Q: In this task, you are given text for US Congressional and California state bills, your task is to generate a summary for this bill.
SECTION 1. SHORT TITLE.

This Act may be cited as the ''Medicare Payment for Quality and
Value Act of 2003''.

SEC. 2. DEMONSTRATION PROJECTS TO IMPROVE HEALTH CARE QUALITY AND
REDUCE COSTS UNDER MEDICARE.

(a) Definitions.--In this section:
(1) Demonstration project.--The term ''demonstration
project'' means a demonstration project established by the
Secretary under subsection (b)(1).
(2) Low-cost high-quality state.--The term ''low-cost high-
quality State'' means a State in the top quartile of cost and
quality efficiency as measured by the Centers for Medicare &
Medicaid Services using 1999 program data.
(3) Medicare beneficiary.--The term ''medicare
beneficiary'' means an individual who is entitled to (or
enrolled for) benefits under part A of the medicare program,
enrolled for benefits under part B of the medicare program, or
both (including an individual who is enrolled in a
Medicare+Choice plan under part C of the medicare program).
(4) Medicare program.--The term ''medicare program'' means
the health benefits program under title XVIII of the Social
Security Act (42 U.S.C. 1395 et seq.).
(5) Secretary.--The term ''Secretary'' means the Secretary
of Health and Human Services.
(b) Demonstration Projects To Improve Health Care Quality and
Reduce Costs Under Medicare.--
(1) Establishment.--There is established a demonstration
program under which the Secretary shall establish demonstration
projects in accordance with the provisions of this section for
the purpose of improving the quality of care--
(A) provided to medicare beneficiaries with high-
volume and high-cost conditions; and
(B) for which payment is made under the medicare
program.
(2) Rewarding quality care.--Under the demonstration
projects, the Secretary shall increase payments under the
medicare program by an amount determined by the Secretary for
purposes of the demonstration projects to health care providers
(as defined by the Secretary) in low-cost high-quality States
that demonstrate adherence to quality standards identified by
the Secretary for purposes of the demonstration projects.
(c) Conduct of Demonstration Projects.--
(1) Demonstration areas.--
(A) In general.--The Secretary shall conduct
demonstration projects in low-cost high-quality States
selected on the basis of proposals submitted under
subparagraph (B). Each demonstration project shall be
conducted on a statewide basis.
(B) Proposals.--The Secretary shall accept
proposals to establish the demonstration projects from
entities that demonstrate an intent to include multiple
public and private payers and a majority of practicing
physicians in a low-cost high-quality State.
(2) Duration.--The Secretary shall complete the
demonstration projects by the date that is 5 years after the
date on which the first demonstration project is implemented.
(d) Report to Congress.--Not later than the date that is 6 months
after the date on which the demonstration projects end, the Secretary
shall submit to Congress a report on the demonstration projects
together with such recommendations for legislation or administrative
action as the Secretary determines is appropriate.
(e) Waiver of Medicare Requirements.--The Secretary shall waive
compliance with such requirements of the medicare program to the extent
and for the period the Secretary finds necessary to conduct the
demonstration projects.
(f) Funding.--
(1) Demonstration projects.--
(A) In general.--Subject to subparagraph (B) and
paragraph (2), the Secretary shall provide for the
transfer from the Federal Hospital Insurance Trust Fund
under section 1817 of the Social Security Act (42
U.S.C. 1395i) and Federal Supplementary Insurance Trust
Fund under section 1841 of such Act (42 U.S.C. 1395t),
in such proportion as the Secretary determines
appropriate, of such funds as are necessary for the
costs of carrying out the demonstration projects under
this section.
(B) Limitation.--In conducting the demonstration
projects under this section, the Secretary shall ensure
that the aggregate payments made by the Secretary under
the medicare program do not exceed the amount which the
Secretary would have paid under the medicare program if
the demonstration projects under this section were not
implemented.
(2) Evaluation and report.--There are authorized to be
appropriated such sums as are necessary for the purpose of
developing and submitting the report to Congress under
subsection (d).

SEC. 3. INSTITUTE OF MEDICINE REPORT ON PAYMENT INCENTIVES AND
PERFORMANCE UNDER THE MEDICARE+CHOICE PROGRAM.

(a) Study.--The Secretary of Health and Human Services shall enter
into an arrangement with the Institute of Medicine of the National
Academy of Sciences under which the Institute shall conduct a study on
clinical outcomes, performance, and quality of care under the
Medicare+Choice program under part C of title XVIII of the Social
Security Act.
(b) Matters Studied.--
(1) In general.--In conducting the study under subsection
(a), the Institute shall review and evaluate the public and
private sector experience related to the establishment of
performance measures and payment incentives. The review shall
include an evaluation of the success, efficiency, and utility
of structural process and performance measurements, and
different methodologies that link performance to payment
incentives. The review shall include the use of incentives--
(A) aimed at plans and their enrollees;
(B) aimed at providers and their patients;
(C) to encourage consumers to purchase based on
quality and value; and
(D) to encourage multiple purchasers, providers,
beneficiaries, and plans within a community to work
together to improve performance.
(2) Identification of options.--As part of the study, the
Institute shall identify options for providing incentives and
rewarding performance, improve quality, outcomes, and
efficiency in the delivery of programs and services under the
Medicare+Choice program, including--
(A) periodic updates of performance measurements to
continue rewarding outstanding performance and
encourage improvements;
(B) payments that vary by type of plan, such as
preferred provider organization plans and MSA plans;
(C) extension of incentives in the Medicare+Choice
program to the fee for service program under title
XVIII of the Social Security Act; and
(D) performance measures needed to implement
alternative methodologies to align payments with
performance.
(c) Report.--Not later than 18 months after the date of the
enactment of this Act, the Institute shall submit to Congress and the
Secretary a report on the study conducted under subsection (a).
A:
Medicare Payment for Quality and Value Act of 2003 - Directs the Secretary of Health and Human Services to establish demonstration projects to improve care provided to Medicare beneficiaries with high-volume and high-cost conditions and for which payment is made under Medicare. Directs the Secretary to increase payments under Medicare to health care providers in low-cost high-quality States that adhere to quality standards identified by the Secretary. Defines a low-cost high-quality State as a State meeting certain cost and quality efficiency standards.Directs the Secretary to accept proposals for projects in low-cost high-quality States from entities planning to include multiple public and private payers and a majority of practicing physicians in the State.Allows the Secretary to waive compliance with such requirements of the Medicare program to the extent and for the period necessary to conduct demonstration projects under this Act.Directs the Secretary to enter into an agreement with the Institute of Medicine of the National Academy of Sciences under which the Institute shall conduct a study on clinical outcomes, performance, and quality of care under the Medicare+Choice program under the Social Security Act.