Sec. 5. Miscellaneous
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The Administrator of the Centers for Medicare & Medicaid Services shall request eligible professional organizations (as defined in section 1848(k)(3) of the Social Security Act ( 42 U.S.C. 1395w–4(k)(3) )) and other relevant stakeholders to submit recommendations for defining non-acute related episodes of care for purposes of applying such definition under subsections
(k)and
(q)of section 1848 of the Social Security Act ( 42 U.S.C. 1395w–4 ) and section 1848A of such Act, as added by subsections
(b)and
(c)of section 2. The Administrator of the Centers for Medicare & Medicaid Services shall solicit from eligible professional organizations (as defined in section 1848(k)(3) of the Social Security Act ( 42 U.S.C. 1395w–4(k)(3) )) recommendations for payment bundles for chronic conditions and expensive, high volume services for which payment is made under title XVIII of such Act. Not later than 24 months after the date of the enactment of this Act, the Administrator shall submit to Congress a report on proposals for such payment bundles. Not later than January 15, 2016, and annually thereafter, the Secretary of Health and Human Services shall submit to Congress and post on the public Internet website of the Centers for Medicare & Medicaid Services a biannual progress report— on the implementation of paragraph
(9)of section 1848(k) of the Social Security Act ( 42 U.S.C. 1395w–4(k) ), as added by section 2(b)(2), and the quality update incentive program under subsection
(q)of section 1848 of the Social Security Act ( 42 U.S.C. 1395w–4 ), as added by section 2(b)(3); that includes an evaluation of such paragraph and such quality update incentive program and recommendations with respect to such program and appropriate update mechanisms; and on the actions taken to promote and fulfill the identification of eligible APMs under section 1848A of the Social Security Act, as added by section 2(c), for application under such section 1848A. The Comptroller General of the United States shall submit to Congress a report for 2019 and each subsequent year analyzing the extent to which the system under section 1848(k)(9) of the Social Security Act ( 42 U.S.C. 1395w–4(k)(9) ) and such quality update incentive program under section 1848(q) of the Social Security Act, as added by section 2(b) is successfully satisfying performance objectives, including with respect to— the process for developing and selecting measures and activities under subsection (k)(9) of section 1848 of such Act ( 42 U.S.C. 1395w–4 ); the process for assessing performance against such measures and activities under subsection
(q)of such section; and the adequacy of the measures and activities so selected. The Comptroller General of the United States shall evaluate the initial phase of the quality update incentive program under subsection
(q)of section 1848 of the Social Security Act ( 42 U.S.C. 1395w–4 ) and shall submit to Congress, not later than 2019, a report with recommendations for improving such quality update incentive program. In the course of its March Report to Congress on Medicare payment policy, MedPAC shall analyze the initial phase of such quality update incentive program and make recommendations, as appropriate, for improving such quality update incentive program. Not later than June 15, 2016, the Medicare Payment Advisory Commission shall submit to Congress a report that analyzes multiple options for alternative payment models in lieu of section 1848 of the Social Security Act ( 42 U.S.C. 1395w–4 ). In analyzing such models, the Medicare Payment Advisory Commission shall examine at least the following models: Accountable care organization payment models. Primary care medical home payment models. Bundled or episodic payments for certain conditions and services. Gainsharing arrangements Such report shall include information on how each recommended new payment model will achieve maximum flexibility to reward high quality, efficient care. Beginning in 2015, the Chief Actuary of the Centers for Medicare & Medicaid Services shall track expenditure growth and beneficiary access to physicians’ services under section 1848 of the Social Security Act ( 42 U.S.C. 1395w–4 ) and shall post on the public Internet website of the Centers for Medicare & Medicaid Services annual reports on such topics. Not later than one year after the date of the enactment of this Act, the Secretary of Health and Human Services shall submit to Congress a report on the extent to which clinical decision support mechanisms and other provider support tools could be used to further program objectives under section 1848 of the Social Security Act ( 42 U.S.C. 1395w–4 )) and recommendation for how such mechanisms and tools should be so used. The development, recognition, or implementation of any guideline or other standard under any Federal health care provision shall not be construed to establish the standard of care or duty of care owed by a health care provider to a patient in any medical malpractice or medical product liability action or claim. For purposes of this subsection: The term Federal health care provision means any provision of the Patient Protection and Affordable Care Act ( Public Law 111–148 ), title I and subtitle B of title III of the Health Care and Education Reconciliation Act of 2010 ( Public Law 111–152 ), and titles XVIII and XIX of the Social Security Act. The term health care provider means any individual or entity— licensed, registered, or certified under Federal or State laws or regulations to provide health care services; or required to be so licensed, registered, or certified but that is exempted by other statute or regulation. The term medical malpractice or medical liability action or claim means a medical malpractice action or claim (as defined in section 431(7) of the Health Care Quality Improvement Act of 1986 ( 42 U.S.C. 11151(7) )) and includes a liability action or claim relating to a health care provider’s prescription or provision of a drug, device, or biological product (as such terms are defined in section 201 of the Federal Food, Drug, and Cosmetic Act or section 351 of the Public Health Service Act). The term State includes the District of Columbia, Puerto Rico, and any other commonwealth, possession, or territory of the United States. No provision of the Patient Protection and Affordable Care Act ( Public Law 111–148 ), title I or subtitle B of title III of the Health Care and Education Reconciliation Act of 2010 ( Public Law 111–152 ), or title XVIII or XIX of the Social Security Act shall be construed to preempt any State or common law governing medical professional or medical product liability actions or claims.
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U.S. Code
6 references not yet in our index
- 42 USC 1395w–4(k)(3)
- 42 USC 1395w–4
- 42 USC 1395w–4(k)
- 42 USC 1395w–4(k)(9)
- Pub. L. 111-148
- Pub. L. 111-152
Citation graph
cites case law
Sec. 5
Miscellaneous
Cite42 USC 1395w–4(k)(3)
Cite42 USC 1395w–4
Cite42 USC 1395w–4(k)
Cite42 USC 1395w–4(k)(9)
Pub. L.Pub. L. 111-148
Cites 7 · showing 6Cited by 0 across 0 sources