[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4327 Introduced in House (IH)]







110th CONGRESS
  1st Session
                                H. R. 4327

   To establish a Medicare Chronic Care Practice Research Network to 
 develop and apply improved practices in care management for Medicare 
            beneficiaries with multiple, chronic conditions.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            December 6, 2007

    Mr. Johnson of Illinois (for himself, Mr. Patrick J. Murphy of 
 Pennsylvania, Ms. Herseth Sandlin, Mr. Latham, Ms. Schwartz, and Mr. 
   Hulshof) 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 Practice Research 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 Practice 
Research Network Act of 2007''.

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 healthcare 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) 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.
            (8) The United States Government should partner with 
        qualified and experienced health care institutions 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 PRACTICE RESEARCH 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 Practice Research 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.
    (b) Purpose and Duties of Network.--
            (1) Purpose.--The purpose of the Network is to enable 
        highly qualified providers, including providers participating 
        in the Medicare Coordinated Care Demonstration under section 
        1807 of the Social Security Act (in this section referred to as 
        the ``MCCD''), 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.
                    (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; 
                        and
                            (ii) provide a reproducible, reliable, and 
                        scalable framework to standardize and translate 
                        best practices for all Medicare beneficiaries.
            (3) Financial support.--The Network shall provide financial 
        support in the following areas:
                    (A) Collaboration.--Support of collaboration and 
                networking, including conference calls, meetings, and 
                other forms of communication between and among Network 
                project sites, of publication of guidelines and 
                findings, and of development and dissemination of 
                information on proven, common care management 
                practices.
                    (B) Infrastructure.--Support of research and 
                infrastructure for Network project sites, which may be 
                based upon enrollment size and success of such sites in 
                realizing targets and compliance with data submission 
                requirements.
                    (C) Patient recruitment and care management.--
                Support of patient recruitment and care management at 
                Network project sites for the delivery of specific 
                services and ongoing testing of improvements to large 
                patient panels.
                    (D) Evaluation.--Support of internal and external 
                evaluation activities, including evaluation activities 
                conducted at individual Network project sites and the 
                Network.
            (4) Establishment of target enrollment numbers.--The 
        Secretary and the Network shall jointly develop, based on 
        demographics and previous history, target enrollment numbers 
        for each Network project site.
    (c) Board of Directors.--
            (1) Membership.--
                    (A) In general.--The Network shall have a Board of 
                Directors (in this section referred to as the 
                ``Board'') composed of the following:
                            (i) CMS administrator.--The Administrator 
                        of the Centers for Medicare & Medicaid 
                        Services, who shall serve as chairman of the 
                        Board and head of the Network.
                            (ii) Ex officio members.--
                                    (I) The Director of the Agency for 
                                Health Research and Quality.
                                    (II) The Director of the National 
                                Institute on Aging.
                                    (III) Representatives of other 
                                Federal health care and research agency 
                                officials, as selected by the 
                                Secretary.
                            (iii) Appointed members.--Members appointed 
                        under subparagraph (B).
                    (B) Appointed members.--
                            (i) Initial appointment.--The Secretary 
                        shall appoint at least 8 individuals to serve 
                        on the Board, including one individual 
                        representing each MCCD site.
                            (ii) Additional members.--The Secretary may 
                        appoint additional members to the Board to the 
                        extent the Secretary determines, including 
                        individuals who represent Network project sites 
                        not otherwise represented under clause (i).
                            (iii) Term.--The term of office of each 
                        member of the Board appointed under this 
                        subparagraph shall be five years.
                    (C) Vacancy.--Any vacancy in the membership of the 
                Board--
                            (i) shall not affect the power of the 
                        remaining members to execute the duties of the 
                        Board; and
                            (ii) shall be filled by appointment by the 
                        Secretary.
            (2) Project evaluations.--The Board shall provide for both 
        an internal and external evaluation of each Network project 
        site.
            (3) Initial meeting.--Not later than 60 days after the date 
        members are first appointed under paragraph (1)(B), the 
        Secretary shall convene a meeting of the members of the Board 
        to--
                    (A) initiate the Network; and
                    (B) begin the planning phase of the Network.
    (d) 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. Each report shall 
        include at least the following:
                    (A) A report on progress made toward developing an 
                efficient and effective research infrastructure capable 
                of robustly testing new interventions and models of 
                care for chronically ill Medicare beneficiaries in a 
                timely manner.
                    (B) An evaluation of the overall quality, 
                satisfaction, and cost effectiveness of interventions 
                tested.
                    (C) An evaluation of the capability of the Network 
                to define and test specifications needed to deploy 
                successful interventions on a large geographic or 
                nationwide scale without loss of effectiveness.
                    (D) A description of benefits to the Medicare 
                program resulting from increased collaboration and 
                partnership between Network sites.
                    (E) Any other information regarding the Network 
                that the Secretary determines to be appropriate.
            (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.
    (e) 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.
    (f) 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. Such amount shall be available to carry out 
this section during a 5-fiscal-year period.
    (g) 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.
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