,i #aai? ,,congress #b;d ,session ,h4 ,r4 #ajgjf ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,octob] #a1 #bjbf,mr4 ,smi? ( ,nebraska introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,en]gy & ,comm]ce1 & 9 addition to ! ,committees on ,ways & ,means1 & ,rules1 = 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 ,,xi ( ! ,social ,security ,act to cl>ify p>amet]s = model te/+ & add acc\ntability to model expansion "u ! ,c5t] = ,m$ic>e & ,m$icaid ,innovation1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,/r5g!n+ ,innovation 9 ,m$ic>e & ,m$icaid ,act4 #b4 ,s5se ( ,congress ,x is ! s5se ( ,congress t3 7#a7 ,! ,c5t] = ,m$ic>e & ,m$icaid ,innovation 7,,cmi7 repres5ts a valuable tool = te/+ innovative heal? c>e paym5t & s]vice deliv]y models :i* c improve ! coord9ation1 quality1 & effici5cy ( heal? c>e s]vices4 7#b7 ,! model te/+ process is int5d$ to te/ concepts on a limit$ scale fir/ 9 ,phase ,i1 !n assess initial results1 &1 if results m]it1 exp& ! model to a l>g] te/ 9 ,phase ,,ii to confirm ! initial results4 7#c7 ,/>t+ model te/+ on a limit$ scale1 assess+ results1 & !n exp&+ ! model to confirm initial results protects ! integrity ( ! ,m$ic>e program by m9imiz+ un9t5tional losses or negative impacts to ! pati5ts or provid]s p>ticipat+ 9 ,phase ,i model te/+4 7#d7 ,,cmi %\ld focus its att5tion on models mo/ likely to succe$ & %\ld cont9ually assess models & t]m9ate ^? :i* are n g5]at+ results 9 keep+ ) its purpose--l[]+ co/s :ile ma9ta9+ or pres]v+ pati5t outcomes4 7#e7 ,m&atory models may be necess>y to te/ c]ta9 paym5t models b %\ld be us$ judici\sly & be z limit$ 9 scope z possible to m9imize accid5tal adv]se impacts4 7#f7 ,z ,,cmi may waive c]ta9 provisions ( ,m$ic>e regulations1 ,congress may block models :i* functionally alt] or *ange ! und]ly+ exi/+ /atutes4 #c4 ,def9+ ,,cmi model te/+ p>amet]s 7a7 ,scope & duration ( models ,section #aaae;,a7a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acae;a7a77 is am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#f7 ,scope & duration ( models te/$ ,beg9n+ on or aft] ! date ( ! enactm5t ( ! ,/r5g!n+ ,innovation ,9 ,m$ic>e & ,m$icaid ,act1 = purposes ( te/+ new paym5t & s]vice deliv]y models1 ! ,secret>y %all limit te/+ ( a ,phase ,i model-- 7,a7 to a p]iod n to exce$ #e ye>s2 & 7,b7 to ! less] ( #aj p]c5t ( applicable individuals or #ejj1jjj b5efici>ies4 4 7b7 ,cap on ,phase ,i model te/+ ,section #aaae;,a7a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acae;a7a771 z am5d$ by subsection 7a71 is fur!r am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#g7 ,phase ,i model limitations ,dur+ ea* fiscal ye> />t+ ) fiscal ye> #bjbg1 ,,cmi %all initiate ,phase ,i te/+ ( no m ?an #f new models ea* fiscal ye>4 ,additionally1 ,,cmi %all n concurr5tly te/ m ?an #e ,phase ,i models :i* involve m&atory1 involunt>y1 or compulsory p>ticipation4 4 7c7 ,requir$ waiv]s = h>d%ip ,section #aaae;,a7a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acae;a7a771 z am5d$ by subsections 7a7 & 7b71 is fur!r am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#h7 ,h>d%ip waiv]s ,n lat] ?an #fj days aft] ! enactm5t ( ! ,/r5g!n+ ,innovation 9 ,m$ic>e & ,m$icaid ,act1 ! ,secret>y %all develop & implem5t a plan to all[ applicable provid]s ( s]vices or supplies to reque/ a waiv] f any requirem5t ( a model if ! ,secret>y det]m9es t su* requirem5t w\ld result 9 undue economic h>d%ip to su* provid] or suppli] or loss ( access to su* heal?c>e s]vices or supplies = vuln]able populations4 4 7d7 ,monitor+ impact ,section #aaae;,a7a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acae;a7a771 z am5d$ by subsections 7a71 7b71 & 7c71 is fur!r am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#i7 ,monitor+ impact ,n lat] ?an #fj days aft] ! enactm5t ( ! ,/r5g!n+ ,innovation 9 ,m$ic>e & ,m$icaid ,act1 ! ,secret>y %all develop & implem5t a plan to-- 7,a7 monitor cont9u\sly & on a real-"t basis ! effect ( a model "u subsection 7b7 on applicable individuals1 & mitigate any adv]se impact1 su* z inappropriate r$uctions 9 c>e or r$uc$ access to c>e2 & 7,b7 mitigate any adv]se impact t ! ,secret>y det]m9es c\ld affect b5efici>y heal?4 4 #d4 ,implem5tation ( te/+ & expansion ( models ) congressional inaction 7a7 ,9 g5]al ,section #aaae;,a7d7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acae;a7d77 is am5d$ by add+ at ! end ! foll[+ new p>agraph3 7#d7 ,implem5tation ( te/+ & expansion ( models ) congressional inaction 7,a7 ,! ,secret>y %all transmit a proposal = ! te/+1 expansion1 or modification ( a model "u subsections 7b7 & 7c71 includ+ a propos$ effective date & a summ>y ( ! det]m9ations & c]tification made "u p>agraphs 7#a7 ?r\gh 7#c7 ( subsection 7c71 if applicable1 to ! ,committee on ,ways & ,means & ! ,committee on ,en]gy & ,comm]ce ( ! ,h\se ( ,repres5tatives & to ! ,committee on ,f9ance & ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions ( ! ,s5ate4 7,b7 ,! te/+1 expansion1 or modification ( a model propos$ 9 a report submitt$ "u subp>agraph 7,a7 %all be c>ri$ out by ! ,secret>y if ,congress does n1 )9 #de days ( receiv+ su* report1 pass a jo9t resolution disapprov+ ( ! propos$ te/+ or expansion 9 accordance ) ! foll[+ proc$ure3 7i7 ,! succe$+ subp>agraphs ( ?is p>agraph are enact$ by ,congress z an ex]cise ( ! rulemak+ p[] ( ! ,s5ate & ! ,h\se ( ,repres5tatives1 respectively1 & z su* !y %all be deem$ a "p ( ! rules ( ea* ,h\se1 respectively1 b applicable only ) ! respect to ! proc$ure to be foll[$ 9 t ,h\se 9 ! case ( resolutions describ$ 9 subp>agraph 7,b74 ,!y %all sup]s$e o!r rules only to ! ext5t t !y are inconsi/5t !re)4 ,!y are enact$ ) full recognition ( ! con/itutional "r ( ei!r ,h\se to *ange ! rules 7s f> z relat+ to ! proc$ure ( t ,h\se7 at any "t1 9 ! same mann] & to ! same ext5t z 9 ! case ( any ruse ( t ,h\se4 7ii7 ,= ! purpose ( ! succe$+ p>agraphs ( ?is subsection1 resolution means only a jo9t resolution1 ! matt] aft] ! resolv+ clause ( :i* is z foll[s3 ,t ,congress disapproves ! model expansion reque/$ pursuant to section #aaae;,a7c7 ( ! ,social ,security ,act transmitt$ by ! ,secret>y on 1 & su* an expansion %all n proce$41 ! blank space !re9 be+ fill$ ) ! date on :i* ! ,secret>y's message propos+ su* expansion 0 deliv]$4 7iii7 ,^u receipt ( a report submitt$ to ,congress "u subp>agraph 7c77#d71 ea* ,h\se %all provide copies ( ! report