S.Amdt. 253

SA 253. Mr. COBURN (for himself, Mr. Grassley, and Mr. Cornyn)
submitted an amendment intended to be proposed to amendment SA 98
proposed by Mr. Inouye (for himself and Mr. Baucus) to the bill H.R. 1,
making supplemental appropriations for job preservation and creation,
infrastructure investment, energy efficiency and science, assistance to
the unemployed, and State and local fiscal stabilization, for fiscal
year ending September 30, 2009, and for other purposes; which was
ordered to lie on the table; as follows:

On page 723, between lines 7 and 8, insert the following:
(3) Plan to establish chronic care disease management
programs.--
(A) In general.--
(i) Submission.--A State is not eligible for an increase in
its FMAP under subsection

[[Page S1565]]

(a), (b), or (c), or an increase in a cap amount under
subsection (d), for any fiscal year quarter occurring during
the recessionary adjustment period that begins on or after
October 1, 2009, and before the date (not later than 6 months
after the date of enactment of this Act) on which the State
submits to the Secretary a plan to establish chronic care
disease management programs with respect to at least the 5
most prevalent diseases within the population of Medicaid
beneficiaries in the State.
(ii) Implementation.--Each State that is paid additional
Federal funds as a result of this section shall, not later
than 18 months after such date of enactment, implement such a
plan that has been approved by the Secretary.
(B) Details.--Such plan shall include the following:
(i) Provide primary care physicians chronic care disease
management payments for assuring that an eligible Medicaid
beneficiary receives appropriate and comprehensive care,
including referral of the eligible Medicaid beneficiary to
specialists, and that the eligible Medicaid beneficiary
receives preventive services.
(ii) The amount of such chronic care disease management
payment shall reflect the amount of time spent with the
eligible Medicaid beneficiary, and the family of the eligible
Medicaid beneficiary, providing chronic care disease
management services to the eligible Medicaid beneficiary.
(C) Definition of eligible medicaid beneficiary.--In this
paragraph, the term ``eligible Medicaid beneficiary'' means
an individual who--
(i) is enrolled in the State Medicaid plan under title XIX
of the Social Security Act; and
(ii) is determined to have 1 or more of the diseases with
respect to which such chronic care disease management
programs are established in the State.
______