,i #aad? ,,congress #b;d ,session ,h4 ,r4 #dfdb ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,febru>y #bf1 #bjaf ,mr4 ,coll9s ( ,new ,york 7= himself & ,mr4 ,mc,nerney7 introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,en]gy & ,comm]ce1 & 9 addition to ! ,committee on ,ways & ,means1 = a p]iod to be subsequ5tly det]m9$ by ! ,speak]1 9 ea* case = consid]ation ( su* provisions z fall )9 ! jurisdiction ( ! committee conc]n$ ,a ,,bill ,to am5d title ,,xviii ( ! ,social ,security ,act to e/abli% a ,m$ic>e diabetic eye disease prev5tion & e>ly treatm5t demon/ration project4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,diabetic ,eye ,disease ,prev5tion ,act ( #bjaf4 #b4 ,m$ic>e diabetic eye disease prev5tion & e>ly treatm5t demon/ration project ,title ,,xviii ( ! ,social ,security ,act is am5d$ by ins]t+ aft] section #ahff;,e 7#db ,u4,s4,c4 #acie;cc-#e7 ! foll[+ new section3 #ahff;,f4 ,diabetic eye disease prev5tion & e>ly treatm5t demon/ration project 7a7 ,e/abli%m5t ,! ,secret>y %all conduct1 dur+ a #e-ye> p]iod beg9n+ no lat] ?an ,janu>y #a1 #bjag1 a diabetic eye disease prev5tion & e>ly treatm5t demon/ration project 79 ?is section ref]r$ to z ! demon/ration project7 to provide inc5tives to prim>y c>e practices to ref] to local eye doctors = compreh5sive dilat$ eye exams-- 7#a7 diabetic ,m$ic>e b5efici>ies at ! "t ( _! diagnosis ( diabetes2 & 7#b7 diabetic ,m$ic>e b5efici>ies :o h be5 diagnos$ ) diabetes mellitus & h n receiv$ a compreh5sive dilat$ eye exam9ation 9 ! previ\s #e ye>s4 7b7 ,requirem5t ,! demon/ration project %all te/ ! ext5t to :i* su* inc5tives result 9-- 7#a7 improv+ e>ly detection & treatm5t ( diabetes-relat$ vision problems & ! r$uction ( significant eye & vision loss & bl9dness associat$ ) delay$ diagnosis & treatm5t ( diabetes-relat$ eye & vision conditions2 7#b7 r$uc+ ! co/ ( heal? c>e s]vices cov]$ "u ?is title2 & 7#c7 a*iev+ b5efici>y satisfaction4 7c7 ,conduct ( project ,! demon/ration project %all be conduct$ consi/5t ) ! foll[+3 7#a7 id5tification ( prim>y c>e practices ,! demon/ration project %all id5tify at lea/ #ajj prim>y c>e practices1 9 ea* ( at lea/ #aj ,/ates :i* h high p] capita co/s ( diabetes c>e = diabetic ,m$ic>e b5efici>ies1 = p>ticipation 9 ! demon/ration project4 7#b7 ,li/+ ( p>ticipat+ eye doctors ,ea* practice s id5tifi$ %all be provid$ ) a li/ ( eye doctors :o are locat$ 9 ! area ( su* practice & :o h agre$ to p>ticipate 9 ! demon/ration project4 7#c7 ,requirem5ts = p>ticipat+ eye doctors ,z "p ( ! p>ticipation agreem5t ( an eye doctor "u ! demon/ration project1 ! eye doctor agrees-- 7,a7 to (f] to furni% to ea* diabetic ,m$ic>e b5efici>y ref]r$ to ! doctor by a prim>y c>e practice s id5tifi$ a compreh5sive dilat$ eye exam9ation & ne$$ diabetes-relat$ eye c>e cov]$ "u ?is title2 & 7,b7 to report back to su* practice on ! results ( su* an exam9ation or c>e )9 #gb h\rs aft] ! "t ( conduct+ su* exam9ation or furni%+ su* c>e4 7d7 ,inc5tive paym5t me?odology 