Medicare Chronic Care Practice Research Network Act of 2009 - Directs the Secretary of Health and Human Services (HHS) to establish a Medicare Chronic Care Rapid Learning Network to develop and evaluate evidence-based chronic care management for Medicare beneficiaries with multiple, chronic illnesses, with a focus on beneficiaries under the Medicare fee-for-service program whose care is most costly.
[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3340 Introduced in House (IH)]
111th CONGRESS
1st Session
H. R. 3340
To establish a Medicare Chronic Care Rapid Learning Network to develop
and apply improved practices in care management for Medicare
beneficiaries with multiple chronic conditions.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
July 24, 2009
Mr. Johnson of Illinois (for himself, Ms. Schwartz, Mr. Patrick J.
Murphy of Pennsylvania, and Mr. Latham) 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
concerned
_______________________________________________________________________
A BILL
To establish a Medicare Chronic Care Rapid Learning Network to develop
and apply improved practices in care management for Medicare
beneficiaries with multiple chronic conditions.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Medicare Chronic Care Rapid Learning
Network (MCCRLN) Act of 2009''.
SEC. 2. FINDINGS.
The Congress makes the following findings:
(1) Two-thirds of all Medicare spending involves
beneficiaries living with 5 or more chronic conditions.
(2) Eighty-four percent of people ages 65 to 70 live with
at least one of the following chronic conditions: hypertension,
heart disease or heart attack, cancer, diabetes, arthritis, or
high cholesterol.
(3) Medicare beneficiaries with chronic conditions are more
likely to undergo duplicative tests, receive contradictory
information from their health care providers, experience
adverse responses to medications, and undergo hospital visits
that could have been prevented.
(4) Both traditional fee-for-service Medicare and Medicare
Advantage are not currently configured to meet the unique needs
of beneficiaries living with multiple chronic conditions.
(5) Care for these patients is typically fragmented and
delivered by multiple providers working at multiple sites.
(6) Medicare has implemented a number of demonstration
projects focused on ways to improve care for beneficiaries with
multiple chronic conditions, yet there has been limited
translation of evidence-based results to the wider chronic care
community in a timely manner.
(7) Using evidence-based approaches to care coordination
and care management have shown promise in reducing illness
burden and improving health for at-risk patients, but the
evidence is not easy to consistently translate into practice.
(8) As the population of Medicare beneficiaries living with
multiple chronic conditions continues to increase, the Centers
for Medicare & Medicaid Services should seek more effective
actions to test various care models, analyze the outcomes, and
implement evidence-based best practices as soon as possible.
(9) The United States Government should partner with
qualified and experienced health care institutions and
universities already serving these beneficiaries to effectively
and efficiently develop, evaluate, and translate improvements
in coordinated care for them. Generating this information and
supporting its translation into clinical practice will serve
beneficiaries far more effectively.
SEC. 3. MEDICARE CHRONIC CARE RAPID LEARNING NETWORK TO DEVELOP AND
APPLY IMPROVED PRACTICES IN COORDINATED CARE FOR MEDICARE
BENEFICIARIES WITH MULTIPLE, CHRONIC CONDITIONS.
(a) Establishment.--
(1) In general.--Not later than 60 days after the date of
the enactment of this Act, the Secretary of Health and Human
Services (in this section referred to as the ``Secretary'')
shall establish in accordance with this section a Medicare
Chronic Care Rapid Learning Network (in this section referred
to as the ``Network'').
(2) Duration.--The initial period of the Network shall be
not less than five years. The Secretary may extend or make
permanent the Network if the Network's performance demonstrates
benefit to the Medicare program. The Secretary may continue or
make permanent any network project site if--
(A)(i) the costs to the Medicare program resulting
from activities carried out by such site pursuant to
this section are not more than the costs to such
program without application of this section; and
(ii) such activities result in improved quality of
care furnished to Medicare beneficiaries who have two
or more chronic illnesses; or
(B) the costs to the Medicare program resulting
from activities carried out by such site pursuant to
this section are less than the costs to such program
without application of this section.
(b) Purpose and Duties of Network.--
(1) Purpose.--The purpose of the Network is to enable
highly qualified health care organizations and universities to
form a stable and flexible research infrastructure that
accelerates the development and deployment of evidence-based
chronic care management practices for Medicare beneficiaries
with multiple, chronic conditions.
