,,ii #aaith ,,congress #b;d ,session ,s4 #ebfg ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,august #e1 #bjbf,mr4 ,banks 7for himself1 ,mr4 ,padilla1 and ,mr4 ,marshall7 introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to amend title ,,xi of the ,social ,security ,act to require the ,center for ,medicare and ,medicaid ,innovation to test a model to reduce chronic diseases by using ,accountable ,produce is ,medicine4 #a4 ,short title ,this ,act may be cited as the ,accountable ,produce is ,medicine ,act of #bjbf4 #b4 ,sense of ,congress ,it is the sense of ,congress that-- 7#a7 diet-related chronic diseases are a leading driver of health care costs in the ,united ,states2 7#b7 evidence-based food-is-medicine interventions1 including medically tailored meals1 medically tailored groceries1 produce prescriptions1 and nutrition counseling1 have the potential to improve health outcomes and reduce health care expenditures2 7#c7 the ,center for ,medicare and ,medicaid ,innovation should1 to the extent practicable1 incorporate such interventions1 as appropriate1 into models tested under section #aaae;,a of the ,social ,security ,act 7#db ,u4,s4,c4 #acae;a72 and 7#d7 incorporating food-is-medicine interventions into the ,center for ,medicare and ,medicaid ,innovation models may improve quality of care1 reduce costs1 and support the prevention and management of chronic disease4 #c4 ,requiring the ,center for ,medicare and ,medicaid ,innovation to test a model to improve outcomes for patients with chronic diseases by using accountable produce is medicine ,section #aaae;,a of the ,social ,security ,act 7#db ,u4,s4,c4 #acae;a7 is amended-- 7#a7 in subsection 7b77#b77;,a71 in the third sentence1 by inserting 1 and1 beginning not later than the date that is #ahj days after the enactment of the ,accountable ,produce is ,medicine ,act of #bjbf1 shall include the ,accountable ,produce is ,medicine ,bundled ,payment ,model described in subsection 7h7 before the period at the end2 and 7#b7 by adding at the end the following new subsection3 7h7 ,accountable ,produce is ,medicine ,bundled ,payment ,model 7#a7 ,in general ,for purposes of subsection 7b77#b77;,a71 the ,accountable ,produce is ,medicine ,bundled ,payment ,model 7in this subsection1 referred to as the model7 described in this subsection is a model under which a bundled payment is made under title ,,xviii1 title ,,xix1 or title ,,xxi1 as appropriate1 for selected programs to furnish ,accountable ,produce is ,medicine services to eligible individuals4 7#b7 ,selection of programs to participate 7,a7 ,selected programs ,the ,secretary shall select to participate in the model at least #e eligible programs1 each to participate for a period of not less than #b years1 that the ,secretary determines have the capacity to satisfy the requirements described in paragraph 7#c74 ,in this subsection1 each such eligible program so selected shall be referred to as a selected program4 7,b7 ,priority ,in selecting eligible programs under subparagraph 7,a71 the ,secretary shall give priority to any such program that furnishes 7including through an arrangement with a provider of services or supplier or other entity7 fresh1 frozen1 or minimally processed fruits and vegetables without added sugars1 sodium1 or saturated fats 7except those occurring naturally71 and other plant-based1 nutrient-dense foods1 including nuts1 seeds1 intact whole grains1 beans1 and lentils4 7#c7 ,minimum program requirements ,under the model1 a selected program shall comply with each of the following requirements3 7,a7 ,screening ,the selected program shall screen individuals who are referred to the program by a physician1 hospital1 or other health care provider1 to determine whether such individuals are eligible individuals4 7,b7 ,accountable ,produce is ,medicine services ,in the case of an individual who is determined by the selected program under subparagraph 7,a7 to be an eligible individual1 the selected program shall1 for the #a-year period following such determination 7subject to subparagraph 7,d771 make available 7including through an arrangement with a provider of services or supplier or other entity7 to such individual the following services 7in this subsection referred to as ,accountable ,produce is ,medicine services or ,,apim services73 7i7 ,a personalized health risk assessment and personalized prevention plan4 7ii7 ,care coordination services4 7iii7 ,telehealth services related to chronic disease monitoring1 education1 and follow-up4 7iv7 ,remote patient monitoring items and services that are clinically appropriate for monitoring chronic disease and facilitating a timely response from a provider in the case that the selected program