7#a7 ,9 g5]al ,"u ! demon/ration project1 subject to p>agraph 7#b71 ! ,secret>y %all pay an inc5tive on an annual basis to ea* prim>y c>e practice p>ticipat+ 9 ! demon/ration project = ea* b5efici>y ! practice ref]s 9 ! ye> = an eye exam9ation "u ! demon/ration project4 ,su* am\nt %all be set at a level s z to enc\rage prim>y c>e practices to p>ticipate 9 ! demon/ration project4 7#b7 ,budget neutrality ,! ,secret>y %all ensure t ! aggregate paym5ts made "u ?is title1 includ+ inc5tive paym5ts made "u ?is section1 ) respect to individuals p>ticipat+ 9 ! demon/ration project d n exce$ ! aggregate am\nts t ! ,secret>y e/imates w\ld h be5 paid "u title ) respect to su* individuals if ! demon/ration project _h n be5 implem5t$4 ,9 ord] to c>ry out ! previ\s s5t5ce1 ! ,secret>y is au?oriz$ to r$uce paym5t rates "u "p ,b = eye c>e s]vices = diabetic ,m$ic>e b5efici>ies 7o!r ?an ^? describ$ 9 subsection 7a77 to take into acc\nt ! co/s ( compreh5sive dilat$ eye exam9ations furni%$ to individuals o!rwise eligible to p>ticipate 9 ! demon/ration project4 7#c7 ,fund+ ,! co/s1 includ+ inc5tive paym5ts1 ( c>ry+ out ! demon/ration project %all be paid f ! ,f$]al ,supplem5t>y ,m$ical ,insurance ,tru/ ,fund e/abli%$ "u section #ahda4 7e7 ,waiv] ,! ,secret>y may waive su* provisions ( ?is title & title ,,xi z ! ,secret>y det]m9es necess>y 9 ord] to implem5t ! demon/ration project4 7f7 ,evaluation & reports 7#a7 ,evaluation ,! ,secret>y %all conduct an indep5d5t evaluation ( ! demon/ration project to assess :e!r ! project has ! results describ$ 9 subsection 7b74 7#b7 ,reports 7,a7 ,prelim9>y report ,n lat] ?an #fj days aft] ! completion ( ! fir/ ye> ( ! demon/ration project1 ! ,secret>y %all submit to ,congress a prelim9>y report on ! results ( ! project4 7,b7 ,f9al report ,no lat] ?an #f mon?s aft] ! date ( ! completion ( ! demon/ration project1 ! ,secret>y %all submit to ,congress a f9al report on ! results ( ! project & %all include 9 su* report ! f9d+s ( ! evaluation conduct$ "u p>agraph 7#a74 7g7 ,def9itions ,9 ?is section3 7#a7 ,diabetic ,m$ic>e b5efici>y ,! t]m diabetic ,m$ic>e b5efici>y means1 ) respect to a prim>y c>e practice1 an individual :o-- 7,a7 is entitl$ to b5efits "u "p ,a & enroll$ = b5efits "u "p ,b2 7,b7 is n enroll$ 9 a ,m$ic>e ,advantage plan "u "p ,c or a ,,pace program "u section #ahid2 7,c7 has be5 det]m9$ to h diabetes mellitus2 & 7,d7 is receiv+ prim>y c>e s]vices ?r\gh "o or m physicians or nurse practition]s 9 su* practice4 7#b7 ,eye doctor ,! t]m eye doctor means a p>ticipat+ physician :o is a ,/ate-lic5s$ optometri/ or oph?almologi/4 7#c7 ,prim>y c>e practice ,! t]m prim>y c>e practice-- 7,a7 means a physician 7z describ$ 9 section #ahfa7r77#a77 :o has a prim>y specialty designation ( family m$ic9e1 int]nal m$ic9e1 or g]iatric m$ic9e2 & 7,b7 includes a gr\p practice ! physicians )9 :i* are prim>ily physicians ) su* a specialty designation & may also include physician assi/ants & nurse practition]s4 4