4)(A)(i).
64. “Medicare Prescription Drug Coverage,” Available at: http://www.medicare.gov/navigation/medicare-basics/medicare-benefits/part-d.aspx.
65. Social Security Act § 1860D-1, 42 U.S.C. 1395w-101.
66. Social Security Act § 1860D-1(b)(4)(A), 42 U.S.C. 1395w-101(b)(4)(A).
67. Social Security Act § 1860D-4, 42 U.S.C. 1395w-104.
68. Social Security Act § 1860D-4(c)(1)(A), 42 U.S.C. 1395w-104(c)(1)(A).
69. Social Security Act § 1860D-4(c)(1)(B), 42 U.S.C. 1395w-104(c)(1)(B).
70. Social Security Act § 1860D-4(c)(1)(C), 42 U.S.C. 1395w-104(c)(1)(C).
71. Social Security Act § 1860D-4(c)(1)(D), 42 U.S.C. 1395w-104(c)(1)(D).
72. A targeted beneficiary is one who has multiple chronic diseases, is taking multiple covered part D drugs and is identified as likely to incur annual costs that exceed a level specified by the Secretary (Social Security Act § 1860D-4(c)(2)(A)(ii), 42 U.S.C. 1395w-104(c)(2)(A)(ii)).
73. Social Security Act § 1860D-4(c)(2)(A)(i), 42 U.SC. 1395w-104(c)(2)(A)(i).
74. Social Security Act § 1860D-4(c)(2)(B)(iii), 42 U.S.C. 1395w-104(c)(2)(B)(iii).
75. Social Security Act § 1860D-4(c)(2)(C)(i), 42 U.S.C. 1395w-104(c)(2)(C)(i).
76. Social Security Act § 1860D-4(c)(2)(C)(ii), 42 U.S.C. 1395w-104(c)(2)(C)(ii).
77. Social Security Act § 1860D-4(c)(2)(D), 42 U.S.C. 1395w-104(c)(2)(D).
78. Social Security Act § 1860D-4(c)(2)(F), 42 U.S.C. 1395w-104(c)(2)(F).
79. Social Security Act § 1860D-4(e)(1), 42 U.S.C. 1395w-104(e)(1).
80. Social Security Act § 1860D-4(e)(2)(B), 42 U.S.C. 1395w-104(e)(2)(B).
81. Social Security Act § 1860D-4(e)(3)(A), 42 U.S.C. 1395w-104(e)(3)(A).
82. Social Security Act § 1860D-4(e)(3)(B)(i), 42 U.S.C. 1395w-104(e)(3)(B)(i).
83. Social Security Act § 1860D-4(e)(3)(B)(ii), 42 U.S.C. 1395w-104(e)(3)(B)(ii).
84. Social Security Act §1860D-4(e)(3)(B)(iii), 42 U.S.C. 1395w-104(e)(3)(B)(iii).
85. Social Security Act § 1860D-4(f), 42 U.S.C. 1395w-104(f).
86. Social Security Act § 1860D-4(i), 42 U.S.C. 1395w-104(i).
87. Social Security Act § 1852(h)(3), 42 U.S.C. 1395w-22(h)(3).
88. Social Security Act § 1860D-11, 42 U.S.C. 1395w-111.
89. Social Security Act § 1860D-11(g)(5)(A)(ii), 42 U.S.C. 1395w-111(g)(5)(A)(ii).
90. Social Security Act §1860D-11(g)(5)(B)(ii), 42 U.S.C. 1395w-11(g)(5)(B)(ii).
91. Social Security Act § 1859(f)(5)(B)(iii), 42 U.S.C. 1395w-28(f)(5)(B)(iii).
92. “Medicare Prescription Drug Coverage,” Available at: http://www.medicare.gov/navigation/medicare-basics/medicare-benefits/part-d.aspx.
93. Social Security Act § 1860D-1, 42 U.S.C. 1395w-101.
94. Social Security Act § 1860D-1(b)(4)(A), 42 U.S.C. 1395w-101(b)(4)(A).
95. Social Security Act § 1860D-4, 42 U.S.C. 1395w-104.
96. Social Security Act § 1860D-4(c)(1)(A), 42 U.S.C. 1395w-104(c)(1)(A).
97. Social Security Act § 1860D-4(c)(1)(B), 42 U.S.C. 1395w-104(c)(1)(B).
98. Social Security Act § 1860D-4(c)(1)(C), 42 U.S.C. 1395w-104(c)(1)(C).
99. Social Security Act § 1860D-4(c)(1)(D), 42 U.S.C. 1395w-104(c)(1)(D).
100. A targeted beneficiary is one who has multiple chronic diseases, is taking multiple covered part D drugs and is identified as likely to incur annual costs that exceed a level specified by the Secretary (Social Security Act § 1860D-4(c)(2)(A)(ii), 42 U.S.C. 1395w-104(c)(2)(A)(ii)).
