115 S963 IS: Social Impact Partnerships to Pay for Results Act
U.S. Senate
2017-04-27
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

		II
		115th CONGRESS1st Session
		S. 963
		IN THE SENATE OF THE UNITED STATES

			April 27, 2017
			Mr. Young (for himself, Mr. Bennet, Ms. Collins, and Mr. Booker) introduced the following bill; which was read twice and referred to the Committee on Finance

		A BILL
		To encourage and support partnerships between the public and private sectors to improve our
			 Nation’s social programs, and for other purposes.

		1.Short title
 This Act may be cited as the Social Impact Partnerships to Pay for Results Act.
 2.Social Impact Partnerships to Pay for ResultsTitle XX of the Social Security Act (42 U.S.C. 1397 et seq.) is amended— (1)in the title heading, by striking to States and inserting and Programs for; and
 (2)by adding at the end the following new subtitle:

					CSocial Impact Partnerships
 2051.PurposesThe purposes of this subtitle are the following: (1)To improve the lives of families and individuals in need in the United States by funding social programs that achieve real results.
 (2)To redirect funds away from programs that, based on objective data, are ineffective, and into programs that achieve demonstrable, measurable results.
 (3)To ensure Federal funds are used effectively on social services to produce positive outcomes for both service recipients and taxpayers.
 (4)To establish the use of social impact partnerships to address some of our Nation’s most pressing problems.
 (5)To facilitate the creation of public-private partnerships that bundle philanthropic or other private resources with existing public spending to scale up effective social interventions already being implemented by private organizations, nonprofits, charitable organizations, and State and local governments across the country.
 (6)To bring pay-for-performance to the social sector, allowing the United States to improve the impact and effectiveness of vital social services programs while redirecting inefficient or duplicative spending.
 (7)To incorporate outcomes measurement and randomized controlled trials or other rigorous methodologies for assessing program impact.
							2052.Social impact partnership application
 (a)NoticeNot later than 1 year after the date of the enactment of this subtitle, the Secretary, in consultation with the Federal Interagency Council on Social Impact Partnerships, shall publish in the Federal Register a request for proposals from States or local governments for social impact partnership projects in accordance with this section.
 (b)Required outcomes for social impact partnership projectTo qualify as a social impact partnership project under this subtitle, a project must produce one or more measurable, clearly defined outcomes that result in social benefit and Federal savings through any of the following:
 (1)Increasing work and earnings by individuals in the United States who are unemployed for more than 6 consecutive months.
 (2)Increasing employment and earnings of individuals who have attained 16 years of age but not 25 years of age.
 (3)Increasing employment among individuals receiving Federal disability benefits. (4)Reducing the dependence of low-income families on Federal means-tested benefits.
 (5)Improving rates of high school graduation. (6)Reducing teen and unplanned pregnancies.
 (7)Improving birth outcomes and early childhood health and development among low-income families and individuals.
 (8)Reducing rates of asthma, diabetes, or other preventable diseases among low-income families and individuals to reduce the utilization of emergency and other high-cost care.
 (9)Increasing the proportion of children living in two-parent families. (10)Reducing incidences and adverse consequences of child abuse and neglect.
 (11)Reducing the number of youth in foster care by increasing adoptions, permanent guardianship arrangements, reunifications, or placements with a fit and willing relative, or by avoiding placing children in foster care by ensuring they can be cared for safely in their own homes.
 (12)Reducing the number of children and youth in foster care residing in group homes, child care institutions, agency-operated foster homes, or other non-family foster homes, unless it is determined that it is in the interest of the child’s long-term health, safety, or psychological well-being to not be placed in a family foster home.
 (13)Reducing the number of children returning to foster care. (14)Reducing recidivism among juvenile offenders, individuals released from prison, or other high-risk populations.
 (15)Reducing the rate of homelessness among our most vulnerable populations. (16)Improving the health and well-being of those with mental, emotional, and behavioral health needs.
 (17)Improving the educational outcomes of special-needs or low-income children. (18)Improving the employment and well-being of returning United States military members.
 (19)Increasing the financial stability of low-income families. (20)Increasing the independence and employability of individuals who are physically or mentally disabled.
 (21)Other measurable outcomes defined by the State or local government that result in positive social outcomes and Federal savings.
 (c)Application requiredThe notice described in subsection (a) shall require a State or local government to submit an application for the social impact partnership project that addresses the following:
 (1)The outcome goals of the project. (2)A description of each intervention in the project and anticipated outcomes of the intervention.
 (3)Rigorous evidence demonstrating that the intervention can be expected to produce the desired outcomes.
 (4)The target population that will be served by the project. (5)The expected social benefits to participants who receive the intervention and others who may be impacted.
 (6)Projected Federal, State, and local government costs and other costs to conduct the project. (7)Projected Federal, State, and local government savings and other savings, including an estimate of the savings to the Federal Government, on a program-by-program basis and in the aggregate, if the project is implemented and the outcomes are achieved as a result of the intervention.
 (8)If savings resulting from the successful completion of the project are estimated to accrue to the State or local government, the likelihood of the State or local government to realize those savings.
 (9)A plan for delivering the intervention through a social impact partnership model. (10)A description of the expertise of each service provider that will administer the intervention, including a summary of the experience of the service provider in delivering the proposed intervention or a similar intervention, or demonstrating that the service provider has the expertise necessary to deliver the proposed intervention.
 (11)An explanation of the experience of the State or local government, the intermediary, or the service provider in raising private and philanthropic capital to fund social service investments.
 (12)The detailed roles and responsibilities of each entity involved in the project, including any State or local government entity, intermediary, service provider, independent evaluator, investor, or other stakeholder.
 (13)A summary of the experience of the service provider in delivering the proposed intervention or a similar intervention, or a summary demonstrating the service provider has the expertise necessary to deliver the proposed intervention.
 (14)A summary of the unmet need in the area where the intervention will be delivered or among the target population who will receive the intervention.
 (15)The proposed payment terms, the methodology used to calculate outcome payments, the payment schedule, and performance thresholds.
 (16)The project budget. (17)The project timeline.
 (18)The criteria used to determine the eligibility of an individual for the project, including how selected populations will be identified, how they will be referred to the project, and how they will be enrolled in the project.
 (19)The evaluation design. (20)The metrics that will be used in the evaluation to determine whether the outcomes have been achieved as a result of the intervention and how the metrics will be measured.
 (21)An explanation of how the metrics used in the evaluation to determine whether the outcomes achieved as a result of the intervention are independent, objective indicators of impact and are not subject to manipulation by the service provider, intermediary, or investor.
 (22)A summary explaining the independence of the evaluator from the other entities involved in the project and the evaluator’s experience in conducting rigorous evaluations of program effectiveness including, where available, well-implemented randomized controlled trials on the intervention or similar interventions.
 (23)Any potential payment disputes related to the outcomes of the evaluation. (24)The capacity of the service provider to deliver the intervention to the number of participants the State or local government proposes to serve in the project.
 (25)A description of whether and how the State or local government and service providers plan to sustain the intervention, if it is timely and appropriate to do so, to ensure that successful interventions continue to operate after the period of the social impact partnership.
 (d)Project intermediary information requiredThe application described in subsection (c) shall also contain the following information about any intermediary for the social impact partnership project (whether an intermediary is a service provider or other entity):