to ! *airman & rank+ memb] ( ! ,committee on ,ways & ,means & ! ,committee on ,en]gy & ,comm]ce ( ! ,h\se ( ,repres5tatives & to ! ,committee on ,f9ance & ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions ( ! ,s5ate4 7iv7 ,a resolution %all be ref]r$ to ! ,committee on ,ways & ,means & ! ,committee on ,en]gy & ,comm]ce ( ! ,h\se ( ,repres5tatives & to ! ,committee on ,f9ance & ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions ( ! ,s5ate4 7v7 ,if a committee to :i* has be5 ref]r$ a resolution has n report$ x be=e ! expiration ( #aj legislative days aft] its introduction1 x %all !n 7b n be=e7 be 9 ord] to move to dis*>ge ! committee f fur!r consid]ation ( t resolution1 or to dis*>ge ! committee f fur!r consid]ation ( any o!r resolution ) respect to ! propos$ expansion :i* has be5 ref]r$ to ! committee4 ,! motion to dis*>ge may be made only by a p]son favor+ ! resolution1 %all be highly privileg$ 7except t x may n be made aft] ! committee has report$ a resolution ) respect to ! same propos$ expansion71 & debate !reon %all be limit$ to n m ?an #a h\r1 to be divid$ equally betwe5 ^? favor+ & ^? oppos+ ! resolution4 ,an am5dm5t to ! motion is n 9 ord]1 & x is n 9 ord] to move to reconsid] ! vote by :i* ! motion is agre$ to or disagre$ to4 ,if ! motion to dis*>ge is agre$ to or disagre$ to1 ! motion may n be r5ew$1 nor may ano!r motion to dis*>ge ! committee be made ) respect to any o!r resolution ) respect to ! same propos$ expansion4 7vi7 ,:5 ! committee has report$1 or has be5 dis*>g$ f fur!r consid]ation ( a resolution1 x is at any "t !reaft] 9 ord] 7ev5 ?\gh a previ\s motion to ! same effect has be5 disagre$ to7 to move to proce$ to ! consid]ation ( ! resolution4 ,! motion is highly privileg$ & is n debatable4 ,an am5dm5t to ! motion is n 9 ord]1 & x is n 9 ord] to move to reconsid] ! vote by :i* ! motion is agre$ to or disagre$ to4 ,debate on ! resolution %all be limit$ to n m ?an #b h\rs1 :i* %all be divid$ equally betwe5 ^? favor+ & ^? oppos+ ! resolution4 ,a motion fur!r to limit debate is n debatable4 ,an am5dm5t to1 or motion to recommit1 ! resolution is n 9 ord]1 & x is n 9 ord] to move to reconsid] ! vote by :i* ! resolution is agre$ to or disagre$ to4 7vii7 ,motions to po/pone1 made ) respect to ! dis*>ge f committee1 or ! consid]ation (1 a resolution & motions to proce$ to ! consid]ation ( o!r bus9ess %all be decid$ )\t debate4 ,appeals f ! decision ( ! ,*air relat+ to ! application ( ! rules ( ! ,s5ate or ! ,h\se ( ,repres5tatives1 z ! case may be1 to ! proc$ure relat+ to a resolution %all be decid$ )\t debate4 7viii7 ,if1 be=e ! passage by "o ,h\se ( a jo9t resolution ( t ,h\se1 t ,h\se receives f ! o!r ,h\se a jo9t resolution1 !n ! foll[+ proc$ures %all apply3 7,i7 ,! jo9t resolution ( ! o!r ,h\se %all n be ref]r$ to a committee4 7,,ii7 ,) respect to a jo9t resolution ( ! ,h\se receiv+ ! resolution1 ! proc$ure 9 t ,h\se %all be ! same z if no jo9t resolution _h be5 receiv$ f ! o!r ,h\se2 b ! vote on passage %all be on ! jo9t resolution ( ! o!r ,h\se4 7ix7 ,if "o ,h\se fails to introduce or consid] a jo9t resolution "u ?is section1 ! jo9t resolution ( ! o!r ,h\se %all be entitl$ to exp$it$ floor proc$ures "u ?is section4 7x7 ,if1 foll[+ passage ( ! jo9t resolution 9 ! ,s5ate1 ! ,s5ate !n receives ! companion measure f ! ,h\se ( ,repres5tatives1 ! companion measure %all n be debatable4 7xi7 ,if ,congress passes a jo9t resolution1 ! p]iod beg9n+ on ! date ! ,presid5t is pres5t$ ) ! jo9t resolution & end+ on ! date ! ,presid5t takes action ) respect to ! jo9t resolution %all be disreg>d$ 9 comput+ ! #de-;cal5d> day p]iod describ$ 9 subsection 7c77#d74 7xii7 ,if ! ,presid5t vetoes ! jo9t resolution-- 7,i7 ! p]iod beg9n+ on ! date ! ,presid5t vetoes ! jo9t resolution & end+ on ! date ! ,congress receives ! veto message ) respect to ! jo9t resolution %all be disreg>d$ 9 comput+ ! #de-;cal5d> day p]iod describ$ 9 subsection 7c77#d72 & 7,,ii7 debate on a veto message 9 ! ,s5ate "u ?is section %all be #a h\r equally divid$ betwe5 ! majority & m9ority lead]s or _! designees4 4 7b7 ,effective date ,! am5dm5ts made by ?is section %all apply beg9n+ on ! date ( ! enactm5t ( ?is ,act4 #e4 ,public input ,section #aaae;,a7d7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acae;a7d77 is am5d$ by section #c1 is fur!r am5d$ by add+ at ! end ( ! foll[+ new p>agraphs3 7#e7 ,public input ,! ,secret>y %all use a process involv+ advance public notice & an opportunity = /akehold] input & public comm5ts to ensure transp>5cy & acc\ntability reg>d+ ! e/abli%m5t1 te/+1 implem5tation1 evaluation1 & expansion ( a model "u section #aaae;,a7b7 & 7c74 ,su* public notice %all describe & def9e ! /&>ds1 crit]ia1 & processes t ! ,secret>y w use = select+ & evaluat+-- 7,a7 dur+ initial /ages ( model developm5t2 7,b7 prior to te/+ "u subsection 7b77#a72 7,c7 prior to modification ( non-contractual models "u subsection 7b77#c77;,b72 & 7,d7 foll[+ evaluation ( a model "u subsection 7b77#d7 & prior to rulemak+ "u subsection 7c74 ,su* notice %all expla9 ! basis = ! ,secret>y's det]m9ation t ! conditions set =? 9 section #aaae;,a7c7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acae;a7c77 h be5 met4 ,additionally1 ! notice %all expla9 ! basis = selection & ! /&>ds e/abli%$ by ! ,secret>y "u ! regulations issu$ "u p>agraph 7#a71 & any additional factors t w be us$ to te/ ! model's impact on quality ( c>e1 pati5t-c5t]$ness1 & innovation4 ,! notice %all provide a m9imum #de-;day p]iod = public comm5t4 ,! ,secret>y %all take /akehold] comm5ts into consid]ation :5 det]m9+ :e!r or h[ to ref9e ! model or :e!r to proce$ ) te/+ "u subsection 7b77#a74 7#f7 ,consultation ,9 c>ry+ out ! duties "u ?is subsection1 ! ,,cmi %all consult repres5tatives ( relevant ,f$]al ag5cies1 & cl9ical & analytical exp]ts ) exp]tise 9 m$ic9e & heal? c>e managem5t1 specifically su* exp]ts ) exp]tise 9 ! f9ancial ne$s ( safety net1 community-bas$1 rural1 & critical access provid]s1 includ+ f$]ally qualifi$ heal? c5t]s4 ,! ,,cmi %all use op5 door =ums or o!r me*anisms to seek ext]nal fe$back f int]e/$ p>ties & incorporate t fe$back into ! developm5t ( models4 4 #f4 ,ree/abli%+ judicial review 7a7 ,9 g5]al ,section #aaae;,a7d77#b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acae7;d77#b77 is am5d$-- 7#a7 9 ! matt] prec$+ subp>agraph 7,a71 by ins]t+ 7except z may