Sec. 208. Quality measure endorsement and selection
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Title XVIII of the Social Security Act ( 42 U.S.C. 1395 et seq. ) is amended— by redesignating section 1890A as section 1890B; and by inserting after section 1890 the following new section: For purposes of activities conducted under this Act, the Secretary shall identify and have in effect a contract with an entity that meets the requirements described in subsection (c). Such contract shall provide that the entity will perform the duties described in subsection (b). The first contract under paragraph
(1)shall begin on October 1, 2014. A contract under paragraph
(1)shall be for a period of 3 years (except as may be renewed after a subsequent bidding process). Competitive procedures (as defined in section 4(5) of the Office of Federal Procurement Policy Act ( 41 U.S.C. 403(5) )) shall be used to enter into a contract under paragraph (1). The duties described in this subsection are the following: The requirements described in this subsection are the following: The requirements described in paragraphs (1), (2), (7), and
(8)of section 1890(c). The entity has at least 4 years of experience working with quality and efficiency measures. . Paragraph
(1)of section 1890(b) of the Social Security Act ( 42 U.S.C. 1395aaa(b) ) is redesignated as paragraph
(1)of section 1890A(b) of such Act, as added by paragraph (1). Paragraphs
(7)and
(8)of such section 1890(b) are redesignated as paragraphs
(2)and (3), respectively, of section 1890A(b) of such Act, as added by paragraph
(1)and amended by subparagraph (A). Section 1890A(b) of such Act, as added by paragraph
(1)and amended by subparagraphs
(A)and (B), is amended by adding at the end the following new paragraphs: The entity shall facilitate increased coordination and alignment between the public and private sector with respect to quality and efficiency measures. The entity shall prepare and make available to the public annual reports on its findings under this paragraph. Such public availability shall include posting each report on the Internet website of the entity. The entity shall conduct an ongoing analysis of— gaps in endorsed quality and efficiency measures, which shall include measures that are within priority areas identified by the Secretary under the national strategy established under section 399HH of the Public Health Service Act; and areas where quality measures are unavailable or inadequate to identify or address such gaps. By not later than March 1 of each year, the entity shall submit to Congress and the Secretary a report containing— a description of— the recommendations made under paragraph (1); the matters described in clauses
(i)and
(ii)of paragraph (2)(A); the results of the analysis under paragraph (5); and the performance by the entity of the duties required under the contract entered into with the Secretary under subsection (a); and any other items determined appropriate by the Secretary. Not later than 6 months after receiving a report under subparagraph
(A)for a year, the Secretary shall— review such report; and publish such report in the Federal Register, together with any comments of the Secretary on such report. . Section 1890A(b) of such Act, as so added and amended, is amended— in paragraph (2)— in the heading of subparagraph
(B)by inserting after and efficiency ; Quality in subparagraph (B)(i)(III), by striking this Act and inserting this title ; and by adding at the end the following new subparagraphs: In providing the input described in subparagraph (A), the multi-stakeholder groups— shall include a detailed description of the rationale for each recommendation made by the multi-stakeholder group, including in areas relating to— the expected impact that implementing the measure will have on individuals; the burden on providers of services and suppliers; the expected influence over the behavior of providers of services and suppliers; the applicability of a measure for more than one setting or program; and other areas determined in consultation with the Secretary; and may consider whether it is appropriate to provide separate recommendations with respect to measures for internal use, public reporting, and payment provisions. In convening multi-stakeholder groups pursuant to this paragraph, the entity shall, to the extent feasible, make every effort to ensure such groups are balanced