 (1)Experience and capacity for providing or facilitating the provision of the type of intervention proposed.
 (2)The mission and goals. (3)Information on whether the intermediary is already working with service providers that provide this intervention or an explanation of the capacity of the intermediary to begin working with service providers to provide the intervention.
 (4)Experience working in a collaborative environment across government and nongovernmental entities. (5)Previous experience collaborating with public or private entities to implement evidence-based programs.
 (6)Ability to raise or provide funding to cover operating costs (if applicable to the project). (7)Capacity and infrastructure to track outcomes and measure results, including—
 (A)capacity to track and analyze program performance and assess program impact; and (B)experience with performance-based awards or performance-based contracting and achieving project milestones and targets.
 (8)Role in delivering the intervention. (9)How the intermediary would monitor program success, including a description of the interim benchmarks and outcome measures.
 (e)Feasibility studies funded through other sourcesThe notice described in subsection (a) shall permit a State or local government to submit an application for social impact partnership funding that contains information from a feasibility study developed for purposes other than applying for funding under this subtitle.
							2053.Awarding social impact partnership agreements
 (a)Timeline in awarding agreementNot later than 6 months after receiving an application in accordance with section 2052, the Secretary, in consultation with the Federal Interagency Council on Social Impact Partnerships, shall determine whether to enter into an agreement for a social impact partnership project with a State or local government.
 (b)Considerations in awarding agreementIn determining whether to enter into an agreement for a social impact partnership project (the application for which was submitted under section 2052) the Secretary, in consultation with the Federal Interagency Council on Social Impact Partnerships (established by section 2056) and the head of any Federal agency administering a similar intervention or serving a population similar to that served by the project, shall consider each of the following:
 (1)The recommendations made by the Commission on Social Impact Partnerships. (2)The value to the Federal Government of the outcomes expected to be achieved if the outcomes specified in the agreement are achieved as a result of the intervention.
 (3)The likelihood, based on evidence provided in the application and other evidence, that the State or local government in collaboration with the intermediary and the service providers will achieve the outcomes.
 (4)The savings to the Federal Government if the outcomes specified in the agreement are achieved as a result of the intervention.
 (5)The savings to the State and local governments if the outcomes specified in the agreement are achieved as a result of the intervention.
 (6)The expected quality of the evaluation that would be conducted with respect to the agreement. (7)The capacity and commitment of the State or local government to sustain the intervention, if appropriate and timely and if the intervention is successful, beyond the period of the social impact partnership.
								(c)Agreement authority
 (1)Agreement requirementsThe Secretary, in consultation with the Federal Interagency Council on Social Impact Partnerships and the head of any Federal agency administering a similar intervention or serving a population similar to that served by the project, may enter into an agreement for a social impact partnership project with a State or local government if the Secretary, in consultation with the Federal Interagency Council on Social Impact Partnerships, determines that each of the following requirements are met:
 (A)The State or local government agrees to achieve one or more outcomes as a result of the intervention, as specified in the agreement and validated by independent evaluation, in order to receive payment.
 (B)The Federal payment to the State or local government for each specified outcome achieved as a result of the intervention is less than or equal to the value of the outcome to the Federal Government over a period not to exceed 10 years, as determined by the Secretary, in consultation with the State or local government.
 (C)The duration of the project does not exceed 10 years. (D)The State or local government has demonstrated, through the application submitted under section 2052, that, based on prior rigorous experimental evaluations or rigorous quasi-experimental studies, the intervention can be expected to achieve each outcome specified in the agreement.
 (E)The State, local government, intermediary, or service provider has experience raising private or philanthropic capital to fund social service investments (if applicable to the project).
 (F)The State or local government has shown that each service provider has experience delivering the intervention, a similar intervention, or has otherwise demonstrated the expertise necessary to deliver the intervention.
 (2)PaymentThe Secretary shall pay the State or local government only if the independent evaluator described in section 2055 determines that the social impact partnership project has met the requirements specified in the agreement and achieved an outcome as a result of the intervention, as specified in the agreement and validated by independent evaluation.
 (3)LimitationThe Secretary may not enter into a contract for a social impact partnership project under paragraph (1) after the date that is 10 years after the date of enactment of the Social Impact Partnerships to Pay for Results Act.
 (d)Notice of agreement awardNot later than 30 days after entering into an agreement under this section, the Secretary shall publish a notice in the Federal Register that includes, with regard to the agreement, the following:
 (1)The outcome goals of the social impact partnership project. (2)A description of each intervention in the project.
 (3)The target population that will be served by the project. (4)The expected social benefits to participants who receive the intervention and others who may be impacted.
 (5)The detailed roles, responsibilities, and purposes of each Federal, State, or local government entity, intermediary, service provider, independent evaluator, investor, or other stakeholder.
 (6)The payment terms, the methodology used to calculate outcome payments, the payment schedule, and performance thresholds.
 (7)The project budget. (8)The project timeline.
 (9)The project eligibility criteria. (10)The evaluation design.
 (11)The metrics that will be used in the evaluation to determine whether the outcomes have been achieved as a result of each intervention and how these metrics will be measured.
 (12)The estimate of the savings to the Federal, State, and local government, on a program-by-program basis and in the aggregate, if the agreement is entered into and implemented and the outcomes are achieved as a result of each intervention.
 (e)Authority To transfer administration of agreementThe Secretary may transfer to the head of another Federal agency the authority to administer (including making payments under) an agreement entered into under this section, and any funds necessary to do so.
 (f)Requirement on funding used To benefit childrenNot less than 50 percent of all Federal payments made to carry out agreements under this section shall be used for initiatives that directly benefit children.
							2054.Feasibility study funding
 (a)Requests for funding for feasibility studiesThe Secretary shall reserve a portion of the amounts appropriated to carry out this subtitle to assist States or local governments in developing feasibility studies to apply for social impact partnership funding under section 2052. To be eligible to receive funding to assist with completing a feasibility study, a State or local government shall submit an application for feasibility study funding addressing the following:
 (1)A description of the outcome goals of the social impact partnership project. (2)A description of the intervention, including anticipated program design, target population, an estimate regarding the number of individuals to be served, and setting for the intervention.
 (3)Evidence to support the likelihood that the intervention will produce the desired outcomes. (4)A description of the potential metrics to be used.
 (5)The expected social benefits to participants who receive the intervention and others who may be impacted.
 (6)Estimated costs to conduct the project. (7)Estimates of Federal, State, and local government savings and other savings if the project is implemented and the outcomes are achieved as a result of each intervention.
 (8)An estimated timeline for implementation and completion of the project, which shall not exceed 10 years.
 (9)With respect to a project for which the State or local government selects an intermediary to operate the project, any partnerships needed to successfully execute the project and the ability of the intermediary to foster the partnerships.
 (10)The expected resources needed to complete the feasibility study for the State or local government to apply for social impact partnership funding under section 2052.
 (b)Federal selection of applications for feasibility studyNot later than 6 months after receiving an application for feasibility study funding under subsection (a), the Secretary, in consultation with the Federal Interagency Council on Social Impact Partnerships and the head of any Federal agency administering a similar intervention or serving a population similar to that served by the project, shall select State or local government feasibility study proposals for funding based on the following:
 (1)The recommendations made by the Commission on Social Impact Partnerships. (2)The likelihood that the proposal will achieve the desired outcomes.
 (3)The value of the outcomes expected to be achieved as a result of each intervention. (4)The potential savings to the Federal Government if the social impact partnership project is successful.
 (5)The potential savings to the State and local governments if the project is successful. (c)Public disclosureNot later than 30 days after selecting a State or local government for feasibility study funding under this section, the Secretary shall cause to be published on the website of the Federal Interagency Council on Social Impact Partnerships information explaining why a State or local government was granted feasibility study funding.
							(d)Funding restriction
 (1)Feasibility study restrictionThe Secretary may not provide feasibility study funding under this section for more than 50 percent of the estimated total cost of the feasibility study reported in the State or local government application submitted under subsection (a).
 (2)Aggregate restrictionOf the total amounts appropriated to carry out this subtitle, the Secretary may not use more than $10,000,000 to provide feasibility study funding to States or local governments under this section.
 (3)No guarantee of fundingThe Secretary shall have the option to award no funding under this section. (e)Submission of feasibility study requiredNot later than 9 months after the receipt of feasibility study funding under this section, a State or local government receiving the funding shall complete the feasibility study and submit the study to the Federal Interagency Council on Social Impact Partnerships.
 (f)Delegation of authorityThe Secretary may transfer to the head of another Federal agency the authorities provided in this section and any funds necessary to exercise the authorities.
							2055.Evaluations
 (a)Authority To enter into agreementsFor each State or local government awarded a social impact partnership project approved by the Secretary under this subtitle, the head of the relevant agency, as recommended by the Federal Interagency Council on Social Impact Partnerships and determined by the Secretary, shall enter into an agreement with the State or local government to pay for all or part of the independent evaluation to determine whether the State or local government project has achieved a specific outcome as a result of the intervention in order for the State or local government to receive outcome payments under this subtitle.
 (b)Evaluator qualificationsThe head of the relevant agency may not enter into an agreement with a State or local government unless the head determines that the evaluator is independent of the other parties to the agreement and has demonstrated substantial experience in conducting rigorous evaluations of program effectiveness including, where available and appropriate, well-implemented randomized controlled trials on the intervention or similar interventions.
 (c)Methodologies To be usedThe evaluation used to determine whether a State or local government will receive outcome payments under this subtitle shall use experimental designs using random assignment or other reliable, evidence-based research methodologies, as certified by the Federal Interagency Council on Social Impact Partnerships, that allow for the strongest possible causal inferences when random assignment is not feasible.
							(d)Progress report
 (1)Submission of reportThe independent evaluator shall— (A)not later than 2 years after a project has been approved by the Secretary and biannually thereafter until the project is concluded, submit to the head of the relevant agency and the Federal Interagency Council on Social Impact Partnerships a written report summarizing the progress that has been made in achieving each outcome specified in the agreement; and
 (B)before the scheduled time of the first outcome payment and before the scheduled time of each subsequent payment, submit to the head of the relevant agency and the Federal Interagency Council on Social Impact Partnerships a written report that includes the results of the evaluation conducted to determine whether an outcome payment should be made along with information on the unique factors that contributed to achieving or failing to achieve the outcome, the challenges faced in attempting to achieve the outcome, and information on the improved future delivery of this or similar interventions.
 (2)Submission to the Secretary and CongressNot later than 30 days after receipt of the written report pursuant to paragraph (1)(B), the Federal Interagency Council on Social Impact Partnerships shall submit the report to the Secretary and each committee of jurisdiction in the House of Representatives and the Senate.
								(e)Final report
 (1)Submission of reportWithin 6 months after the social impact partnership project is completed, the independent evaluator shall—
 (A)evaluate the effects of the activities undertaken pursuant to the agreement with regard to each outcome specified in the agreement; and
 (B)submit to the head of the relevant agency and the Federal Interagency Council on Social Impact Partnerships a written report that includes the results of the evaluation and the conclusion of the evaluator as to whether the State or local government has fulfilled each obligation of the agreement, along with information on the unique factors that contributed to the success or failure of the project, the challenges faced in attempting to achieve the outcome, and information on the improved future delivery of this or similar interventions.
 (2)Submission to the Secretary and CongressNot later than 30 days after receipt of the written report pursuant to paragraph (1)(B), the Federal Interagency Council on Social Impact Partnerships shall submit the report to the Secretary and each committee of jurisdiction in the House of Representatives and the Senate.
 (f)Limitation on cost of evaluationsOf the amounts appropriated to carry out this subtitle, the Secretary may not obligate more than 15 percent to evaluate the implementation and outcomes of the projects.
 (g)Delegation of authorityThe Secretary may transfer to the head of another Federal agency the authorities provided in this section and any funds necessary to exercise the authorities.
							2056.Federal interagency council on social impact partnerships
 (a)EstablishmentThere is established the Federal Interagency Council on Social Impact Partnerships (in this section referred to as the Council) to—
 (1)coordinate with the Secretary on the efforts of social impact partnership projects funded under this subtitle;
 (2)advise and assist the Secretary in the development and implementation of the projects; (3)advise the Secretary on specific programmatic and policy matter related to the projects;
 (4)provide subject-matter expertise to the Secretary with regard to the projects; (5)certify to the Secretary that each State or local government that has entered into an agreement with the Secretary for a social impact partnership project under this subtitle and each evaluator selected by the head of the relevant agency under section 2055 has access to Federal administrative data to assist the State or local government and the evaluator in evaluating the performance and outcomes of the project;
 (6)address issues that will influence the future of social impact partnership projects in the United States;
 (7)provide guidance to the executive branch on the future of social impact partnership projects in the United States;
 (8)prior to approval by the Secretary, certify that each State and local government application for a social impact partnership contains rigorous, independent data and reliable, evidence-based research methodologies to support the conclusion that the project will yield savings to the State or local government or the Federal Government if the project outcomes are achieved;
 (9)certify to the Secretary, in the case of each approved social impact partnership that is expected to yield savings to the Federal Government, that the project will yield a projected savings to the Federal Government if the project outcomes are achieved, and coordinate with the relevant Federal agency to produce an after-action accounting once the project is complete to determine the actual Federal savings realized, and the extent to which actual savings aligned with projected savings; and
 (10)provide periodic reports to the Secretary and make available reports periodically to Congress and the public on the implementation of this subtitle.
 (b)Composition of councilThe Council shall have 11 members, as follows: (1)ChairThe Chair of the Council shall be the Director of the Office of Management and Budget.
 (2)Other membersThe head of each of the following entities shall designate one officer or employee of the entity to be a Council member:
 (A)The Department of Labor. (B)The Department of Health and Human Services.
 (C)The Social Security Administration. (D)The Department of Agriculture.
 (E)The Department of Justice. (F)The Department of Housing and Urban Development.
 (G)The Department of Education. (H)The Department of Veterans Affairs.
 (I)The Department of the Treasury. (J)The Corporation for National and Community Service.
									2057.Commission on social impact partnerships
 (a)EstablishmentThere is established the Commission on Social Impact Partnerships (in this section referred to as the Commission).
