TITLE I--MEDICARE PRESCRIPTION DRUG BENEFIT
SEC. 109. EXPANDING THE WORK OF MEDICARE QUALITY IMPROVEMENT
ORGANIZATIONS TO INCLUDE PARTS C AND D.
(a) APPLICATION TO MEDICARE MANAGED CARE AND
PRESCRIPTION DRUG COVERAGE- Section 1154(a)(1) (42 U.S.C. 1320c-3(a)(1)) is
amended by inserting `, to Medicare Advantage organizations pursuant to contracts
under part C, and to prescription drug sponsors pursuant to contracts under
part D' after `under section 1876'.
(b) PRESCRIPTION DRUG THERAPY QUALITY IMPROVEMENT-
Section 1154(a) (42 U.S.C. 1320c-3(a)) is amended by adding at the end the following
new paragraph:
`(17) The organization shall execute its responsibilities under
subparagraphs (A) and (B) of paragraph (1) by offering to providers,
practitioners, Medicare Advantage organizations offering Medicare Advantage
plans under part C, and prescription drug sponsors offering prescription
drug plans under part D quality improvement assistance pertaining to
prescription drug therapy. For purposes of this part and title XVIII, the
functions described in this paragraph shall be treated as a review
function.'.
(c) EFFECTIVE DATE- The amendments made by
this section shall apply on and after January 1, 2004.
(1) IN GENERAL- The Secretary shall
request the Institute of Medicine of the National Academy of Sciences to conduct
an evaluation of the program under part B of title XI of the Social Security
Act. The study shall include a review of the following:
(A) An overview of the program
under such part.
(B) The duties of organizations
with contracts with the Secretary under such part.
(C) The extent to which quality
improvement organizations improve the quality of care for medicare beneficiaries.
(D) The extent to which other
entities could perform such quality improvement functions as well as, or
better than, quality improvement organizations.
(E) The effectiveness of reviews
and other actions conducted by such organizations in carrying out those
duties.
(F) The source and amount of
funding for such organizations.
(G) The conduct of oversight
of such organizations.
(2) REPORT TO CONGRESS- Not later than
June 1, 2006, the Secretary shall submit to Congress a report on the results
of the study described in paragraph (1), including any recommendations for
legislation.
(3) INCREASED COMPETITION- If the Secretary
finds based on the study conducted under paragraph (1) that other entities
could improve quality in the medicare program as well as, or better than,
the current quality improvement organizations, then the Secretary shall provide
for such increased competition through the addition of new types of entities
which may perform quality improvement functions.
[