101. Social Security Act § 1860D-4(c)(2)(A)(i), 42 U.SC. 1395w-104(c)(2)(A)(i).
102. Social Security Act § 1860D-4(c)(2)(B)(iii), 42 U.S.C. 1395w-104(c)(2)(B)(iii).
103. Social Security Act § 1860D-4(c)(2)(C)(i), 42 U.S.C. 1395w-104(c)(2)(C)(i).
104. Social Security Act § 1860D-4(c)(2)(C)(ii), 42 U.S.C. 1395w-104(c)(2)(C)(ii).
105. Social Security Act § 1860D-4(c)(2)(D), 42 U.S.C. 1395w-104(c)(2)(D).
106. Social Security Act § 1860D-4(c)(2)(F), 42 U.S.C. 1395w-104(c)(2)(F).
107. Social Security Act § 1860D-4(e)(1), 42 U.S.C. 1395w-104(e)(1).
108. Social Security Act § 1860D-4(e)(2)(B), 42 U.S.C. 1395w-104(e)(2)(B).
109. Social Security Act § 1860D-4(e)(3)(A), 42 U.S.C. 1395w-104(e)(3)(A).
110. Social Security Act § 1860D-4(e)(3)(B)(i), 42 U.S.C. 1395w-104(e)(3)(B)(i).
111. Social Security Act § 1860D-4(e)(3)(B)(ii), 42 U.S.C. 1395w-104(e)(3)(B)(ii).
112. Social Security Act §1860D-4(e)(3)(B)(iii), 42 U.S.C. 1395w-104(e)(3)(B)(iii).
113. Social Security Act § 1860D-4(f), 42 U.S.C. 1395w-104(f).
114. Social Security Act § 1860D-4(i), 42 U.S.C. 1395w-104(i).
115. Social Security Act § 1852(h)(3), 42 U.S.C. 1395w-22(h)(3).
116. Social Security Act § 1860D-11, 42 U.S.C. 1395w-111.
117. Social Security Act § 1860D-11(g)(5)(A)(ii), 42 U.S.C. 1395w-111(g)(5)(A)(ii).
118. Social Security Act §1860D-11(g)(5)(B)(ii), 42 U.S.C. 1395w-11(g)(5)(B)(ii).
119. Social Security Act § 1859(f)(5)(B)(iii), 42 U.S.C. 1395w-28(f)(5)(B)(iii).
120. Social Security Act § 1866B(f), 42 U.S.C. 1395cc-2(f).
121. Social Security Act § 1866C, 42 U.S.C. 1395cc-3.
122. Social Security Act § 1866C(b), 42 U.S.C. 1395cc-3(b).
123. Social Security Act § 1866C(b)(1), 42 U.S.C. 1395cc-3(b)(1).
124. Social Security Act § 1866C(b)(3), 42 U.S.C. 1395cc-3(b)(3).
125. Social Security Act § 1866C(b)(4), 42 U.S.C. 1395cc-3(b)(4).
126. Social Security Act § 1866C(b)(5), 42 U.S.C. 1395cc-3(b)(5).
127. Social Security Act § 1866C(b)(6), 42 U.S.C. 1395cc-3(b)(6).
128. Social Security Act § 1866C(d)(2), 42 U.S.C. 1395cc-3(d)(2).
129. Social Security Act § 1866C(d)(2)(A), 42 U.S.C. 1395cc-3(d)(2)(A).
130. Social Security Act § 1866C(d)(2)(B), 42 U.S.C. 1395cc-3(d)(2)(B).
131. Social Security Act § 1866C(d)(2)(C), 42 U.S.C. 1395cc-3(d)(2)(C).
132. Social Security Act § 1866C(d)(2)(D), 42 U.S.C. 1395cc-3(d)(2)(D).
133. Social Security Act § 1866C(h)(1), 42 U.S.C. 1395cc-3(h)(1).
134. Social Security Act § 1866C(h)(2), 42 U.S.C. 1395cc-3(h)(2).
135. Social Security Act § 1866C(h)(3), 42 U.S.C. 1395cc-3(h)(3).
136. Social Security Act § 1866D, 42 U.S.C. 1395cc-4.
137. Episode of care is defined in Social Security Act § 1866D(a)(2)(D), 42 U.S.C. 1395cc-4(a)(2)(D).
138. “Applicable beneficiary” is defined as an individual who is admitted to a hospital for an applicable condition and is entitled to, or enrolled for, benefits under part A and enrolled for benefits under part B, but not enrolled under part C or a PACE program. Social Security Act § 1866D(a)(2)(A), 42 U.S.C. 1395cc-4(a)(2)(A). “Applicable condition” means 1 or more of 10 conditions selected by the Secretary. Social Security Act § 1866D(a)(2)(B), 42 U.S.C. 1395cc-4(a)(2)(A).
139. “Applicable services” is defined in Social Security Act § 1866D(a)(2)(C), 42 U.S.C. 1395cc-4(a)(2)(C).
140. Social Security Act § 1866D(c)(3)(B), 42 U.S.C. 1395cc-4(c)(3)(B).
141. Social Security Act § 1866D(c)(4)(A), 42 U.S.C. 1395cc-4(c)(4)(A).
142. Social Security Act § 1866D(c)(4)(A)(i), 42 U.S.C. 1395cc-4(c)(4)(A)(i).
143. Social Security Act § 1866D(c)(4)(A)(ii), 42 U.S.C. 1395cc-4(c)(4)(A)(ii).
144. Social Security Act § 1866D(c)(4)(A)(iv), 42 U.S.C. 1395cc-4(c)(4)(A)(iv).
145. Social Security Act § 1866D(c)(4)(A)(v), 42 U.S.C. 1395cc-4(c)(4)(A)(v).
146. Social Security Act § 1866D(c)(4)(A)(vii), 42 U.S.C. 1395cc-4(c)(4)(A)(vii).
147. Social Security Act § 1866D(c)(4)(A)(viii), 42 U.S.C. 1395cc-4(c)(4)(A)(viii).
148. Social Security Act § 1866D(c)(4)(B)(i), 42 U.S.C. 1395cc-4(c)(4)(B)(i).
149. Social Security Act s 1866D(c)(4)(B)(ii), 42 U.S.C. 1395cc-4(c)(4)(B)(ii).
150. Social Security Act § 1866D(e)(1), 42 U.S.C. 1395cc-4(e)(1).
151. Social Security Act § 1866D(e)(1)(A), 42 U.S.C. 1395cc-4(e)(1)(A).
152. Social Security Act § 1866D(e)(1)(B), 42 U.S.C. 1395cc-4(e)(1)(B).
153. Social Security Act § 1866D(e)(1)(C), 42 U.S.C. 1395cc-4(e)(1)(C).
154. Social Security Act § 1866D(e)(2)(A), 42 U.S.C. 1395cc-4(e)(2)(A).
155. Social Security Act § 1866D(e)(2)(B), 42 U.S.C. 1395cc-4(e)(2)(B).
156. Social Security Act § 1866E, 42 U.S.C. 1395cc-5.
157. “Applicable beneficiary” is defined in Social Security Act § 1866E(d)(1), 42 U.S.C. 1395cc-5(d)(1).