 (b)DutiesThe duties of the Commission shall be to— (1)assist the Secretary and the Federal Interagency Council on Social Impact Partnerships in reviewing applications for funding under this subtitle;
 (2)make recommendations to the Secretary and the Federal Interagency Council on Social Impact Partnerships regarding the funding of social impact partnership agreements and feasibility studies; and
 (3)provide other assistance and information as requested by the Secretary or the Federal Interagency Council on Social Impact Partnerships.
 (c)CompositionThe Commission shall be composed of nine members, of whom— (1)one shall be appointed by the President, who will serve as the Chair of the Commission;
 (2)one shall be appointed by the Majority Leader of the Senate; (3)one shall be appointed by the Minority Leader of the Senate;
 (4)one shall be appointed by the Speaker of the House of Representatives; (5)one shall be appointed by the Minority Leader of the House of Representatives;
 (6)one shall be appointed by the Chairman of the Committee on Finance of the Senate; (7)one shall be appointed by the ranking member of the Committee on Finance of the Senate;
 (8)one member shall be appointed by the Chairman of the Committee on Ways and Means of the House of Representatives; and
 (9)one shall be appointed by the ranking member of the Committee on Ways and Means of the House of Representatives.
 (d)Qualifications of commission membersThe members of the Commission shall— (1)be experienced in finance, economics, pay for performance, or program evaluation;
 (2)have relevant professional or personal experience in a field related to one or more of the outcomes listed in section 2052(b); or
 (3)be qualified to review applications for social impact partnership projects to determine whether the proposed metrics and evaluation methodologies are appropriately rigorous and reliant upon independent data and evidence-based research.
 (e)Timing of appointmentsThe appointments of the members of the Commission shall be made not later than 120 days after the date of the enactment of this subtitle, or, in the event of a vacancy, not later than 90 days after the date the vacancy arises. If a member of Congress fails to appoint a member by that date, the President may select a member of the President's choice on behalf of the member of Congress. Notwithstanding the preceding sentence, if not all appointments have been made to the Commission as of that date, the Commission may operate with no fewer than 5 members until all appointments have been made.
							(f)Term of appointments
 (1)In generalThe members appointed under subsection (c) shall serve as follows: (A)Three members shall serve for 2 years.
 (B)Three members shall serve for 3 years. (C)Three members (one of which shall be Chair of the Commission appointed by the President) shall serve for 4 years.
 (2)Assignment of termsThe Commission shall designate the term length that each member appointed under subsection (c) shall serve by unanimous agreement. In the event that unanimous agreement cannot be reached, term lengths shall be assigned to the members by a random process.
 (g)VacanciesSubject to subsection (e), in the event of a vacancy in the Commission, whether due to the resignation of a member, the expiration of a member's term, or any other reason, the vacancy shall be filled in the manner in which the original appointment was made and shall not affect the powers of the Commission.
 (h)Ethics guidelinesAt the first meeting of the Commission, the Commission shall draft appropriate ethics guidelines for members of the Commission and staff. The guidelines shall include provisions relating to conflicts of interest, including financial conflicts of interest, divided allegiances, and financial disclosure requirements. The Commission shall consult with the Secretary as a part of drafting the guidelines and shall furnish the Secretary with a copy of the completed guidelines.
 (i)Appointment powerMembers of the Commission appointed under subsection (c) shall not be subject to confirmation by the Senate.
							2058.Funding
 (a)In generalOut of any money in the Treasury not otherwise appropriated, there is hereby appropriated to the Secretary, $300,000,000 to carry out the activities authorized under this subtitle, which shall remain available for expenditure through the date described in section 2053(c)(3).
 (b)Limitation on use of fundsOf the amounts appropriated to carry out this subtitle, the Secretary may not use more than $2,000,000 in any fiscal year to support the review, approval, and oversight of social impact partnership projects, including activities conducted by—
 (1)the Federal Interagency Council on Social Impact Partnerships established under section 2056; (2)the Commission on Social Impact Partnerships established under section 2057; and
 (3)any other agency consulted by the Secretary before approving a social impact partnership project or a feasibility study under section 2054.
 (c)No Federal funding for credit enhancementsNo amount appropriated to carry out this subtitle may be used to provide any insurance, guarantee, or other credit enhancement to a State or local government under which a Federal payment would be made to a State or local government as the result of a State or local government failing to achieve an outcome specified in an agreement.
 2059.WebsiteThe Federal Interagency Council on Social Impact Partnerships shall establish and maintain a public website that shall display the following:
 (1)A copy of, or method of accessing, each notice published regarding a social impact partnership project pursuant to this subtitle.
 (2)A copy of each feasibility study funded under section 2054. (3)For each State or local government that has entered into an agreement with the Secretary for a social impact partnership project, the website shall contain the following information:
 (A)The outcome goals of the project. (B)A description of each intervention in the project.
 (C)The target population that will be served by the project. (D)The expected social benefits to participants who receive the intervention and others who may be impacted.
 (E)The detailed roles, responsibilities, and purposes of each Federal, State, or local government entity, intermediary, service provider, independent evaluator, investor, or other stakeholder.
 (F)The payment terms, methodology used to calculate outcome payments, the payment schedule, and performance thresholds.
 (G)The project budget. (H)The project timeline.
 (I)The project eligibility criteria. (J)The evaluation design.
 (K)The metrics used to determine whether the proposed outcomes have been achieved and how these metrics are measured.
 (4)A copy of the progress reports and the final reports relating to each social impact partnership project.
 (5)An estimate of the savings to the Federal, State, and local government, on a program-by-program basis and in the aggregate, resulting from the successful completion of the social impact partnership project.
 2060.RegulationsThe Secretary, in consultation with the Federal Interagency Council on Social Impact Partnerships, may issue regulations as necessary to carry out this subtitle.
						2061.GAO evaluation
 (a)In generalFive years after the date of enactment of the Social Impact Partnerships to Pay for Results Act, the Comptroller General of the United States shall— (1)conduct an evaluation of the social impact partnership projects funded under this subtitle and, to the extent the Comptroller General determines necessary, of any other activities carried out with funds made available to carry out this subtitle; and
 (2)submit a report to the Committee on Ways and Means of the House of Representatives and to the Committee on Finance of the Senate that contains the results of such evaluation.
 (b)Access to recordsThe Comptroller General of the United States shall have access to any books, accounts, records, correspondence, and other documents that are related to the expenditure of Federal funds under this subtitle and that are in the possession, custody, or control of any entity receiving Federal funds under this subtitle or of any grantee or contractor of such an entity.
 2062.DefinitionsIn this subtitle (1)AgencyThe term agency has the meaning given that term in section 551 of title 5, United States Code.
 (2)InterventionThe term intervention means a specific service delivered to achieve an impact through a social impact partnership project.
 (3)SecretaryThe term Secretary means the Secretary of the Treasury. (4)Social impact partnership projectThe term social impact partnership project means a project that finances social services using a social impact partnership model.
 (5)Social impact partnership modelThe term social impact partnership model means a method of financing social services in which— (A)Federal funds are awarded to a State or local government only if a State or local government achieves certain outcomes agreed on by the State or local government and the Secretary; and
 (B)the State or local government coordinates with service providers, investors (if applicable to the project), and (if necessary) an intermediary to identify—
 (i)an intervention expected to produce the outcome; (ii)a service provider to deliver the intervention to the target population; and
 (iii)investors to fund the delivery of the intervention. (6)StateThe term State means each State of the United States, the District of Columbia, each commonwealth, territory or possession of the United States, and each federally recognized Indian tribe.
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114 HR 502 IH: Veterans Health Administration Management Improvement Act
U.S. House of Representatives
2015-01-22
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