(2) Duties of the network.--
(A) In general.--The Network shall develop and
evaluate evidence-based chronic care management
practices for Medicare beneficiaries who have two or
more chronic illnesses, with a focus on such
beneficiaries who are provided benefits under the
Medicare fee-for-service program and whose care is most
costly. In carrying out its duties, the Network shall
use and build upon applicable interventions that have
been proven successful through demonstrations carried
out by the Centers for Medicare & Medicaid Services,
including the Medicare Coordinated Care Demonstration
project.
(B) Specific duties.--The Network shall--
(i) research, design, implement, test, and
validate specific interventions designed to
improve care management for Medicare
beneficiaries with multiple chronic conditions;
(ii) provide a reproducible, reliable, and
scalable framework to standardize and translate
best practices for all Medicare beneficiaries;
and
(iii) not later than 90 days after the date
of the enactment of this Act, establish target
enrollment numbers and capitated payment rates
for care management interventions to be
established for each Medicare Chronic Care
Rapid Learning Network site.
(c) Membership.--
(1) Initial sites.--The network shall initially consist of
not less than 12 network project sites. Nothing in this Act
prohibits more than 1 network project site from participating
under this section together as a network.
(2) Additional sites.--The Secretary may appoint network
project sites, in addition to such initial sites under
paragraph (1), to the network either as standing members or in
order to meet the goals of a specific project if such sites
satisfy each of the characteristics described in subparagraph
(B).
(3) Required characteristics of network.--The network shall
collectively--
(A) be a group of health care organizations,
universities, or researchers and clinicians in health
care organizations or universities experienced in
research and direct delivery of care management
services for Medicare beneficiaries;
(B) have previously participated in care
coordination projects, demonstrations, or research
projects (or any combination of such projects); and
(C) have demonstrated an existing ability to
interact with each other to design and implement
projects and share and analyze information.
(d) Coordinating Center.--A Coordinating Center shall be
established to facilitate network communication, training of network
project sites, and development and reporting of performance and
implementation metrics.
(e) Advisory Board.--The Network shall have an Advisory Board (in
this section referred to as the ``Board'') composed of the following:
(1) CMS administrator.--The Administrator of the Centers
for Medicare & Medicaid Services, who shall serve as chairman
of the Board and head of the Network.
(2) Appointed members.--
(A) Initial appointments.--Twelve individuals
appointed by the Secretary to serve on the Board,
including one individual representing each network
site.
(B) Additional members.--Any additional members to
the Board, which the Secretary may appoint, including
representatives from other relevant Federal agencies,
experts in the fields of quality improvement, public
health, geriatrics, research methodology, health
economists, and other individuals to the extent the
Secretary determines such additions further the work of
the Network.
(f) Project Evaluations.--The Board shall provide for both an
internal and external evaluation of each Network project. Network
members will receive timely and regular access to data for purposes of
modifying, refining, and evaluating the project under study.
(g) Biennial Reports.--
(1) Congressional reports.--Beginning not later than 2
years after the date of the establishment of the Network, the
Secretary shall submit to the appropriate committees of
Congress biennial reports on the Network.
(2) Public reports on care models.--Every two years, the
Network shall develop and the Secretary shall issue a public
report of recommended practices and guidelines for chronic care
that summarizes the care models the Network has found to be
most effective in managing Medicare beneficiaries with
multiple, chronic problems.
(h) Waiver.--The Secretary shall waive such provisions of title
XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) as may be
necessary for the Network to conduct activities under this section.
(i) Funding.--There are authorized to be appropriated from the
Federal Hospital Insurance Trust Fund under section 1817 of the Social
Security Act (42 U.S.C. 1395i) and from the Federal Supplementary
Medical Insurance Trust Fund under section 1841 of such Act (42 U.S.C.
1395t), in such proportions as the Secretary determines to be
appropriate, $60,000,000 to carry out this section during the 5-year
period beginning with fiscal year 2010.
(j) Definitions.--For purposes of this section:
(1) Medicare program.--The term ``Medicare program'' means
the programs under title XVIII of the Social Security Act.
(2) Network project site.--The term ``Network project
site'' means the site of a chronic care management program
conducted under the authority of the Network.
<all>
Introduced in House
Introduced in House
Referred to House Energy and Commerce
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 concerned.
Referred to House Ways and Means
Referred to the Subcommittee on Health.
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