158. Social Security Act § 1866E(a)(1), 42 U.S.C. 1395cc-5(a)(1).
159. Social Security Act § 1866E(a)(2), 42 U.S.C. 1395cc-5(a)(2).
160. Social Security Act § 1866E(a)(2)(A), 42 U.S.C. 1395cc-5(a)(2)(A).
161. Social Security Act § 1866E(a)(2)(B), 42 U.S.C. 1395cc-5(a)(2)(B).
162. Social Security Act § 1866E(a)(2)(C), 42 U.S.C. 1395cc-5(a)(2)(C).
163. “Medicare Prescription Drug Coverage,” Available at: http://www.medicare.gov/navigation/medicare-basics/medicare-benefits/part-d.aspx.
164. Social Security Act § 1860D-1, 42 U.S.C. 1395w-101.
165. Social Security Act § 1860D-1(b)(4)(A), 42 U.S.C. 1395w-101(b)(4)(A).
166. Social Security Act § 1860D-4, 42 U.S.C. 1395w-104.
167. Social Security Act § 1860D-4(c)(1)(A), 42 U.S.C. 1395w-104(c)(1)(A).
168. Social Security Act § 1860D-4(c)(1)(B), 42 U.S.C. 1395w-104(c)(1)(B).
169. Social Security Act § 1860D-4(c)(1)(C), 42 U.S.C. 1395w-104(c)(1)(C).
170. Social Security Act § 1860D-4(c)(1)(D), 42 U.S.C. 1395w-104(c)(1)(D).
171. A targeted beneficiary is one who has multiple chronic diseases, is taking multiple covered part D drugs and is identified as likely to incur annual costs that exceed a level specified by the Secretary (Social Security Act § 1860D-4(c)(2)(A)(ii), 42 U.S.C. 1395w-104(c)(2)(A)(ii)).
172. Social Security Act § 1860D-4(c)(2)(A)(i), 42 U.SC. 1395w-104(c)(2)(A)(i).
173. Social Security Act § 1860D-4(c)(2)(B)(iii), 42 U.S.C. 1395w-104(c)(2)(B)(iii).
174. Social Security Act § 1860D-4(c)(2)(C)(i), 42 U.S.C. 1395w-104(c)(2)(C)(i).
175. Social Security Act § 1860D-4(c)(2)(C)(ii), 42 U.S.C. 1395w-104(c)(2)(C)(ii).
176. Social Security Act § 1860D-4(c)(2)(D), 42 U.S.C. 1395w-104(c)(2)(D).
177. Social Security Act § 1860D-4(c)(2)(F), 42 U.S.C. 1395w-104(c)(2)(F).
178. Social Security Act § 1860D-4(e)(1), 42 U.S.C. 1395w-104(e)(1).
179. Social Security Act § 1860D-4(e)(2)(B), 42 U.S.C. 1395w-104(e)(2)(B).
180. Social Security Act § 1860D-4(e)(3)(A), 42 U.S.C. 1395w-104(e)(3)(A).
181. Social Security Act § 1860D-4(e)(3)(B)(i), 42 U.S.C. 1395w-104(e)(3)(B)(i).
182. Social Security Act § 1860D-4(e)(3)(B)(ii), 42 U.S.C. 1395w-104(e)(3)(B)(ii).
183. Social Security Act §1860D-4(e)(3)(B)(iii), 42 U.S.C. 1395w-104(e)(3)(B)(iii).
184. Social Security Act § 1860D-4(f), 42 U.S.C. 1395w-104(f).
185. Social Security Act § 1860D-4(i), 42 U.S.C. 1395w-104(i).
186. Social Security Act § 1852(h)(3), 42 U.S.C. 1395w-22(h)(3).
187. Social Security Act § 1860D-11, 42 U.S.C. 1395w-111.
188. Social Security Act § 1860D-11(g)(5)(A)(ii), 42 U.S.C. 1395w-111(g)(5)(A)(ii).
189. Social Security Act §1860D-11(g)(5)(B)(ii), 42 U.S.C. 1395w-11(g)(5)(B)(ii).
190. Social Security Act § 1859(f)(5)(B)(iii), 42 U.S.C. 1395w-28(f)(5)(B)(iii).
191. “Medicare Prescription Drug Coverage,” Available at: http://www.medicare.gov/navigation/medicare-basics/medicare-benefits/part-d.aspx.
192. Social Security Act § 1860D-1, 42 U.S.C. 1395w-101.
193. Social Security Act § 1860D-1(b)(4)(A), 42 U.S.C. 1395w-101(b)(4)(A).
194. Social Security Act § 1860D-4, 42 U.S.C. 1395w-104.
195. Social Security Act § 1860D-4(c)(1)(A), 42 U.S.C. 1395w-104(c)(1)(A).
196. Social Security Act § 1860D-4(c)(1)(B), 42 U.S.C. 1395w-104(c)(1)(B).
197. Social Security Act § 1860D-4(c)(1)(C), 42 U.S.C. 1395w-104(c)(1)(C).
198. Social Security Act § 1860D-4(c)(1)(D), 42 U.S.C. 1395w-104(c)(1)(D).
199. A targeted beneficiary is one who has multiple chronic diseases, is taking multiple covered part D drugs and is identified as likely to incur annual costs that exceed a level specified by the Secretary (Social Security Act § 1860D-4(c)(2)(A)(ii), 42 U.S.C. 1395w-104(c)(2)(A)(ii)).