		I
		114th CONGRESS
		1st Session
		H. R. 502
		IN THE HOUSE OF REPRESENTATIVES

			January 22, 2015
			Mr. Kilmer (for himself, Mr. Carney, and Mr. Cuellar) introduced the following bill; which was referred to the Committee on Veterans’ Affairs, and in addition to the Committee on the Budget, for a period to be subsequently determined by the Speaker, in each case for consideration of such
			 provisions as fall within the jurisdiction of the committee concerned

		A BILL
		To establish a pilot program to improve the management and accountability within the Veterans
			 Health Administration of the Department of Veterans Affairs, to provide
			 oversight of the Veterans Health Administration, and for other purposes.

 1.Short titleThis Act may be cited as the Veterans Health Administration Management Improvement Act. 2.Comptroller General management review of Veterans Health Administration (a)Management review (1)In generalDuring the five-year period beginning on the date of the enactment of this Act, the Comptroller General of the United States shall conduct a management review of the Veterans Health Administration of the Department of Veterans Affairs.
 (2)Matters includedThe management review under paragraph (1) shall include a review, with respect to the Veterans Health Administration, of the following:
 (A)The management structure, including the roles and responsibilities among the various organizational components (local facilities, regional networks, and the central office).
 (B)The oversight of core functions, including the extent to which lines of accountability are clearly delineated.
 (C)The evaluation plan, operations, and capacity to implement results-based strategic planning. (D)The extent to which contractors are used and monitored to support core management functions.
 (E)Internal communication mechanisms, including expectations for communications, that support the mission.
 (F)The setting of priorities and the monitoring of such priorities. (G)Budgeting and resource allocation processes.
 (H)Workforce planning. (I)Human capital processes, including training activities, to ensure timely hiring and effective retention of a qualified workforce.
 (J)Information technology to support core functions and activities. (K)How each of the matters described in subparagraphs (A) through (J) may differ for rural medical facilities of the Department of Veterans Affairs.
 (L)Incentives, including any perverse incentives, affecting employee actions, quality of care, and the provision of services.
 (M)Insights from employees and employee representatives about the work environment and the level of engagement of such employees as can be derived from the results of the annual Federal employee survey and other internal surveys administered by the Secretary of Veterans Affairs.
 (N)Insights on the findings of the Comptroller General from veteran service organizations, organizations representing employees of the Veterans Health Administration, other stakeholders, and the Management and Accountability Ombudsman described in section 312B of title 38, United States Code, as added by section 4.
 (b)ReportsNot later than one year after the date of the enactment of this Act, and annually thereafter for a four-year period, the Comptroller General shall submit to Congress one or more reports that include—
 (1)the matters reviewed under subsection (a)(1); and (2)recommendations of the Comptroller General based on such matters.
				3.Pilot program to improve management and accountability of Veterans Health Administration
 (a)EstablishmentThe Secretary of Veterans Affairs shall establish a pilot program to improve the management and accountability within the Veterans Health Administration.
 (b)Goals of pilot programThe Secretary shall carry out the pilot program under subsection (a) in a manner that ensures that— (1)the employees of the Veterans Health Administration have an opportunity to learn, implement, and identify successful means of advancing the management of the Veterans Health Administration and the delivery of care and services; and
 (2)the management and delivery of care and services at medical facilities of the Department is improved by implementing the recommendations of the Comptroller General of the United States based on the management review conducted under section 2, and any other appropriate recommendations, with respect to the planning and evaluation capabilities of the Veterans Health Administration.
				(c)Application of certain laws during pilot program
 (1)Application of performance plan requirementsDuring the period in which the Secretary carries out the pilot program under subsection (a), the Secretary shall carry out section 1115(b) of title 31, United States Code, as follows:
 (A)In paragraph (2), by substituting , unless authorized to be in an alternative form under subsection (c), and situate each goal in the context of its own logic modeling of how the operations and activities of the agency, in coordination with any significant operations and activities from external entities, will contribute toward achieving the goals and responsibilities of the agency; for unless authorized to be in an alternative form under subsection (c);.
 (B)By including in the agency performance plan described in such section 1115(b), for each performance goal covered by the plan, an identification and assessment of the risks of creating new, or perpetuating existing, perverse incentives, and strategies for risk assessment, monitoring, and mitigation, using a suitable risk management approach.
 (2)Application of performance reporting requirementsDuring the period in which the Secretary carries out the pilot program under subsection (a), the Secretary shall carry out subsection (c) of section 1116 of title 31, United States Code, by including in the update required by such subsection statistical information regarding the Veterans Health Administration that—
 (A)is useful to multiple stakeholders for internal management and external oversight; and (B)provides insight into how programs are planned, financed, and managed, regarding—
 (i)the population of veterans, important subgroups thereof, and the status of such veterans; (ii)the capacity of the operations of the Veterans Health Administration under enacted resource levels, listed by important subcategories as appropriate; and
 (iii)the workload of the Veterans Health Administration, listed by important subcategories as appropriate.
 (3)Application of functions of chief operating officerDuring the period in which the Secretary carries out the pilot program under subsection (a), the Secretary shall carry out section 1123(b)(1) of title 31, United States Code, by substituting strategic and performance planning, measurement, evaluation, analysis, regular assessment of progress, risk management (including the risks of perverse incentives), and use of performance information to improve the results achieved for strategic and performance planning, measurement, analysis, regular assessment of progress, and use of performance information to improve the results achieved.
 (d)Evaluation planThe Secretary shall prepare an annual organization evaluation plan for the Veterans Health Administration that is informed by the recommendations of the Comptroller General based on the management review conducted under section 2.
 (e)Assistance in pilot programThe Management and Accountability Ombudsman described in section 312B of title 38, United States Code, as added by section 4(a), shall assist in the pilot program under subsection (a) by—