across stakeholders. ; and in paragraph (3), by striking Not later and all that follows through the period at the end and inserting the following: Not later than the applicable dates described in section 1890B(a)(3) of each year (or, as applicable, the timeframe described in section 1890A(a)(4)), the entity shall transmit to the Secretary the input of the multi-stakeholder group under paragraph (2). . Section 1890(a) of the Social Security Act (42 U.S.C. 1395aaa(a)) is amended— in paragraph (1), by striking , such as the National Quality Forum, ; and in paragraph (3), by striking 4 years and inserting 3 years . Section 1890(b) of the Social Security Act (42 U.S.C. 1395aaa(b)), as amended by subsection (a)(2), is amended— by redesignating paragraphs
(2)and
(3)as paragraphs
(1)and (2), respectively; in paragraph (2), as redesignated by subparagraph (A), by striking paragraph
(2)and inserting paragraph
(1); by striking paragraphs
(5)and (6); and by adding at the end the following new paragraphs: The entity shall facilitate increased coordination and alignment between the public and private sector with respect to quality and efficiency measures. The entity shall prepare and make available to the public annual reports on its findings under this paragraph. Such public availability shall include posting each report on the Internet website of the entity. By not later than March 1 of each year, the entity shall submit to Congress and the Secretary a report containing— a description of— the coordination of quality initiatives under this Act with quality initiatives implemented by other payers; areas in which evidence is insufficient to support endorsement of quality measures in priority areas identified by the Secretary under the national strategy established under section 399HH of the Public Health Service Act and where targeted research may address such gaps; and the performance by the entity of the duties required under the contract entered into with the Secretary under subsection (a); and any other items determined appropriate by the Secretary. Not later than 6 months after receiving a report under subparagraph
(A)for a year, the Secretary shall— review such report; and publish such report in the Federal Register, together with any comments of the Secretary on such report. . Section 1890(c) of the Social Security Act (42 U.S.C. 1395aaa(c)) is amended by adding at the end the following new paragraph: The entity is not a measure developer. . Section 1890B(a) of the Social Security Act (42 U.S.C. 1395aaa–1(a)), as redesignated by subsection (a)(1)(A), is amended— by striking section 1890(b)(7)(B) each place it appears and inserting section 1890A(b)(2)(B) ; in paragraph (1)— by striking section 1890(b)(7) and inserting section 1890A(b)(2) ; and by striking section 1890 and inserting section 1890A ; by striking paragraphs
(2)and
(3)and inserting the following: Subject to paragraph (4), not later than October 1 or December 31 of each year, the Secretary shall make available to the public a list of quality and efficiency measures described in section 1890A(b)(2)(B) that the Secretary is considering under this title. The Secretary shall provide for an appropriate balance of the number of measures to be made available by each such date in a year. Subject to paragraph (4), not later than the applicable date described in subparagraph
(B)of each year, the entity with a contract under section 1890A shall, pursuant to subsection (b)(3) of such section, transmit to the Secretary the input of multi-stakeholder groups described in paragraph (1). The applicable date described in this subparagraph for a year is— February 1 with respect to quality and efficiency measures made available under paragraph
(2)by October 1 of the preceding year; and April 1 with respect to quality and efficiency measures made available under paragraph
(2)by December 31 of the preceding year. ; by redesignating— paragraph
(6)as paragraph (8); and paragraphs
(4)and
(5)as paragraphs
(5)and (6), respectively; by inserting after paragraph
(3)the following new paragraph: In addition to the Secretary making measures publically available pursuant to the dates described in paragraph