200. Social Security Act § 1860D-4(c)(2)(A)(i), 42 U.SC. 1395w-104(c)(2)(A)(i).
201. Social Security Act § 1860D-4(c)(2)(B)(iii), 42 U.S.C. 1395w-104(c)(2)(B)(iii).
202. Social Security Act § 1860D-4(c)(2)(C)(i), 42 U.S.C. 1395w-104(c)(2)(C)(i).
203. Social Security Act § 1860D-4(c)(2)(C)(ii), 42 U.S.C. 1395w-104(c)(2)(C)(ii).
204. Social Security Act § 1860D-4(c)(2)(D), 42 U.S.C. 1395w-104(c)(2)(D).
205. Social Security Act § 1860D-4(c)(2)(F), 42 U.S.C. 1395w-104(c)(2)(F).
206. Social Security Act § 1860D-4(e)(1), 42 U.S.C. 1395w-104(e)(1).
207. Social Security Act § 1860D-4(e)(2)(B), 42 U.S.C. 1395w-104(e)(2)(B).
208. “Medicare Prescription Drug Coverage,” Available at: http://www.medicare.gov/navigation/medicare-basics/medicare-benefits/part-d.aspx.
209. Social Security Act § 1860D-1, 42 U.S.C. 1395w-101.
210. Social Security Act § 1860D-1(b)(4)(A), 42 U.S.C. 1395w-101(b)(4)(A).
211. Social Security Act § 1860D-4, 42 U.S.C. 1395w-104.
212. Social Security Act § 1860D-4(c)(1)(A), 42 U.S.C. 1395w-104(c)(1)(A).
213. Social Security Act § 1860D-4(c)(1)(B), 42 U.S.C. 1395w-104(c)(1)(B).
214. Social Security Act § 1860D-4(c)(1)(C), 42 U.S.C. 1395w-104(c)(1)(C).
215. Social Security Act § 1860D-4(c)(1)(D), 42 U.S.C. 1395w-104(c)(1)(D).
216. A targeted beneficiary is one who has multiple chronic diseases, is taking multiple covered part D drugs and is identified as likely to incur annual costs that exceed a level specified by the Secretary (Social Security Act § 1860D-4(c)(2)(A)(ii), 42 U.S.C. 1395w-104(c)(2)(A)(ii)).
217. Social Security Act § 1860D-4(c)(2)(A)(i), 42 U.SC. 1395w-104(c)(2)(A)(i).
218. Social Security Act § 1860D-4(c)(2)(B)(iii), 42 U.S.C. 1395w-104(c)(2)(B)(iii).
219. Social Security Act § 1860D-4(c)(2)(C)(i), 42 U.S.C. 1395w-104(c)(2)(C)(i).
220. Social Security Act § 1860D-4(c)(2)(C)(ii), 42 U.S.C. 1395w-104(c)(2)(C)(ii).
221. Social Security Act § 1860D-4(c)(2)(D), 42 U.S.C. 1395w-104(c)(2)(D).
222. Social Security Act § 1860D-4(c)(2)(F), 42 U.S.C. 1395w-104(c)(2)(F).
223. “Medicare Prescription Drug Coverage,” Available at: http://www.medicare.gov/navigation/medicare-basics/medicare-benefits/part-d.aspx.
224. Social Security Act § 1860D-1, 42 U.S.C. 1395w-101.
225. Social Security Act § 1860D-1(b)(4)(A), 42 U.S.C. 1395w-101(b)(4)(A).
226. Social Security Act § 1860D-4, 42 U.S.C. 1395w-104.
227. Social Security Act § 1860D-4(c)(1)(A), 42 U.S.C. 1395w-104(c)(1)(A).
228. Social Security Act § 1860D-4(c)(1)(B), 42 U.S.C. 1395w-104(c)(1)(B).
229. Social Security Act § 1860D-4(c)(1)(C), 42 U.S.C. 1395w-104(c)(1)(C).
230. Social Security Act § 1860D-4(c)(1)(D), 42 U.S.C. 1395w-104(c)(1)(D).
231. A targeted beneficiary is one who has multiple chronic diseases, is taking multiple covered part D drugs and is identified as likely to incur annual costs that exceed a level specified by the Secretary (Social Security Act § 1860D-4(c)(2)(A)(ii), 42 U.S.C. 1395w-104(c)(2)(A)(ii)).