 (1)identifying areas in which employees of the Department have problems implementing the pilot program, including application of logic modeling, managing risk of perverse incentives, and other issues that the Ombudsman determine appropriate;
 (2)to the extent practicable, proposing changes in the administrative practices of the implementation of the pilot program to mitigate problems identified under paragraph (1); and
 (3)reviewing, examining, and making recommendations regarding logic modeling policies, strategies, and programs of the Veterans Health Administration.
				(f)Briefings
 (1)Initial briefingNot later than 90 days before the Secretary commences the pilot program under subsection (a), the Secretary shall provide to the Committees on Veterans’ Affairs of the House of Representatives and the Senate and the Comptroller General a briefing on—
 (A)a logic model of how the features of the pilot program will address the problems identified in the management review conducted under section 2; and
 (B)such other items as the Secretary determines appropriate. (2)UpdatesNot later than 240 days after the Secretary commences the pilot program under subsection (a), and annually thereafter during the period in which the Secretary carries out the pilot program, the Secretary shall provide to the Committees on Veterans’ Affairs of the House of Representatives and the Senate and the Comptroller General a briefing on—
 (A)an evaluation of the implementation and effectiveness of carrying out this section, including any challenges encountered and lessons learned;
 (B)planned actions to improve the success of the pilot program, including a milestone plan for such actions; and
 (C)such other items as the Secretary determines appropriate. (g)DurationThe Secretary shall—
 (1)commence the pilot program under subsection (a) by not later than 180 days after the date on which the Comptroller General submits the report under section 2(b); and
 (2)carry out the pilot program for a period of five years. (h)DefinitionsIn this section:
 (1)The term logic modeling means an approach, also referred to as program theory, program modeling, or theory of change, that articulates the assumptions of the strategy or tactics of a program or activity and how such strategy or tactics relate to the benefits that the program or activity is expected to contribute toward in order to achieve certain goals, objectives or responsibilities, and may include—
 (A)the mapping of direct and indirect relationships among relevant resources, activities, milestones, outputs, intermediate outcomes, and end outcomes; and
 (B)if significant coordination or cooperation with entities external to a program or activity may contribute to achieving the relevant goals, objectives, or responsibilities, the mapping of the roles of entities external to the program or activity.
 (2)The term risk management means the processes that are used to identify, assess, monitor, mitigate, and report on risks to achieving the missions, goals, and objectives of a department, agency, or program using resources and processes appropriate to the nature of risks and resources available.
				4.Management and accountability ombudsman
 (a)In generalChapter 3 of title 38, United States Code, is amended by inserting after section 312A the following new section:

					312B.Management and accountability ombudsman
						(a)In general
 (1)There is in the Department an Office of the Management and Accountability Ombudsman (in this section referred to as the Office). There is at the head of the Office an Ombudsman, who shall be appointed by the President from among individuals with a background in enterprise risk management.
 (2)The Ombudsman shall report directly to the Secretary but the Secretary may not prevent or prohibit the Ombudsman from initiating, carrying out, or completing any responsibility of the Ombudsman.
 (3)The Secretary shall determine the appropriate level of staffing and distribution of responsibility to ensure the success of the Office.
 (4)The President shall include in the budget transmitted to the Congress for each fiscal year pursuant to section 1105 of title 31 an estimate of the amount for the Office that is sufficient to provide for a number of full-time positions in the Office.
 (b)ResponsibilitiesThe Ombudsman shall— (1)receive and address reports from employees and employee representatives of the Veterans Health Administration Affairs and assist in resolving problems with the management, administration, and delivery of care of the Veterans Health Agency;
 (2)communicate to the Secretary the observations and findings received pursuant to paragraph (1); (3)conduct inspections of medical facilities of the Veterans Health Administration, including non-Department facilities that provide care pursuant to a contract entered into under chapter 17 of this title as necessary;
 (4)establish a program under which the Ombudsman and the Secretary shall— (A)provide incentives to employees of the Veterans Health Administration who suggest methods to improve the management and operations of the Veterans Health Administration;
 (B)carry out in a pilot program the suggestions that are likely to be successful; and (C)if such a pilot program demonstrates that a suggestion causes a marked improvement in such management and operations—
 (i)reward the employee who made such suggestion; and (ii)carry out such suggestion throughout the Veterans Health Administration; and
 (5)not less frequently than once each calendar quarter, provide to the Secretary a summary and relevant statistics concerning the activities and findings of the Ombudsman, including a summary of the suggestions made and carried out pursuant to paragraph (4).
 (c)Request for investigationsThe Ombudsman may request the Inspector General of the Department to conduct an inspection, investigation, or audit. Upon such a request, the Inspector General shall respond to the Ombudsman explaining the plan of the Inspector General to comply with such request or the rationale of the Inspector General for denying such request.
 (d)CoordinationThe Secretary shall ensure that each element of the Department has procedures to provide the Ombudsman with formal responses to any recommendation submitted by the Ombudsman to the head of such element.
 (e)Annual reportsNot later than June 30 of each year, the Ombudsman shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives a report on the objectives of the Ombudsman for the fiscal year beginning in such calendar year. Each report shall—
 (1)contain a full and substantive analysis, in addition to statistical information; and (2)set forth any recommendations the Ombudsman has made on improving the management and accountability of the employees of the Department and any responses received under subsection (d) with respect to the estimates described in section 117(b) of this title.
 (f)Risk management definedIn this section, the term risk management means the processes that are used to identify, assess, monitor, mitigate, and report on risks to achieving a the mission, goals, and objectives of a department, agency, or program using resources and processes appropriate to the nature of risks and resources available..
 (b)Clerical amendmentThe table of sections at the beginning of such chapter is amended by inserting after the item relating to section 312A the following new item:

						312B. Management and Accountability Ombudsman..
 (c)Comptroller General reportsThe Comptroller General of the United States shall review each budget of the President submitted to Congress under section 1105 of title 31 during 2015 through 2020 to evaluate the proposed budget for health care provided by the Secretary of Veterans Affairs. The Comptroller General shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives a report containing the results of each such review, at such times and with such additional matters as the Comptroller General determines appropriate in consultation with such committees.
			5.Veterans’ Bill of Rights
 (a)DisplayThe Secretary of Veterans Affairs shall ensure that the Veterans’ Bill of Rights described in subsection (e) is printed on signage in accessible formats and displayed prominently and conspicuously in each medical facility of the Department of Veterans Affairs in accordance with subsection (c).
 (b)Education of Department employeesThe Secretary shall ensure that employees of the Department receive training on the Veterans’ Bill of Rights described in subsection (e).
 (c)OutreachThe Secretary shall conduct outreach to inform veterans about the Veterans’ Bill of Rights described in subsection (e) by—
 (1)ensuring that such Bill of Rights is available on the Internet website of the Department and prominently displayed (using posters printed in a large type that allows for individuals with 20/20 vision to read the print from 10 feet away) in public spaces, lobbies, visitor centers, clinic waiting rooms, and patient sitting rooms of the Department;
 (2)briefing patients about such Bill of Rights when the patient enrolls in the system of patient enrollment system under section 1705 of title 38, United States Code; and
 (3)conducting other types of outreach targeted at specific groups of veterans, which may include, at a minimum, outreach conducted on other Internet websites or through veterans service organizations, health fairs, and the Veterans Health Administration Veterans Center outreach program.
 (d)ImplementationThe Secretary shall ensure that the Veterans Health Administration honors the rights described in subsection (e).
 (e)Veterans’ bill of rightsThe Veterans’ Bill of Rights described in this subsection is a statement that veterans who receive health care provided under the laws administered by the Secretary of Veterans Affairs should have, at a minimum, the following rights (to the extent of the eligibility and enrollment of the veteran for such health care):
 (1)The right to access the highest quality care, including the right to the most appropriate technology and qualified practitioners.
 (2)The right to know what rules and regulations apply to patients. (3)The right to continuity of care in the transition from the health program of the Department of Defense to the health care system of the Department of Veterans Affairs.
 (4)The right to receive careful explanation of proposed diagnostic or therapeutic procedures or courses of treatment by the responsible medical personnel, including with respect to risks, complications, alternative health practices, results, information and reasoning for prescribed pain management plans, and a daily review of the medical chart of the patient.
 (5)The right for the patient to ask questions and be involved in all decisions regarding the care received by the patient.
 (6)The right to a second opinion or change of provider, if available. (7)The right to know the reason for any change in medical practitioners responsible for the care of the patient.
 (8)The right to know the identity and professional status of individuals providing service and to know who is primarily responsible for the care of the patient.
 (9)The right to not be transferred to another facility, organization, or department unless the patient receives a complete explanation for the need, was notified of alternatives, and the receiving organization, facility, or department is ready to accept the transfer.
 (10)The right to receive considerate, respectful care at all times and under all circumstances with recognition of personal dignity, diversity, and religious, or other spiritual and cultural preferences.
 (11)The right, in accordance with relevant provisions of law, to personal and informational confidentiality and privacy in the discussion of the care and management of records of patients.
 (12)The right to visitors within the policies of the facility and to be informed of the visitation rights, including any clinically necessary restrictions.
 (13)The right to be free from all forms of abuse or harassment. (14)The right to access protective and advocacy services, when available, and file grievances.
 (15)The right to remain free of chemical and physical restraints unless safety requires otherwise. (16)The right to care provided in a safe and clean setting, free from excessive noise and with sufficient lighting for comfort and safety.


114 SCON 1 IS: Expressing the sense of Congress that a carbon tax is not in the economic interest of the United States.
U.S. Senate
2015-01-07
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

III114th CONGRESS1st SessionS. CON. RES. 1IN THE SENATE OF THE UNITED STATESJanuary 7, 2015Mr. Vitter submitted the following concurrent resolution; which was referred to the Committee on FinanceCONCURRENT RESOLUTIONExpressing the sense of Congress that a carbon tax is not in the economic interest of the United
			 States.Whereas a carbon tax is regressive in nature and would
			 unfairly burden those vulnerable individuals and families in the United
			 States
			 that are already struggling with increasing electricity rates and a slow
			 economic recovery;Whereas a carbon tax would increase the cost of every good
			 manufactured in the United States;Whereas a carbon tax would harm the entire United States
			 manufacturing sector;Whereas European nations that have adopted carbon policies and regulatory regimes have forced
			 energy poverty on their citizens and undermined their economies;Whereas the increase in production of domestic fossil energy
			 resources on private and State-owned land has created significant job
			 growth
			 and private capital investment; andWhereas affordable and reliable energy sources are
			 critical to maintaining the United States global competitiveness: Now,
			 therefore, be itThat it is the sense of Congress that
			 a carbon tax would be detrimental to families and businesses in the United
			 States, and
			 is
			 not in the interest of the United States.


115 HR 7001 IH: Capped Allowable Payments from Seniors for Prescriptions Act
U.S. House of Representatives
2018-09-28
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

I115th CONGRESS2d SessionH. R. 7001IN THE HOUSE OF REPRESENTATIVESSeptember 28, 2018Mr. O'Halleran introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such
			 provisions as fall within the jurisdiction of the committee concernedA BILLTo amend title XVIII of the Social Security Act to provide for a combined Medicare part B and D
			 drug out-of-pocket costs limitation.

