To amend title XVIII of the Social Security Act to establish a population based payment demonstration project under which Patient Care Networks are paid prospective monthly capitated payments for coordinated care furnished to Medicare beneficiaries.

[AI summary unavailable — showing source text] This bill amends title XVIII (Medicare) of the Social Security Act to establish a five-year, population-based payment demonstration project through which provider networks are prospectively paid monthly capitated payments for coordinated care furnished to Medicare beneficiaries. To be eligible to participate in the project, a provider network must: be an integrated care system that provides Medicare services directly; include physicians in group practice arrangements, a federally qualified health center, and at least one hospital; enter into, and be responsible for making payments to providers under, appropriate contractual arrangements; be accountable for the quality, cost, and overall care of the network's participating beneficiaries; enter into a participation agreement with the Centers for Medicare & Medicaid Services (CMS); and meet other specified requirements. CMS shall establish a process for prospectively assigning Medicare fee-for-service beneficiaries to a participating provider network. This process must allow beneficiaries to opt out of such assignment. The bill limits Medicare payment for out-of-network services furnished to a participating beneficiary. …