Chronic Illness Care Improvement Act of 2000

Chronic Illness Care Improvement Act of 2000 - Title I: National Commission on Improving Chronic Illness Care - Establishes the National Commission on Improving Chronic Illness Care to: (1) develop a national policy to coordinate the multiple Federal resources devoted to health care for persons with serious and disabling chronic illnesses in order to facilitate a comprehensive continuum of care; (2) review and analyze whether coordination of the multiple Federal resources is best accomplished by a completely new governmental structure, or a new structure within an existing department, or a new mechanism for coordination of the various Government programs; (3) identify statutory and regulatory barriers to effective care for serious and disabling chronic illness and to develop legislative and regulatory recommendations; (4) develop a plan to integrate Medicare and Medicaid (titles XVIII and XIX of the Social Security Act (SSA)) Federal budget functions for purposes of projecting future costs of serious and disabling chronic conditions and cost savings from improved care of the chronically ill;(5) develop guidelines for payment methods that establish compatible financial incentives among health care providers and professionals serving the same chronically ill persons; (6) commission an expert panel to make recommendations for the design of the prototypes (the National Diabetes Pilot Initiative to Improve Chronic Illness Care and the National Alzheimer's Disease Pilot Initiative To Improve Chronic Illness Care established under title III of this Act) in order to enhance the design of the later expanded program (The National Initiative to Improve Chronic Illness Care); (7) commission an expert panel to develop a plan to introduce a single, integrated medical record for patients with chronic conditions; (8) commission an expert panel to recommend new outcome measures of cost-effectiveness based on improvements in or maintenance of functional status, delayed dependency, and other appropriate related matters; (9) contract for reports detailing the need for changes in current laws and regulations; (10) recommend national goals for reduction in serious and disabling chronic illness and cost savings over the next generation; (11) analyze the impact of emerging trends in the management of serious and disabling chronic illness, disability, and long-term care; and (12) report to the President and Congress.

(Sec. 101) Authorizes appropriations.

(Sec. 102) Defines "serious and disabling chronic illness," which includes Alzheimer's Disease and related disorders, arthritis, cancer, diabetes, hypertension, multiple sclerosis, and renal disease.

Title II: Preparing the Groundwork for the National Initiative to Improve Chronic Illness Care - Subtitle A: Expansion of Preventive Benefits - Amends SSA title XVIII concerning authority to provide preventive services under part B (Supplemental Medical Insurance) of the Medicare program to prevent, reduce, delay, or detect serious and disabling chronic illness. Defines "qualified preventive services" to include smoking cessation services, screening for hypertension, screening for cholesterol, screening for end stage renal disease and kidney function, screening for reduced visual and audio acuity and low vision rehabilitation services, and screening for glaucoma.

(Sec. 201) Provides for alternative payment for preventive services, authorizing the Secretary of Health and Human Services (HHS) to waive copayments for certain preventive services. Waives the deductible applicable to such services. Adds lancets to the definition of durable medical equipment.

(Sec. 202) Directs the Secretary to carry out a nationwide education campaign to promote awareness about the nature of chronic diseases and disabilities and strategies for preventing, delaying, or minimizing disability progression at various stages of chronic conditions, including health promotion and self-care activities.

(Sec. 203) Directs the Secretary to study and report to Congress on what preventive care services, if furnished to individuals before Medicare eligibility, could reasonably be expected to save Medicare and other Government programs more in future discounted costs under those programs than the cost of furnishing such preventive services.

(Sec. 204) Requires the Director of the Congressional Budget Office to report to Congress on methodologies to measure aggregate savings, to both society and the individual, in payments that would otherwise be made under the Medicare, Medicaid, and other Federal health care programs that are attributable to certain preventive services, if such services were furnished over the course of an individual's life before entitlement to benefits under those programs.

Subtitle B: Development of National Goals and Measures for the Effective Management of Chronic Illness - Establishes within HHS the Office of Integration and Coordination of Care for Chronic Illness.

(Sec. 212) Directs the Secretary to develop the National Database for Serious and Disabling Chronic Illness to: (1) generate accurate information about the prevalence, demographics, health status, functional status, financial status, support systems, and quality of life of persons suffering from serious and disabling chronic illnesses; (2) compile aggregate data on the utilization, cost, and outcomes of chronic illness; and (3) enable the Secretary to set goals and measure progress in reducing the cost to society of improving care of the chronically ill.

(Sec. 213) Directs the Secretary to establish and report annually on targets for reducing the prevalence of the highest-cost and fastest-growing chronic illnesses, as well as national goals for reducing the prevalence of high-cost chronic care conditions.

(Sec. 214) Directs the Secretary to: (1) identify risk factors associated with progression of serious and disabling chronic illnesses, and identify interventions for primary, secondary, and tertiary prevention; (2) conduct patient-oriented research trials that will have the greatest and most immediate impact on the largest number of people with chronic illness; (3) develop disease prevention guidelines for the highest-cost chronic diseases and disabilities, measured by severity and prevalence; and (4) develop disability-based outcome measures that evaluate effectiveness in preventing, delaying, or minimizing the progression of chronic diseases and disabilities and associated comorbidities and loss of independence on a longitudinal basis.

Requires each Medicare+Choice organization under SSA title XVIII part C (Medicare+Choice) to conduct annually: (1) at least one new continuous quality improvement initiative involving chronic care focusing on delaying the progression of disability and preventing the emergence of disease-related complications; or (2) at least one new initiative to reduce preventable medical errors involving chronic care.

(Sec. 215) Directs the Secretary to establish and implement standard patient assessment instruments under the Medicare program that provide comparability of information and reduce the need for repeated evaluations and data entry at each new site of service. Provides that by January 1, 2005, standard patient assessment instruments established under this section shall be the sole patient assessment instrument utilized by the Secretary with respect to Medicare and Medicaid items and services.

(Sec. 216) Directs the Agency of Healthcare Research and Quality to develop and make available in electronic format an authoritative, reliable national resource center for serious and disabling chronic illnesses, to be used by patients and their families that include information necessary for patient education and facilitate self-management.

Subtitle C: Payment Incentives for Furnishing Quality Services to the Chronically Ill - Creates within the Federal Supplemental Medical Insurance Trust Fund the Performance Bonus Pool Account to consist of amounts attributable to certain reductions in payments to Medicare+Choice organizations. Provides for bonus payments from such account to organizations that meet or exceed chronic illness target goals.

(Sec. 223) Directs the Secretary to study and report to Congress on the need for additional physician and nonphysician health care staff and expertise in the management of chronic illness for Medicare beneficiaries.

Grants the Secretary authority to adjust graduate medical education payments for approved medical residency training programs under certain conditions.

Title III: Development of Prototypes of Integration and Coordination of Care for 2 Chronic Illness Subpopulations to be Expanded in 2007 to All Serious and Disabling Chronic Illnesses - Amends SSA title XVIII to provide for disease management services for eligible individuals for serious and disabling chronic illness through the National Initiative to Improve Chronic Illness Care program which the Secretary shall establish and implement in accordance with specified guidelines that involve specified initial pilot projects. Provides for coverage of disease management services as a Medicare part B medical service. Authorizes appropriations.

Title IV: Integrating Medicare and Medicaid for Dual Eligibles - Amends SSA title XVIII to allow a State, health plan, or provider to request the Secretary to waive Medicare requirements to permit States to enhance the coordination and integration of Medicare and Medicaid items and services and administration.