(2)and multi-stakeholder groups transmitting the input pursuant to the applicable dates described in paragraph (3)— the Secretary may, at times that do not meet the time requirements described in paragraph (2), make available to the public a limited number of quality and efficiency measures described in section 1890A(b)(2) that the Secretary is considering under this title; and if the Secretary uses the authority under subparagraph (A), the entity with a contract under section 1890A shall, pursuant to section 1890A(b)(3), transmit to the Secretary on a timely basis the input from a multi-stakeholder group described in paragraph
(1)with respect to such measures. ; in paragraph (6), as redesignated by subparagraph (D)(ii), by inserting or that has not been recommended by the multi-stakeholder group under section 1890A(b)(2) before the period at the end; and by inserting after paragraph
(6)the following new paragraph: For each year (beginning with 2015), the Secretary shall include a list of concordance rates for each type of provider of services and supplier in the annual final rule applicable to such type of provider or supplier. . Section 1890B(c) of the Social Security Act (42 U.S.C. 1395aaa–1(c)), as redesignated by subsection (a)(1)(A), is amended— in paragraph (1)(A), by striking section 1890(b)(7)(B) and inserting section 1890A(b)(2)(B) ; and in paragraph (2)— in subparagraph (A), by striking and at the end; in subparagraph (B), by striking the period at the end and inserting ; and ; and by adding at the end the following new subparagraph: take into consideration the benefits of the alignment of measures between the public and private sector. . In addition to amounts transferred under section 3014(c) of the Patient Protection and Affordable Care Act ( Public Law 111–148 ), for purposes of carrying out section 1890 and section 1890A (other than subsections
(e)and (f)), the Secretary shall provide for the transfer, from the Federal Hospital Insurance Trust Fund under section 1817 and the Federal Supplementary Medical Insurance Trust Fund under section 1841, in such proportion as the Secretary determines appropriate, to the Centers for Medicare & Medicaid Services Program Management Account of $7,000,000 for fiscal year 2014. Amounts transferred under the preceding sentence shall remain available until expended. Section 1890B of the Social Security Act (42 U.S.C. 1395aaa–1), as redesignated by subsection (a)(1)(A), is amended by adding at the end the following new subsection: For purposes of carrying out this section (other than subsections
(e)and (f)) and sections 1890 and 1890A, the Secretary shall provide for the transfer, from the Federal Hospital Insurance Trust Fund under section 1817 and the Federal Supplementary Medical Insurance Trust Fund under section 1841, in such proportion as the Secretary determines appropriate, to the Centers for Medicare & Medicaid Services Program Management Account of $25,000,000 for each of fiscal years 2015 through 2017. Amounts transferred under paragraph
(1)shall remain available until expended. . Subsection
(d)of section 1890 of the Social Security Act (42 U.S.C. 1395aaa) is repealed. Section 1848(m)(3)(E)(iii) of the Social Security Act ( 42 U.S.C. 1395w–4(m)(3)(E)(iii) ) is amended by striking section 1890(b)(7) and 1890A(a) and inserting section 1890A(b)(2) and 1890B(a) . Section 1866D(b)(2)(C) of the Social Security Act ( 42 U.S.C. 1395cc–4(b)(2)(C) ) is amended by striking section 1890 and 1890A and inserting sections 1890, 1890A, and 1890B . Section 1899A(n)(2)(A) of the Social Security Act ( 42 U.S.C. 1395cc–4(n)(2)(A) ) is amended by striking section 1890(b)(7)(B) and inserting section 1890A(b)(2)(B) . The amendments made by this section shall take effect on October 1, 2014, and shall apply with respect to contract periods under sections 1890 and 1890A of the Social Security Act that begin on or after such date. The Secretary of Health and Human Services shall enter into a new contract under both sections 1890 and 1890A of the Social Security Act, as amended by this Act, for a contract period beginning on October 1, 2014.
Connectionstraces to 2
8 references not yet in our index
- 41 USC 403(5)
- 42 USC 1395aaa–1(a)
- 42 USC 1395aaa–1(c)
- Pub. L. 111-148
- 42 USC 1395aaa–1
- 42 USC 1395w–4(m)(3)(E)(iii)
- 42 USC 1395cc–4(b)(2)(C)
- 42 USC 1395cc–4(n)(2)(A)
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cites case law
Sec. 208
Quality measure endorsement and selection
Cite41 USC 403(5)
Cite42 USC 1395aaa–1(a)
Cite42 USC 1395aaa–1(c)
Pub. L.Pub. L. 111-148
Cite42 USC 1395aaa–1
Cites 10 · showing 7Cited by 0 across 0 sources