be necess>y to en=ce ! requirem5ts ( ?is section or o!r laws or con/itutional provisions int5d$ to protect b5efici>ies ( affect$ programs7 aft] or o!rwise2 7#b7 by /rik+ subp>agraph 7,c72 7#c7 9 subp>agraph 7,d71 by add+ & at ! end2 7#d7 9 subp>agraph 7,e71 by /rik+ 2 & & ins]t+ a p]iod2 7#e7 by r$esignat+ subp>agraphs 7,d7 & 7,e7 z subp>agraphs 7,c7 & 7,d71 respectively2 & 7#f7 by /rik+ subp>agraph 7,f74 7b7 ,effective date ,! am5dm5ts made by ?is section %all apply beg9n+ on ! date ( ! enactm5t ( ?is ,act4 #g4 ,revision ( report+ requirem5t ,section #aaae;,a7g7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acae;a7g77 is am5d$-- 7#a7 by /rik+ & n less ?an once e o!r ye> !reaft] & ins]t+ &1 = ye>s be=e #bjbg1 n less ?an once bi5nially 7&1 = ye>s beg9n+ ) #bjbg1 n less ?an annually7 !reaft]2 & 7#b7 by add+ at ! end ! foll[+ new s5t5ce3 ,) respect to #bjbg & ea* subsequ5t ye>1 ! ,secret>y %all submit ea* su* report by n lat] ?an ,decemb] #ae ( su* ye>44 #h4 ,address+ ov]lap 9 value-bas$ c>e programs 7a7 ,9 g5]al 7#a7 ,,cmi ,section #aaae;,a7a77#e7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acae;a7a77#e77 is am5d$ by add+ at ! end ! foll[+ new s5t5ce3 ,9 e/abli%+ su* limits1 ! ,secret>y %all take into acc\nt paym5t & s]vice deliv]y models 9 progress 9 su* geographic areas44 7#b7 ,repeal ( ,m$ic>e duplication prohibition ,section #ahii7;b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie;jjj7b77 is am5d$ by /rik+ p>agraph 7#d77;,a74 7b7 ,report ,n lat] ?an #fj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,heal? & ,human ,s]vices %all conduct an assessm5t & submit to ,congress a report on alt]native paym5t model ov]lap "u ! ,m$ic>e program "u title ,,xviii ( ! ,social ,security ,act4 ,su* report %all include a description ( & recomm5dations relat+ to-- 7#a7 appropriate p>ticipation 9 multiple alt]native paym5t models = heal? c>e provid]s2 7#b7 feasibility ( adequate evaluation ( alt]native paym5t models if p>ticipants are p>ticipat+ 9 multiple arrangem5ts2 & 7#c7 ob/acles creat$ by compet+ inc5tives ) respect to alt]native paym5t models4 #i4 ,model eligibility & quality ( c>e 7a7 ,cl>ification ( model eligibility ,section #aaae;,a ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acae;a7 is am5d$-- 7#a7 9 subsection 7a77#a71 by /rik+ also be=e improve2 & 7#b7 9 subsection 7b77#b77;,a71 by ins]t+ aft] ! second s5t5ce ! foll[+ new s5t5ce3 ,! ,secret>y may also focus on models solely aim$ at implem5t+ practices to demon/rate ways to significantly improve ! c>e1 pati5t safety1 & heal? outcomes ( individuals receiv+ b5efits "u ! applicable title 9 anticipation t quality ( c>e b5efits & pot5tial direct or indirect sav+s w ov] "t accrue to ! ,m$ic>e or ,m$icaid program4 4 7b7 ,additional opportunity ,section #aaae;,a7b77#b77;,b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acae;a7b77#b77;,b77 is am5d$ by add+ at ! end ! foll[+ new clause3 7xxviii7 ,implem5t+ newly recogniz$ & evid5ce-bas$1 pr(essionally support$ c>e deliv]y practices & bundles to improve ! effici5t & effective deliv]y ( hospital-bas$ c>e & lead to enhanc$ pati5t outcomes1 r$uctions 9 readmissions1 or avoidance ( co/ly m$ical