detects significant changes in the data being monitored4 7v7 ,lifestyle modification programs1 including nutrition counseling provided by a registered dietician or other qualified provider1 exercise programs1 and smoking cessation counseling4 7vi7 ,healthy1 nutrient-dense foods meeting such standards as the ,secretary shall determine1 with preference given to produce grown within #bej miles of the selected program or through the use of regenerative agriculture4 7,c7 ,collection of health data2 reenrollment assessment ,in the case of an individual who is determined by the selected program under subparagraph 7,a7 to be an eligible individual1 the selected program shall-- 7i7 track the ,,apim services that the individual has received from the program under the model2 7ii7 regularly evaluate the individual's engagement with the program and adherence to program requirements2 7iii7 on a quarterly basis collect from such individual updated weight1 blood pressure1 and blood glucose measurements1 and any other measurements determined appropriate by the ,secretary2 and 7iv7 at the end of the #a-year period described in subparagraph 7,b7-- 7,i7 evaluate the measurements collected under clause 7iii72 7,,ii7 submit to the ,secretary such data as the ,secretary determines necessary for purposes of evaluating the health care cost savings achieved for such individual during such period2 and 7,,iii7 provide for an additional determination under subparagraph 7,a7 as to whether such individual remains an eligible individual4 7,d7 ,disenrollment ,in the case of an individual who is determined by the selected program under subparagraph 7,a7 to be an eligible individual1 if the selected program determines 7in accordance with standards established by the ,secretary7 before the end of the #a-year period described in subparagraph 7,b7 that such individual is not adequately engaging with the program or is not adhering to program requirements1 the selected program shall terminate the individual's participation in the program and may not furnish any additional ,,apim services to such individual under the model4 7#d7 ,payment 7,a7 ,in general ,the ,secretary shall determine the form1 manner1 and amount of bundled payment to be provided to selected programs under the model and1 beginning in the third year in which such model is carried out1 may require that selected programs assume financial risk for performance under the model4 7,b7 ,cost sharing ,,apim services furnished by a selected program to an eligible individual shall be provided without application of deductibles1 copayments1 coinsurance1 or other cost-sharing under the applicable title4 7#e7 ,duration ,the model shall be carried out for a period of not less than #e years4 7#f7 ,definitions ,in this subsection3 7,a7 ,eligible individual ,the term eligible individual means an individual-- 7i7 who is-- 7,i7 entitled to benefits under part ,a of title ,,xviii or enrolled for benefits under part ,b of such title2 7,,ii7 enrolled under a ,state plan 7or waiver of such plan7 under title ,,xix2 or 7,,iii7 enrolled under a ,state child health plan 7or waiver of such plan7 under title ,,xxi2 7ii7 who resides in a medically underserved area 7as designated pursuant to section #ccj7;b77#c77;,a7 of the ,public ,health ,service ,act71 a rural area 7as defined in section #ahhf7;d77#b77;,d771 a health professional shortage area described in section #ccb7;a77#a77;,a7 of the ,public ,health ,service ,act1 or another area determined appropriate by the ,secretary2 7iii7 who has diabetes1 obesity1 cardiovascular disease1 hypertension1 malnutrition1 or any other disease or chronic condition that the ,secretary determines appropriate2 7iv7 in the clinical judgment of a physician or other health care professional1 who would benefit from participation in the model2 7v7 who the eligible program determines to be prepared to participate in the model2 and 7vi7 who is not already receiving items or services that the ,secretary determines are substantially similar 7and duplicative in purpose and clinical function7 to the ,,apim services described in clause 7v7 of paragraph 7#c77;,b74 7,b7 ,eligible program ,the term eligible program means a provider of services 7as defined in section #ahfa7u77 or supplier enrolled in the program under title ,,xviii1 title ,,xix1 or title ,,xxi4 7,c7 ,regenerative agriculture ,the term regenerative agriculture means a conservation management approach that emphasizes natural resources through improved soil health1 water management1 and natural vitality4 7,d7 ,supplier ,the term supplier means a physician or other practitioner1 a facility1 or other entity that furnishes services under title ,,xviii1 title ,,xix1 or title ,,xxi4 4