232. Social Security Act § 1860D-4(c)(2)(A)(i), 42 U.SC. 1395w-104(c)(2)(A)(i).
233. Social Security Act § 1860D-4(c)(2)(B)(iii), 42 U.S.C. 1395w-104(c)(2)(B)(iii).
234. Social Security Act § 1860D-4(c)(2)(C)(i), 42 U.S.C. 1395w-104(c)(2)(C)(i).
235. Social Security Act § 1860D-4(c)(2)(C)(ii), 42 U.S.C. 1395w-104(c)(2)(C)(ii).
236. Social Security Act § 1860D-4(c)(2)(D), 42 U.S.C. 1395w-104(c)(2)(D).
237. Social Security Act § 1860D-4(c)(2)(F), 42 U.S.C. 1395w-104(c)(2)(F).
238. Social Security Act § 1860D-4(e)(1), 42 U.S.C. 1395w-104(e)(1).
239. Social Security Act § 1860D-4(e)(2)(B), 42 U.S.C. 1395w-104(e)(2)(B).
240. Social Security Act § 1860D-4(e)(3)(A), 42 U.S.C. 1395w-104(e)(3)(A).
241. Social Security Act § 1860D-4(e)(3)(B)(i), 42 U.S.C. 1395w-104(e)(3)(B)(i).
242. Social Security Act § 1860D-4(e)(3)(B)(ii), 42 U.S.C. 1395w-104(e)(3)(B)(ii).
243. Social Security Act §1860D-4(e)(3)(B)(iii), 42 U.S.C. 1395w-104(e)(3)(B)(iii).
244. Social Security Act § 1860D-4(f), 42 U.S.C. 1395w-104(f).
245. Social Security Act § 1860D-4(i), 42 U.S.C. 1395w-104(i).
246. Social Security Act § 1852(h)(3), 42 U.S.C. 1395w-22(h)(3).
247. Social Security Act § 1860D-11, 42 U.S.C. 1395w-111.
248. Social Security Act § 1860D-11(g)(5)(A)(ii), 42 U.S.C. 1395w-111(g)(5)(A)(ii).
249. Social Security Act §1860D-11(g)(5)(B)(ii), 42 U.S.C. 1395w-11(g)(5)(B)(ii).
250. Social Security Act § 1859(f)(5)(B)(iii), 42 U.S.C. 1395w-28(f)(5)(B)(iii).
251. Social Security Act § 1866B(f), 42 U.S.C. 1395cc-2(f).
252. Social Security Act § 1866C, 42 U.S.C. 1395cc-3.
253. Social Security Act § 1866C(b), 42 U.S.C. 1395cc-3(b).
254. Social Security Act § 1866C(b)(1), 42 U.S.C. 1395cc-3(b)(1).
255. Social Security Act § 1866C(b)(3), 42 U.S.C. 1395cc-3(b)(3).
256. Social Security Act § 1866C(b)(4), 42 U.S.C. 1395cc-3(b)(4).
257. Social Security Act § 1866C(b)(5), 42 U.S.C. 1395cc-3(b)(5).
258. Social Security Act § 1866C(b)(6), 42 U.S.C. 1395cc-3(b)(6).
259. Social Security Act § 1866C(d)(2), 42 U.S.C. 1395cc-3(d)(2).
260. Social Security Act § 1866C(d)(2)(A), 42 U.S.C. 1395cc-3(d)(2)(A).
261. “Medicare Prescription Drug Coverage,” Available at: http://www.medicare.gov/navigation/medicare-basics/medicare-benefits/part-d.aspx.
262. Social Security Act § 1860D-1, 42 U.S.C. 1395w-101.
263. Social Security Act § 1860D-1(b)(4)(A), 42 U.S.C. 1395w-101(b)(4)(A).
264. Social Security Act § 1860D-4, 42 U.S.C. 1395w-104.
265. Social Security Act § 1860D-4(c)(1)(A), 42 U.S.C. 1395w-104(c)(1)(A).
266. Social Security Act § 1860D-4(c)(1)(B), 42 U.S.C. 1395w-104(c)(1)(B).
267. Social Security Act § 1860D-4(c)(1)(C), 42 U.S.C. 1395w-104(c)(1)(C).
268. “Medicare Prescription Drug Coverage,” Available at: http://www.medicare.gov/navigation/medicare-basics/medicare-benefits/part-d.aspx.
269. Social Security Act § 1860D-1, 42 U.S.C. 1395w-101.
270. Social Security Act § 1860D-1(b)(4)(A), 42 U.S.C. 1395w-101(b)(4)(A).
271. Social Security Act § 1860D-4, 42 U.S.C. 1395w-104.
272. Social Security Act § 1860D-4(c)(1)(A), 42 U.S.C. 1395w-104(c)(1)(A).
273. Social Security Act § 1860D-4(c)(1)(B), 42 U.S.C. 1395w-104(c)(1)(B).
274. Social Security Act § 1860D-4(c)(1)(C), 42 U.S.C. 1395w-104(c)(1)(C).
275. Social Security Act § 1860D-4(c)(1)(D), 42 U.S.C. 1395w-104(c)(1)(D).
276. A targeted beneficiary is one who has multiple chronic diseases, is taking multiple covered part D drugs and is identified as likely to incur annual costs that exceed a level specified by the Secretary (Social Security Act § 1860D-4(c)(2)(A)(ii), 42 U.S.C. 1395w-104(c)(2)(A)(ii)).
277. Social Security Act § 1860D-4(c)(2)(A)(i), 42 U.SC. 1395w-104(c)(2)(A)(i).
278. Social Security Act § 1860D-4(c)(2)(B)(iii), 42 U.S.C. 1395w-104(c)(2)(B)(iii).
279. Social Security Act § 1860D-4(c)(2)(C)(i), 42 U.S.C. 1395w-104(c)(2)(C)(i).
280. Social Security Act § 1860D-4(c)(2)(C)(ii), 42 U.S.C. 1395w-104(c)(2)(C)(ii).
281. Social Security Act § 1860D-4(c)(2)(D), 42 U.S.C. 1395w-104(c)(2)(D).
282. Social Security Act § 1860D-4(c)(2)(F), 42 U.S.C. 1395w-104(c)(2)(F).
283. Social Security Act § 1860D-4(e)(1), 42 U.S.C. 1395w-104(e)(1).
284. Social Security Act § 1860D-4(e)(2)(B), 42 U.S.C. 1395w-104(e)(2)(B).
285. Social Security Act § 1860D-4(e)(3)(A), 42 U.S.C. 1395w-104(e)(3)(A).
286. Social Security Act § 1860D-4(e)(3)(B)(i), 42 U.S.C. 1395w-104(e)(3)(B)(i).
287. Social Security Act § 1860D-4(e)(3)(B)(ii), 42 U.S.C. 1395w-104(e)(3)(B)(ii).
288. Social Security Act §1860D-4(e)(3)(B)(iii), 42 U.S.C. 1395w-104(e)(3)(B)(iii).
289. Social Security Act § 1860D-4(f), 42 U.S.C. 1395w-104(f).
290. Social Security Act § 1860D-4(i), 42 U.S.C. 1395w-104(i).
291. Social Security Act § 1852(h)(3), 42 U.S.C. 1395w-22(h)(3).
292. Social Security Act § 1860D-11, 42 U.S.C. 1395w-111.
293. Social Security Act § 1860D-11(g)(5)(A)(ii), 42 U.S.C. 1395w-111(g)(5)(A)(ii).
294. Social Security Act §1860D-11(g)(5)(B)(ii), 42 U.S.C. 1395w-11(g)(5)(B)(ii).
295. “Medicare Prescription Drug Coverage,” Available at: http://www.medicare.gov/navigation/medicare-basics/medicare-benefits/part-d.aspx.