errors or complications4 4 7c7 ,inclusion ( indirect sav+s ,section #aaae;,a7b77#c77;,a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acae;a7b77#c77;,a77 is am5d$ by ins]t+ or t sav+s _c be made indirectly ov] "t :5 te/+ quality ( c>e deliv]y models be=e ! p]iod at ! end4 7d7 ,availability ( actu>ial assumptions & data ,section #aaae;,a ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acae;a7 is am5d$-- 7#a7 9 subsection 7b77#c77;,b7-- 7,a7 by r$esignat+ clauses 7i7 ?r\gh 7iii7 z subclauses 7,i7 ?r\gh 7,,iii71 respectively1 & adju/+ ! m>g9s accord+ly2 7,b7 by /rik+ ,! ,secret>y %all & ins]t+ ! foll[+3 7i7 ,9 g5]al ,! ,secret>y %all 2 & 7,c7 by add+ at ! end ! foll[+ new clause3 7ii7 ,publicly available in=mation ,! ,secret>y %all provide to ea* provid] ( s]vices & suppli] p>ticipat+ 9 a model1 & include 9 any rules promulgat$ ) respect to ! consid]ation ( su* model = t]m9ation or modification1 ! assumptions & data us$ by ! ,*ief ,actu>y ( ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices z ! basis = mak+ 7or decl9+ to make7 ! c]tification describ$ 9 clause 7i7 ) respect to su* model4 2 & 7#b7 9 subsection 7c71 9 ! flu%-left text at ! end1 by add+ at ! end ! foll[+ new s5t5ce3 ,! ,secret>y %all provide to ea* provid] ( s]vices & suppli] p>ticipat+ 9 a model or demon/ration project1 & include 9 any rules promulgat$ ) respect to ! consid]ation ( su* model = expansion1 ! assumptions & data us$ by ! ,*ief ,actu>y ( ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices z ! basis = mak+ 7or decl9+ to make7 ! c]tification describ$ 9 p>agraph 7#b7 ) respect to su* model44 7e7 ,evaluat+ quality ( c>e ,section #aaae;,a7b77#d7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acae;a7b77#d77 is am5d$-- 7#a7 9 subp>agraph 7,a71 by am5d+ clause 7i7 to read z foll[s3 7i7 ! quality ( c>e furni%$ "u ! model1 includ+ ! measurem5t ( pati5t-level outcomes1 pati5t-c5t]$ness1 & any un9t5d$ consequ5ces1 su* z access to s]vices1 us+ crit]ia det]m9$ appropriate by ! ,secret>y = ea* model2 & 2 & 7#b7 9 subp>agraph 7,c71 by /rik+ & be=e pati5t-c5t]$ c>e & ins]t+ 1 are appropriate to issues ( quality outcomes relat$ to ! m$ical conditions "u /udy1 & are4 #aj4 ,,gao report ,n lat] ?an #ab mon?s aft] ! date ( enactm5t ( ?is ,act1 ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates %all submit to ,congress a report t conta9s an analysis (-- 7#a7 ! ef=ts ( ! ,c5t] = ,m$ic>e & ,m$icaid ,innovation to attract1 reta91 & develop em]g+ exp]ts2 7#b7 ! impact ( ! exi/+ au?ority provid$ to ! ,c5t] = ,m$ic>e & ,m$icaid ,innovation to address work=ce %ortages & gaps 9 priority areas2 & 7#c7 ! simil>ities & diff]5ces betwe5 ! au?ority provid$ to ! ,c5t] = ,m$ic>e & ,m$icaid ,innovation "u section #aaae;,a ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acae;a7 & ! au?ority provid$ to ! ,secret>y ( ,heal? & ,human ,s]vices "u section #djb ( ! ,social ,security ,am5dm5ts ( #aifg 7#db ,u4,s4,c4 #acie;b-#a74 #aa4 ,effective date ,except z o!rwise provid$ 9 ! previ\s sections ( ?is ,act 7& ! am5dm5ts made by su* sections71 su* am5dm5ts %all apply ) respect to ! te/+1 expansion1 or modification ( models on or aft] ,janu>y #a1 #bjbg4