applicable condition

(B)The term “applicable condition” means 1 or more of 10 conditions selected by the Secretary. In selecting conditions under the preceding sentence, the Secretary shall take into consideration the following factors: (i)Whether the conditions selected include a mix of chronic and acute conditions. (ii)Whether the conditions selected include a mix of surgical and medical conditions. (iii)Whether a condition is one for which there is evidence of an opportunity for providers of services and suppliers to improve the quality of care furnished while reducing total expenditures under this subchapter. (iv)Whether a condition has significant variation in— (I)the number of readmissions; and (II)the amount of expenditures for post-acute care spending under this subchapter. (v)Whether a condition is high-volume and has high post-acute care expenditures under this subchapter. (vi)Which conditions the Secretary determines are most amenable to bundling across the spectrum of care given practice patterns under this subchapter.

Source

42 USC § 1395cc-4(a)(2)(B)


Scoping language

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