Legal Authority

Part A, Attachment 1
Legal Authority for Data Collection

Part A, Attachment 1 – Legal Authority for Data Collection, Affordable
Care Act, Section 4202(b)
SEC. 4202. HEALTHY AGING, LIVING WELL; EVALUATION OF COMMUNITY-BASED
PREVENTION AND WELLNESS PROGRAMS FOR MEDICARE BENEFICIARIES.
(b) EVALUATION AND PLAN FOR COMMUNITY-BASED PREVENTION AND WELLNESS
PROGRAMS FOR MEDICARE BENEFICIARIES.—
(1) IN GENERAL.—The Secretary shall conduct an evaluation of community-based prevention
and wellness programs and develop a plan for promoting healthy lifestyles and chronic disease
self-management for Medicare beneficiaries.
(2) MEDICARE EVALUATION OF PREVENTION AND WELLNESS PROGRAMS.—
(A) IN GENERAL.—The Secretary shall evaluate community prevention and wellness
programs including those that are sponsored by the Administration on Aging, are
evidence-based, and have demonstrated potential to help Medicare beneficiaries
(particularly beneficiaries that have attained 65 years of age) reduce their risk of disease,
disability, and injury by making healthy lifestyle choices, including exercise, diet, and
self-management of chronic diseases.
(B) EVALUATION.—The evaluation under subparagraph (A) shall consist of the
following:
(i) EVIDENCE REVIEW.—The Secretary shall review available evidence,
literature, best practices, and resources that are relevant to programs that promote
healthy lifestyles and reduce risk factors for the Medicare population. The
Secretary may determine the scope of the evidence review and such issues to be
considered, which shall include, at a minimum—
(I) physical activity, nutrition, and obesity;
(II) falls;
(III) chronic disease self-management; and
(IV) mental health.
(ii) INDEPENDENT EVALUATION OF EVIDENCE-BASED COMMUNITY
PREVENTION AND WELLNESS PROGRAMS.— The Administrator of the
Centers for Medicare & Medicaid Services, in consultation with the Assistant
Secretary for Aging, shall, to the extent feasible and practicable, conduct an
evaluation of existing community prevention and wellness programs that are
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Part A, Attachment 1
Legal Authority for Data Collection
sponsored by the Administration on Aging to assess the extent to which Medicare
beneficiaries who participate in such programs—
(I) reduce their health risks, improve their health outcomes, and adopt
and maintain healthy behaviors;
(II) improve their ability to manage their chronic conditions; and
(III) reduce their utilization of health services and associated costs under
the Medicare program for conditions that are amenable to improvement
under such programs.
(3) REPORT.—Not later than September 30, 2013, the Secretary shall submit to Congress a
report that includes—
(A) recommendations for such legislation and administrative action as the Secretary
determines appropriate to promote healthy lifestyles and chronic disease selfmanagement for Medicare beneficiaries;
(B) any relevant findings relating to the evidence review under paragraph (2)(B)(i); and
(C) the results of the evaluation under paragraph (2)(B)(ii).
(4) FUNDING.—For purposes of carrying out this subsection, the Secretary shall provide for the
transfer, from the Federal Hospital Insurance Trust Fund under section 1817 of the Social
Security Act (42 U.S.C. 1395i) and the Federal Supplemental Medical Insurance Trust Fund
under section 1841 of such Act (42 U.S.C. 1395t), in such proportion as the Secretary determines
appropriate, of $50,000,000 to the Centers for Medicare & Medicaid Services Program
Management Account. Amounts transferred under the preceding sentence shall remain available
until expended.
(5) ADMINISTRATION.—Chapter 35 of title 44, United States Code shall not apply to the this
subsection.
(6) MEDICARE BENEFICIARY.—In this subsection, the term ‘‘Medicare beneficiary’’ means
an individual who is entitled to benefits under part A of title XVIII of the Social Security Act and
enrolled under part B of such title.

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