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Code · BILL · 113th Congress · S. 1871 (Placed on Calendar Senate) — To amend title XVIII of the Social Security Act to repeal the Medicare sustainable growth rate formula and to improve... · Sec. 102

Sec. 102. Priorities and funding for quality measure development

742 words·~3 min read·/bill/113/s/1871/pcs/section-102·

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Section 1848 of the Social Security Act ( 42 U.S.C. 1395w–4 ), as amended by subsections
(c)and
(h)of section 101, is further amended by inserting at the end the following new subsection: Not later than October 1, 2014, the Secretary shall develop, and post on the Internet website of the Centers for Medicare & Medicaid Services, a draft plan for the development of quality measures for application under the applicable provisions. Such plan shall address how measures used by private payers and integrated delivery systems could be incorporated under such subsection. In developing the draft plan under subparagraph (A), the Secretary shall consider— gap analyses conducted by the entity with a contract under section 1890(a) or other contractors or entities; and whether measures are applicable across health care settings. In developing the draft plan under subparagraph (A), the Secretary shall give priority to the following types of measures: Outcome measures including patient reported outcome and functional status measures. Patient experience measures. Care coordination measures. Measures of appropriate use of services, including measures of over use. In this subsection, the term applicable provisions means the following provisions: Subsection (q)(2)(B)(i). Section 1833(z)(2)(C). The Secretary shall accept through December 1, 2014, comments on the draft plan posted under paragraph (1)(A) from the public, including health care providers, payers, consumers, and other stakeholders. Not later than February 1, 2015, taking into account the comments received under subparagraph (B), the Secretary shall post on the Internet website of the Centers for Medicare & Medicaid Services an operational plan for the development of quality measures for use under subsection (q)(2)(A)(i). The Secretary shall enter into contracts or other arrangements with entities for the purpose of developing, improving, updating, or expanding quality measures for application under the applicable provisions. Such entities may include physician specialty societies and other practitioner organizations. In entering into contracts or other arrangements under subparagraph (A), the Secretary shall give priority to the development of the types of measures described in paragraph (1)(A)(iii). In selecting measures for development under this subsection, the Secretary shall consider whether such measures would be electronically specified. Not later than February 1, 2016, and annually thereafter, the Secretary shall post on the Internet website of the Centers for Medicare & Medicaid Services a report on the progress made in developing quality measures for application under the applicable provisions. Each report submitted pursuant to paragraph
(1)shall include the following: A description of the Secretary’s efforts to implement this subsection. With respect to the measures developed during the previous year— a description of the total number of quality measures developed and the types of such measures, such as an outcome or patient experience measure; the name of each measure developed; the name of the developer and steward of each measure; with respect to each type of measure, an estimate of the total amount expended under this title to develop all measures of such type; and whether the measure would be electronically specified. With respect to measures in development at the time of the report— the information described in clause (ii), if available; and a timeline for completion of the development of such measures. An update on the progress in developing the types of measures described in paragraph (1)(A)(iii), including a description of issues affecting such progress. A list of quality topics and concepts that are being considered for development of measures and the rationale for the selection of topics and concepts including their relationship to gap analyses. A description of any updates to the plan under paragraph
(1)(including newly identified gaps and the status of previously identified gaps) and the inventory of measures applicable under the applicable provisions. Other information the Secretary determines to be appropriate. With respect to measures applicable under the applicable provisions, the Secretary shall seek stakeholder input with respect to— the identification of gaps where no quality measures exist, particularly with respect to the types of measures described in paragraph (1)(A)(iii); prioritizing quality measure development to address such gaps; and other areas related to quality measure development determined appropriate by the Secretary. For purposes of carrying out this subsection, the Secretary shall provide for the transfer, from the Federal Supplementary Medical Insurance Trust Fund under section 1841, of $15,000,000 to the Centers for Medicare & Medicaid Services Program Management Account for each of fiscal years 2014 through 2018. Amounts transferred under this paragraph shall remain available through the end of fiscal year 2021. .
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  • 42 USC 1395w–4
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Sec. 102
Priorities and funding for quality measure development
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