Sec. 4. Medicare Indirect Medical Education (IME) performance adjustment and primary care training bonus
891 words·~4 min read·
/bill/113/s/1978/is/section-4A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
Section 1886(d)(5)(B) of the Social Security Act ( 42 U.S.C. 1395ww(d)(5)(B) ) is amended— by redesignating the clause
(x)as added by section 5505(b) of the Patient Protection and Affordable Care Act as clause (xi); and by adding at the end the following new clauses: The Secretary, in consultation with the advisory body under clause (xiii), shall establish and implement procedures under which the amount of payments that a hospital would otherwise receive for indirect medical education costs under this subparagraph for discharges occurring during an applicable period is adjusted based on the performance of the hospital on measures specified by the Secretary. The measures specified by the Secretary under this clause shall include measures on quality measurement and improvement, evidence-based medicine, interprofessional teamwork, multidisciplinary teamwork, care coordination, and health information technology. Such measures shall include factors that promote training in primary care, such as— resident training in outpatient and community settings, including Federally qualified health centers, rural health clinics, teaching health centers, rural medical practices, facilities operated by the Veterans Administration, Indian Health Service facilities, including primary care training sites that are carried out through self determination contracts and are located in a rural or primary care health professional shortage area; salary and loan conditions for primary care residents; the percentage of all graduates practicing primary care 5 years after graduation; the percentage of all graduates practicing primary care in health professional shortage areas 5 years after graduation; the percentage of all primary care graduates from underrepresented minority groups, including African-Americans, Hispanic-Americans, and Native Americans, as well as other underserved populations; how the residency is responding to the workforce needs identified by State and regional centers for workforce analysis established under the National Center for Health Care Workforce Analysis or the National Health Care Workforce Commission; the provision of service to all socioeconomic levels of patients, including but not limited to Medicaid program populations; mentoring curriculum in primary care; systems-based practice, including training in new forms of delivery system models, such as care coordination, accountable care organizations, and patient-centered medical homes; and training in preventive care, chronic disease management, and population health and public health. Not later than January 1, 2016, the Secretary shall publish in the Federal Register a proposed set of measures for use under this clause. The Secretary shall provide for a period of public comment on such measures. Not later than June 30, 2016, the Secretary shall publish in the Federal Register the final set of measures to be specified by the Secretary for use under this clause. Subject to subclause (V), the Secretary shall determine the amount of any adjustment under this clause to payments to a hospital under this subparagraph in an applicable period. In making adjustments under this clause, the Secretary shall ensure that the total amount of payments made to all hospitals under this subparagraph for an applicable period is equal to the total amount of payments that would have been made to such hospitals under this subparagraph in such period if this clause had not been enacted. In this clause, the term primary care means family medicine, general internal medicine, general pediatrics, preventive medicine, obstetrics and gynecology, psychiatry, and any other specialty which provides integrated, accessible health care services and is accountable for addressing a large majority of health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. In this clause, the term applicable period means the 12-month period beginning on July 1 of each year (beginning with 2015). Subject to subclause (III), the Secretary shall establish an advisory group to advise the Secretary on the application of clause (xii), including the development of the measures to be used, how data on the measures may be collected, which measures will be required in any given reporting period, the applicable thresholds for the measures, and the mechanisms to be used in order to determine whether a hospital has met a threshold. The advisory group established under subclause
(I)shall include— representatives of accrediting and certifying organizations; representatives of facilities that receive payments under this subparagraph; representatives of specialty boards and primary care boards; representatives of high-performing health care systems; experts in family medicine, primary care, and preventive medicine; representatives of public and private purchasers; representatives of consumer and patient organizations, especially those from rural areas; and other entities and individuals as determined by the Secretary of Health and Human Services. If the Secretary determines that an existing entity is comprised of the individuals described in subclause
(II)and that such entity has the expertise to advise the Secretary on the matters described in subclause (I), the Secretary may enter into an arrangement with such entity to advise the Secretary on such matters rather than establishing a new advisory group under subclause (I). . The Comptroller General of the United States shall conduct a study on the application of clause
(xii)of section 1886(d)(5)(B) of the Social Security Act, as added by subsection (a), including an analysis of any changes in workforce patterns as a result of the application of such clause. Not later than January 1, 2018, the Comptroller General of the United States shall submit to Congress a report on the study conducted under paragraph (1), together with recommendations for such legislation and administrative action as the Comptroller General determines to be appropriate.
Connectionstraces to 1
Traces to 1 document
Citation graph
cites case law
Sec. 4
Medicare Indirect Medical Education (IME) performance adjustment and primary care training bonus
Cites 1Cited by 0 across 0 sources