296. Social Security Act § 1860D-1, 42 U.S.C. 1395w-101.
297. Social Security Act § 1860D-1(b)(4)(A), 42 U.S.C. 1395w-101(b)(4)(A).
298. Social Security Act § 1860D-4, 42 U.S.C. 1395w-104.
299. Social Security Act § 1860D-4(c)(1)(A), 42 U.S.C. 1395w-104(c)(1)(A).
300. Social Security Act § 1860D-4(c)(1)(B), 42 U.S.C. 1395w-104(c)(1)(B).
301. Social Security Act § 1860D-4(c)(1)(C), 42 U.S.C. 1395w-104(c)(1)(C).
302. Social Security Act § 1860D-4(c)(1)(D), 42 U.S.C. 1395w-104(c)(1)(D).
303. A targeted beneficiary is one who has multiple chronic diseases, is taking multiple covered part D drugs and is identified as likely to incur annual costs that exceed a level specified by the Secretary (Social Security Act § 1860D-4(c)(2)(A)(ii), 42 U.S.C. 1395w-104(c)(2)(A)(ii)).
304. Social Security Act § 1860D-4(c)(2)(A)(i), 42 U.SC. 1395w-104(c)(2)(A)(i).
305. Social Security Act § 1860D-4(c)(2)(B)(iii), 42 U.S.C. 1395w-104(c)(2)(B)(iii).
306. Social Security Act § 1860D-4(c)(2)(C)(i), 42 U.S.C. 1395w-104(c)(2)(C)(i).
307. Social Security Act § 1860D-4(c)(2)(C)(ii), 42 U.S.C. 1395w-104(c)(2)(C)(ii).
308. Social Security Act § 1860D-4(c)(2)(D), 42 U.S.C. 1395w-104(c)(2)(D).
309. Social Security Act § 1860D-4(c)(2)(F), 42 U.S.C. 1395w-104(c)(2)(F).
310. Social Security Act § 1860D-4(e)(1), 42 U.S.C. 1395w-104(e)(1).
311. Social Security Act § 1860D-4(e)(2)(B), 42 U.S.C. 1395w-104(e)(2)(B).
312. Social Security Act § 1860D-4(e)(3)(A), 42 U.S.C. 1395w-104(e)(3)(A).
313. Social Security Act § 1860D-4(e)(3)(B)(i), 42 U.S.C. 1395w-104(e)(3)(B)(i).
314. Social Security Act § 1860D-4(e)(3)(B)(ii), 42 U.S.C. 1395w-104(e)(3)(B)(ii).
315. Social Security Act §1860D-4(e)(3)(B)(iii), 42 U.S.C. 1395w-104(e)(3)(B)(iii).
316. Social Security Act § 1860D-4(f), 42 U.S.C. 1395w-104(f).
317. Social Security Act § 1860D-4(i), 42 U.S.C. 1395w-104(i).
318. Social Security Act § 1852(h)(3), 42 U.S.C. 1395w-22(h)(3).
319. Social Security Act § 1860D-11, 42 U.S.C. 1395w-111.
320. Social Security Act § 1860D-11(g)(5)(A)(ii), 42 U.S.C. 1395w-111(g)(5)(A)(ii).
321. Social Security Act §1860D-11(g)(5)(B)(ii), 42 U.S.C. 1395w-11(g)(5)(B)(ii).
322. Social Security Act § 1859(f)(5)(B)(iii), 42 U.S.C. 1395w-28(f)(5)(B)(iii).
323. Social Security Act § 1866B(f), 42 U.S.C. 1395cc-2(f).
324. Social Security Act § 1866C, 42 U.S.C. 1395cc-3.
325. Social Security Act § 1866C(b), 42 U.S.C. 1395cc-3(b).
326. Social Security Act § 1866C(b)(1), 42 U.S.C. 1395cc-3(b)(1).
327. Social Security Act § 1866C(b)(3), 42 U.S.C. 1395cc-3(b)(3).
328. Social Security Act § 1866C(b)(4), 42 U.S.C. 1395cc-3(b)(4).
329. Social Security Act § 1866C(b)(5), 42 U.S.C. 1395cc-3(b)(5).
330. Social Security Act § 1866C(b)(6), 42 U.S.C. 1395cc-3(b)(6).
331. Social Security Act § 1866C(d)(2), 42 U.S.C. 1395cc-3(d)(2).
332. Social Security Act § 1866C(d)(2)(A), 42 U.S.C. 1395cc-3(d)(2)(A).
333. Social Security Act § 1866C(d)(2)(B), 42 U.S.C. 1395cc-3(d)(2)(B).
334. Social Security Act § 1866C(d)(2)(C), 42 U.S.C. 1395cc-3(d)(2)(C).
335. Social Security Act § 1866C(d)(2)(D), 42 U.S.C. 1395cc-3(d)(2)(D).
336. Social Security Act § 1866C(h)(1), 42 U.S.C. 1395cc-3(h)(1).
337. Social Security Act § 1866C(h)(2), 42 U.S.C. 1395cc-3(h)(2).
338. Social Security Act § 1866C(h)(3), 42 U.S.C. 1395cc-3(h)(3).
339. Social Security Act § 1866D, 42 U.S.C. 1395cc-4.
340. Episode of care is defined in Social Security Act § 1866D(a)(2)(D), 42 U.S.C. 1395cc-4(a)(2)(D).
341. “Applicable beneficiary” is defined as an individual who is admitted to a hospital for an applicable condition and is entitled to, or enrolled for, benefits under part A and enrolled for benefits under part B, but not enrolled under part C or a PACE program. Social Security Act § 1866D(a)(2)(A), 42 U.S.C. 1395cc-4(a)(2)(A). “Applicable condition” means 1 or more of 10 conditions selected by the Secretary. Social Security Act § 1866D(a)(2)(B), 42 U.S.C. 1395cc-4(a)(2)(A).
342. “Applicable services” is defined in Social Security Act § 1866D(a)(2)(C), 42 U.S.C. 1395cc-4(a)(2)(C).