 1.Short titleThis Act may be cited as the Capped Allowable Payments from Seniors for Prescriptions Act or the CAPS for Prescriptions Act. 2.Limiting Medicare part B and D drug out-of-pocket costs (a)Medicare combined part B and D drug OOP catastrophic limit and part D subsidiesPart D of title XVIII of the Social Security Act is amended by inserting after section 1860D–14A (42 U.S.C. 1395w–114a) the following new section:

					1860D–14B.Medicare drug out-of-pocket limit subsidies
 (a)In generalFor plan year 2021 and each subsequent plan year, in the case of a part D eligible individual enrolled in a prescription drug plan under this part for such year—
 (1)if during such year such individual becomes a catastrophic limit subsidy eligible individual, such individual is entitled to the elimination of any beneficiary coinsurance described in section 1860D–2(b)(2) for covered part D drugs furnished to such individual during the remainder of such year; and
 (2)the Secretary shall provide for payment to the PDP sponsor that offers such prescription drug plan of a catastrophic limit coverage subsidy (calculated under subsection (b)) in accordance with this section for such individual and remainder of such year.
 (b)Catastrophic limit coverage subsidy amountFor purposes of this section, a catastrophic limit coverage subsidy, with respect to a catastrophic limit subsidy eligible individual enrolled for coverage under this part in a prescription drug plan for a plan year, shall be calculated as an amount (or amounts) equal to any cost-sharing amount that—
 (1)would otherwise apply without application of subsection (a)(1) to such individual under such coverage for covered part D drugs furnished to such individuals during such year; but
 (2)does not apply to such individual with application of subsection (a)(1). Such subsidy may be paid in such manner and at such times as specified by the Secretary.(c)Catastrophic limit subsidy eligible individualFor purposes of this section, the term catastrophic limit subsidy eligible individual means, with respect to a prescription drug plan under this part and plan year, a part D eligible individual enrolled in such plan for such year who has incurred out-of-pocket costs described in subsection (e) for eligible Medicare drugs furnished to such individual during such year above the OOP drug catastrophic limit specified in subsection (d) for such year.
 (d)OOP drug catastrophic limitFor purposes of this part, the OOP drug catastrophic limit specified in this subsection is— (1)for plan year 2021, $2,600; and
 (2)for a subsequent plan year, the dollar amount applied under this subsection for the previous plan year, increased by the annual percentage increase in average per capita aggregate expenditures for covered part D drugs in the United States for part D eligible individuals, as determined by the Secretary for the 12-month period ending in July of the previous year using such methods as the Secretary shall specify.
							(e)Out-of-Pocket costs described
 (1)In generalFor purposes of this section— (A)incurred out-of-pocket costs shall only include—
 (i)costs incurred with respect to covered part D drugs for the annual deductible described in paragraph (1), for cost-sharing described in paragraph (2), and for amounts for which benefits are not provided because of the application of the initial coverage limit described in paragraph (3), but does not include any costs incurred for covered part D drugs which are not included (or treated as being included) in the plan’s formulary; and
 (ii)costs, determined based on submitted claims and without regard to any deductible under part B, incurred for cost-sharing under such part for part B drugs described in subsection (g)(1)(B);
 (B)subject to subparagraph (C), such costs shall be treated as incurred only if they are paid by the part D eligible individual (or by another person, such as a family member, on behalf of the individual) and the part D eligible individual (or other person) is not reimbursed through insurance or otherwise, a group health plan, or other third-party payment arrangement (other than under such section or such a Program) for such costs; and
 (C)such costs shall be treated as incurred and shall not be considered to be reimbursed under subparagraph (B) if such costs are borne or paid—
 (i)under section 1860D–14; (ii)under a State Pharmaceutical Assistance Program;
 (iii)by the Indian Health Service, an Indian tribe or tribal organization, or an urban Indian organization (as defined in section 4 of the Indian Health Care Improvement Act); or
 (iv)under an AIDS Drug Assistance Program under part B of title XXVI of the Public Health Service Act. (2)Information exchangeThe provisions of section 1860D–2(b)(4)(D) shall apply for purposes of this subsection in the same manner as such provisions apply for purposes of section 1860D–2(b)(4).
 (f)CoordinationThe Secretary shall provide for such procedures as is necessary, including by requiring submission of information from PDP sponsors, to implement the provisions of this section and apply the OOP drug catastrophic limit applicable to costs incurred for eligible Medicare drugs for purposes of coverage of such drugs under part B and this part.
						(g)Eligible Medicare drugs
 (1)In generalFor purposes of this section, the term eligible Medicare drug means any of the following: (A)A covered part D drug.
 (B)Subject to paragraph (2), a drug or biological paid for under section 1833(t), 1847, 1847A, or 1847B.
 (2)ExceptionA drug or biological described in paragraph (1)(B) does not include a drug or biological furnished as part of a grouping of items and services and paid for as such a grouping in an ambulatory payment classification under section 1833(t) (instead of separately payable under such section)..
 (b)Application of OOP drug catastrophic limit under part BSection 1833 of the Social Security Act— (1)in subsection (a)(1)(S), by inserting subject to subsection (bb), before the amounts paid;
 (2)by redesignating the subsection (z), relating to medical review of spinal subluxation services, as subsection (aa); and
 (3)by adding at the end the following new subsection:  (bb)Application of OOP drug catastrophic limitIf an individual covered under this part incurs out-of-pocket costs described in subsection (e) of section 1860D–14B for eligible Medicare drugs (as defined in subsection (g) of such section) furnished to such individual during a year that equals the OOP drug catastrophic limit specified in subsection (d) of such section for such year, subsection (a)(1)(S) shall be applied with respect to expenses incurred for eligible Medicare drugs described in subsection (g)(1)(B) of such section furnished to such individual during the remainder of the year as if the reference in such subsection (a)(1)(S) to 80 percent were a reference to 100 percent.
						.
				(c)Premium hold harmless
 (1)In generalSection 1839(a)(1) of the Social Security Act (42 U.S.C. 1395r(a)(1)) is amended by inserting , payments under section 1860D–14B, additional payments by reason of application of section 1833(bb), after section 1853(l)(3).
 (2)PaymentSection 1844(a) of the Social Security Act (42 U.S.C. 1395w(a)) is amended— (A)in paragraph (3), by striking the period at the end and inserting ; plus; and
 (B)by inserting after paragraph (3) the following new paragraph:  (4)a Government contribution equal to the amount of catastrophic limit coverage subsidies payable under section 1860D–14B and additional payments by reason of application of section 1833(bb)..
 (d)Conforming amendmentsSection 1860D–2(b) of the Social Security Act— (1)in paragraph (2)(A), by inserting and section 1860D–14B after subparagraphs (C) and (D);
 (2)in paragraph (2)(C)(i), by inserting and subject to section 1860D–14B after paragraph(4); (3)in paragraph (2)(D)(i), by inserting and subject to section 1860D–14B after paragraph(4);
 (4)in paragraph (3)(A), by striking and (4) and inserting and (4) and subject to section 1860D–14B; and (5)in paragraph (4)(A)(i), by inserting subject to section 1860D–14B, after subparagraph (B),.