Teacher:In this task, you are given text for US Congressional and California state bills, your task is to generate a summary for this bill.
Teacher: Now, understand the problem? Solve this instance: SECTION 1. SHORT TITLE.

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

SEC. 2. MODIFICATION OF PAYMENT RULES.

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

SEC. 3. CONTINUOUS OPEN ENROLLMENT FOR QUALIFIED INDIVIDUALS.

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

SEC. 4. DEVELOPMENT OF QUALITY MEASUREMENT PROGRAM.

(a) In General.--Section 1852(e) of the Social Security Act (42
U.S.C. 1395w-22(e)) is amended by adding at the end the following new
paragraph:
''(5) Quality measurement program for specialized programs
for the frail elderly as part of medicare+choice plans.--The
Secretary shall develop and implement a program to measure the
quality of care provided in specialized programs for the frail
elderly (as defined in section 1853(i)(2)) in order to reflect
the unique health aspects and needs of frail elderly
Medicare+Choice beneficiaries (as defined in section
1853(i)(3)). Such quality measurements may include indicators
of the prevalence of pressure sores, reduction of iatrogenic
disease, use of urinary catheters, use of anti-anxiety
medications, use of advance directives, incidence of pneumonia,
and incidence of congestive heart failure.''.
(b) Effective Date.--The Secretary of Health and Human Services
shall first provide for the implementation of the quality measurement
program for specialized programs for the frail elderly under the
amendment made by subsection (a) by not later than July 1, 2000.
Student:
Medicare's Elderly Receiving Innovative Treatments (MERIT) Act of 1999 - Amends part C (Medicare+Choice) of title XVIII (Medicare) of the Social Security Act with regard to the frail elderly, modifying: (1) payment rules (including requiring the Secretary of Health and Human Services to develop and implement a new payment system); (2) eligibility, election, and enrollment provisions (adding special rules for frail elderly Medicare+Choice beneficiaries enrolling in specialized programs for the frail elderly that establish a continuous open enrollment period for such individuals); and (3) benefits and beneficiary protections provisions (requiring the Secretary to develop and implement a program to measure the quality of care provided in specialized programs for the frail elderly). Exempts Medicare+Choice beneficiaries in a specialized program for the frail elderly from any risk adjustment system until the Secretary certifies to Congress that a comprehensive risk adjustment methodology taking certain factors into account is being fully implemented.