343. Social Security Act § 1866D(c)(3)(B), 42 U.S.C. 1395cc-4(c)(3)(B).
344. Social Security Act § 1866D(c)(4)(A), 42 U.S.C. 1395cc-4(c)(4)(A).
345. Social Security Act § 1866D(c)(4)(A)(i), 42 U.S.C. 1395cc-4(c)(4)(A)(i).
346. Social Security Act § 1866D(c)(4)(A)(ii), 42 U.S.C. 1395cc-4(c)(4)(A)(ii).
347. Social Security Act § 1866D(c)(4)(A)(iv), 42 U.S.C. 1395cc-4(c)(4)(A)(iv).
348. Social Security Act § 1866D(c)(4)(A)(v), 42 U.S.C. 1395cc-4(c)(4)(A)(v).
349. Social Security Act § 1866D(c)(4)(A)(vii), 42 U.S.C. 1395cc-4(c)(4)(A)(vii).
350. Social Security Act § 1866D(c)(4)(A)(viii), 42 U.S.C. 1395cc-4(c)(4)(A)(viii).
351. Social Security Act § 1866D(c)(4)(B)(i), 42 U.S.C. 1395cc-4(c)(4)(B)(i).
352. Social Security Act s 1866D(c)(4)(B)(ii), 42 U.S.C. 1395cc-4(c)(4)(B)(ii).
353. Social Security Act § 1866D(e)(1), 42 U.S.C. 1395cc-4(e)(1).
354. Social Security Act § 1866D(e)(1)(A), 42 U.S.C. 1395cc-4(e)(1)(A).
355. Social Security Act § 1866D(e)(1)(B), 42 U.S.C. 1395cc-4(e)(1)(B).
356. Social Security Act § 1866D(e)(1)(C), 42 U.S.C. 1395cc-4(e)(1)(C).
357. Social Security Act § 1866D(e)(2)(A), 42 U.S.C. 1395cc-4(e)(2)(A).
358. Social Security Act § 1866D(e)(2)(B), 42 U.S.C. 1395cc-4(e)(2)(B).
359. Social Security Act § 1866E, 42 U.S.C. 1395cc-5.
360. “Applicable beneficiary” is defined in Social Security Act § 1866E(d)(1), 42 U.S.C. 1395cc-5(d)(1).
361. Social Security Act § 1866E(a)(1), 42 U.S.C. 1395cc-5(a)(1).
362. Social Security Act § 1866E(a)(2), 42 U.S.C. 1395cc-5(a)(2).
363. Social Security Act § 1866E(a)(2)(A), 42 U.S.C. 1395cc-5(a)(2)(A).
364. Social Security Act § 1866E(a)(2)(B), 42 U.S.C. 1395cc-5(a)(2)(B).
365. Social Security Act § 1866E(a)(2)(C), 42 U.S.C. 1395cc-5(a)(2)(C).
366. Social Security Act § 1866E(a)(2)(D), 42 U.S.C. 1395cc-5(a)(2)(D).
367. Social Security Act § 1866E(a)(2)(E), 42 U.S.C. 1395cc-5(a)(2)(E).
368. Social Security Act § 1866E(a)(2)(G), 42 U.S.C. 1395cc-5(a)(2)(G).
369. “Independence at home medical practice” is defined in Social Security Act § 1866E(b)(1)(A), 42 U.S.C. 1395cc-5(b)(1)(A).
370. Social Security Act § 1866E(b)(1)(A)(vi), 42 U.S.C. 1395cc-5(b)(1)(A)(vi).
371. Social Security Act § 1866E(b), 42 U.S.C. 1395cc-5(b).
372. Social Security Act § 1866E(f)(1), 42 U.S.C. 1395cc-5(f)(1).
373. Social Security Act §1866E(f)(2), 42 U.S.C. 1395cc-5(f)(2).
374. Social Security Act § 1866E(g), 42 U.S.C. 1395cc-5(g).
375. Social Security Act § 1899, 42 U.S.C. 1395jjj.
376. Social Security Act § 1899(a)(1), 42 U.S.C. 1395jjj(a)(1).
377. Social Security Act § 1899(a)(1)(A), 42 U.S.C. 1395jjj(a)(1)(A).
378. Social Security Act § 1899(a)(1)(B), 42 U.S.C. 1395jjj(a)(1)(B).
379. Social Security Act § 1899(b)(2)(A), 42 U.S.C. 1395jjj(b)(2)(A).
380. Social Security Act § 1899(b)(2)(G), 42 U.S.C. 1395jjj(b)(2)(G).
381. Social Security Act § 1899(b)(2)(H), 42 U.S.C. 1395jjj(b)(2)(H).
382. Social Security Act § 1899(b)(3)(A), 42 U.S.C. 1395jjj(b)(3)(A).
383. Social Security Act § 1899(b)(3)(A)(i), 42 U.S.C. 1395jjj(b)(3)(A)(i).
384. Social Security Act § 1899(b)(3)(A)(ii), 42 U.S.C. 1395jjj(b)(3)(A)(ii).
385. Social Security Act § 1899(b)(3)(A)(iii), 42 U.S.C. 1395jjj(b)(3)(A)(iii).
386. Social Security Act § 1899(b)(3)(B), 42 U.S.C. 1395jjj(b)(3)(B).
387. Social Security Act § 1899(b)(3)(C), 42 U.S.C. 1395jjj(b)(3)(C).
388. Social Security Act § 1899(b)(3)(D), 42 U.S.C. 1395jjj(b)(3)(D).
389. “Medicare Prescription Drug Coverage,” Available at: http://www.medicare.gov/navigation/medicare-basics/medicare-benefits/part-d.aspx.
390. Social Security Act § 1860D-1, 42 U.S.C. 1395w-101.
391. Social Security Act § 1860D-1(b)(4)(A), 42 U.S.C. 1395w-101(b)(4)(A).
392. Social Security Act § 1860D-4, 42 U.S.C. 1395w-104.
393. Social Security Act § 1860D-4(c)(1)(A), 42 U.S.C. 1395w-104(c)(1)(A).
394. Social Security Act § 1860D-4(c)(1)(B), 42 U.S.C. 1395w-104(c)(1)(B).
395. Social Security Act § 1860D-4(c)(1)(C), 42 U.S.C. 1395w-104(c)(1)(C).
396. Social Security Act § 1860D-4(c)(1)(D), 42 U.S.C. 1395w-104(c)(1)(D).
397. A targeted beneficiary is one who has multiple chronic diseases, is taking multiple covered part D drugs and is identified as likely to incur annual costs that exceed a level specified by the Secretary (Social Security Act § 1860D-4(c)(2)(A)(ii), 42 U.S.C. 1395w-104(c)(2)(A)(ii)).
