S.Amdt. 3273

SA 3273. Mrs. SHAHEEN (for herself, Mr. Bennet, and Ms. Collins)
submitted an amendment intended to be proposed to amendment SA 2786
proposed by Mr. Reid (for himself, Mr. Baucus, Mr. Dodd, and Mr.
Harkin) to the bill H.R. 3590, to amend the Internal Revenue Code of
1986 to modify the first-time homebuyers credit in the case of members
of the Armed Forces and certain other Federal employees, and for other
purposes; which was ordered to lie on the table; as follows:

On page 796, between lines 5 and 6, insert the following:

SEC. 3028. IMPROVEMENTS TO COMMUNITY-BASED CARE TRANSITIONS
PROGRAM.

Section 3026 is amended--
(1) in subsection (a), by inserting ``evidence-based''
before ``care transition services'';
(2) in subsection (b)--
(A) in paragraph (1), in the matter preceding subparagraph
(A), by striking ``The term'' and inserting ``Subject to
paragraph (7), the term''; and
(B) by adding at the end the following new paragraph:
``(7) Limitation.--The term `eligible entity' includes a
subsection (d) hospital described in paragraph (1)(A) or a
community-based organization described in paragraph (1)(B)
only if the provider of services or organization demonstrates
to the Secretary relevant training and experience in the
delivery of care transition services, including for
individuals providing such services under the program.'';
(3) in subsection (c)--
(A) in paragraph (1)--
(i) by redesignating subparagraph (B) as subparagraph (C);
(ii) by inserting after subparagraph (A) the following new
subparagraph:
``(B) Evaluation.--
``(i) In general.--The Secretary shall conduct an
evaluation of the program, and shall take such evaluation
into account in determining whether to expand the program
under subparagraph (C).
``(ii) Determination of criteria.--The Secretary shall
determine the criteria used under such evaluation, taking
into account hospital readmission rates and the experiences
of primary caregivers and high-risk Medicare beneficiaries
under the program, including the quality of care transition
interventions and health outcomes.'';
(iii) in subparagraph (C), as redesignated by subparagraph
(A), by striking ``that such expansion'' and all that follows
through the period at the end and inserting ``that such
expansion would--
``(i) reduce spending under title XVIII of the Social
Security Act without reducing quality of care;
``(ii) improve quality of care and reduce such spending; or
``(iii) improve quality of care without increasing such
spending.''; and
(iv) by adding at the end the following new subparagraph:
``(D) Required elements of program during expansion
period.--If the Secretary expands the program under
subparagraph (C), the following shall apply with respect to
such expansion:
``(i) Evidence-based services.--The Secretary shall require
the use of only evidence-based care transition services
during such expansion.
``(ii) Expansion of eligible entities.--The Secretary shall
expand the type of providers of services or organizations
that may qualify as eligible entities for the provision of
care transition services under subsection (b)(1), such as a
home health agency, primary health care practice, or a
Federally qualified health center. Any provider of services
or organization that so qualifies under the preceding
sentence shall be required to demonstrate to the Secretary
relevant training and experience in the delivery of evidence-
based care transition services, including for individuals
providing such services under the program.'';
(B) in paragraph (2)(B)--
(i) in the matter preceding clause (i), by striking ``,
which may include the following:'' and inserting ``. Each
care transition intervention proposed shall include, at a
minimum, the following:'';
(ii) in clause (i)--

(I) by inserting ``(and, as appropriate, the primary
caregiver of the beneficiary)'' after ``high-risk Medicare
beneficiary'';
(II) by striking ``not later than 24 hours''; and
(III) by inserting ``, with a recommendation that such
services should be initiated not less than 24 hours prior to
such discharge and, whenever possible, earlier in the stay at
the eligible entity'' before the period at the end; and

(iii) by adding at the end the following new clauses:
``(vi) Providing care transition services to the high-risk
Medicare beneficiary (and, as appropriate, the primary
caregiver of the beneficiary) under the care transition
intervention after admission and prior to the discharge of
the beneficiary from the eligible entity and for a period of
up to 90 days after such discharge.
``(vii) Providing at least some of the care transition
services provided to the high-risk Medicare beneficiary under
the care transition intervention in-person.''; and
(C) in paragraph (3)--
(i) in subparagraph (A), by striking ``or'' at the end;
(ii) in subparagraph (B), by striking the period at the end
and inserting ``; or''; and
(iii) by adding at the end the following new subparagraph:
``(C) support inpatient and ambulatory health care
providers in improving the safety and quality of care, with a
governing body that is not comprised of a majority of any
type of provider or profession.'';
(4) by redesignating subsection (f) as subsection (g); and
(5) by inserting after subsection (e) the following new
subsection:
``(f) Provision of De-Identified Data to Providers of
Services and Suppliers.--
``(1) In general.--Notwithstanding any other provision of
law, subject to paragraph (3), an eligible entity
participating in the program may make available to providers
of services and suppliers participating in a care transition
intervention under the program de-identified data with
respect to high-risk Medicare beneficiaries.
``(2) Data.--Data made available under paragraph (1) shall
identify services provided by providers of services and
suppliers to high-risk Medicare beneficiaries, for the
purposes of--
``(A) improving the safety, quality, and effectiveness of
care transition services provided to those beneficiaries
under the program; and
``(B) measuring the safety, quality, and effectiveness of
such services provided by a provider of services or supplier
to the safety, quality, and effectiveness of such services
provided by another provider of services or supplier.
``(3) Privacy standards.--Nothing in this subsection shall
be construed to limit, alter, or affect the requirements
imposed by the regulations promulgated under section 264(c)
of the Health Insurance Portability and Accountability Act of
1996.''.
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