398. Social Security Act § 1860D-4(c)(2)(A)(i), 42 U.SC. 1395w-104(c)(2)(A)(i).
399. Social Security Act § 1860D-4(c)(2)(B)(iii), 42 U.S.C. 1395w-104(c)(2)(B)(iii).
400. Social Security Act § 1860D-4(c)(2)(C)(i), 42 U.S.C. 1395w-104(c)(2)(C)(i).
401. Social Security Act § 1860D-4(c)(2)(C)(ii), 42 U.S.C. 1395w-104(c)(2)(C)(ii).
402. Social Security Act § 1860D-4(c)(2)(D), 42 U.S.C. 1395w-104(c)(2)(D).
403. Social Security Act § 1860D-4(c)(2)(F), 42 U.S.C. 1395w-104(c)(2)(F).
404. Social Security Act § 1860D-4(e)(1), 42 U.S.C. 1395w-104(e)(1).
405. Social Security Act § 1860D-4(e)(2)(B), 42 U.S.C. 1395w-104(e)(2)(B).
406. Social Security Act § 1860D-4(e)(3)(A), 42 U.S.C. 1395w-104(e)(3)(A).
407. Social Security Act § 1860D-4(e)(3)(B)(i), 42 U.S.C. 1395w-104(e)(3)(B)(i).
408. Social Security Act § 1860D-4(e)(3)(B)(ii), 42 U.S.C. 1395w-104(e)(3)(B)(ii).
409. Social Security Act §1860D-4(e)(3)(B)(iii), 42 U.S.C. 1395w-104(e)(3)(B)(iii).
410. Social Security Act § 1860D-4(f), 42 U.S.C. 1395w-104(f).
411. Social Security Act § 1860D-4(i), 42 U.S.C. 1395w-104(i).
412. Social Security Act § 1852(h)(3), 42 U.S.C. 1395w-22(h)(3).
413. Social Security Act § 1860D-11, 42 U.S.C. 1395w-111.
414. Social Security Act § 1860D-11(g)(5)(A)(ii), 42 U.S.C. 1395w-111(g)(5)(A)(ii).
415. Social Security Act §1860D-11(g)(5)(B)(ii), 42 U.S.C. 1395w-11(g)(5)(B)(ii).
416. Social Security Act § 1859(f)(5)(B)(iii), 42 U.S.C. 1395w-28(f)(5)(B)(iii).
417. “Medicare Prescription Drug Coverage,” Available at: http://www.medicare.gov/navigation/medicare-basics/medicare-benefits/part-d.aspx.
418. Social Security Act § 1860D-1, 42 U.S.C. 1395w-101.
419. Social Security Act § 1860D-1(b)(4)(A), 42 U.S.C. 1395w-101(b)(4)(A).
420. Social Security Act § 1860D-4, 42 U.S.C. 1395w-104.
421. Social Security Act § 1860D-4(c)(1)(A), 42 U.S.C. 1395w-104(c)(1)(A).
422. Social Security Act § 1860D-4(c)(1)(B), 42 U.S.C. 1395w-104(c)(1)(B).
423. Social Security Act § 1860D-4(c)(1)(C), 42 U.S.C. 1395w-104(c)(1)(C).
424. Social Security Act § 1860D-4(c)(1)(D), 42 U.S.C. 1395w-104(c)(1)(D).
425. A targeted beneficiary is one who has multiple chronic diseases, is taking multiple covered part D drugs and is identified as likely to incur annual costs that exceed a level specified by the Secretary (Social Security Act § 1860D-4(c)(2)(A)(ii), 42 U.S.C. 1395w-104(c)(2)(A)(ii)).
426. Social Security Act § 1860D-4(c)(2)(A)(i), 42 U.SC. 1395w-104(c)(2)(A)(i).
427. Social Security Act § 1860D-4(c)(2)(B)(iii), 42 U.S.C. 1395w-104(c)(2)(B)(iii).
428. Social Security Act § 1860D-4(c)(2)(C)(i), 42 U.S.C. 1395w-104(c)(2)(C)(i).
429. Social Security Act § 1860D-4(c)(2)(C)(ii), 42 U.S.C. 1395w-104(c)(2)(C)(ii).
430. Social Security Act § 1860D-4(c)(2)(D), 42 U.S.C. 1395w-104(c)(2)(D).
431. Social Security Act § 1860D-4(c)(2)(F), 42 U.S.C. 1395w-104(c)(2)(F).
432. Social Security Act § 1860D-4(e)(1), 42 U.S.C. 1395w-104(e)(1).
433. Social Security Act § 1860D-4(e)(2)(B), 42 U.S.C. 1395w-104(e)(2)(B).
434. Social Security Act § 1860D-4(e)(3)(A), 42 U.S.C. 1395w-104(e)(3)(A).
435. Social Security Act § 1860D-4(e)(3)(B)(i), 42 U.S.C. 1395w-104(e)(3)(B)(i).
436. Social Security Act § 1860D-4(e)(3)(B)(ii), 42 U.S.C. 1395w-104(e)(3)(B)(ii).
437. Social Security Act §1860D-4(e)(3)(B)(iii), 42 U.S.C. 1395w-104(e)(3)(B)(iii).
438. Social Security Act § 1860D-4(f), 42 U.S.C. 1395w-104(f).
439. Social Security Act § 1860D-4(i), 42 U.S.C. 1395w-104(i).
440. Social Security Act § 1852(h)(3), 42 U.S.C. 1395w-22(h)(3).
441. Social Security Act § 1860D-11, 42 U.S.C. 1395w-111.
442. Social Security Act § 1860D-11(g)(5)(A)(ii), 42 U.S.C. 1395w-111(g)(5)(A)(ii).
443. Social Security Act §1860D-11(g)(5)(B)(ii), 42 U.S.C. 1395w-11(g)(5)(B)(ii).

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