Sec. 102. Priorities and funding for measure development

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Section 1848 of the Social Security Act ( 42 U.S.C. 1395w–4 ), as amended by subsections

(c)and

(f)of section 101, is further amended by inserting at the end the following new subsection: Not later than January 1, 2016, 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 (as defined in paragraph (5)). Under such plan the Secretary shall— address how measures used by private payers and integrated delivery systems could be incorporated under title XVIII; describe how coordination, to the extent possible, will occur across organizations developing such measures; and take into account how clinical best practices and clinical practice guidelines should be used in the development of quality measures. For purposes of this subsection, the term quality domains means at least the following domains: Clinical care. Safety. Care coordination. Patient and caregiver experience. Population health and prevention. In developing the draft plan under this paragraph, the Secretary shall consider— gap analyses conducted by the entity with a contract under section 1890(a) or other contractors or entities; whether measures are applicable across health care settings; clinical practice improvement activities submitted under subsection (q)(2)(C)(iv) for identifying possible areas for future measure development and identifying existing gaps with respect to such measures; and the quality domains applied under this subsection. In developing the draft plan under this paragraph, 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. The Secretary shall accept through March 1, 2016, 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 May 1, 2016, taking into account the comments received under this subparagraph, the Secretary shall finalize the plan and post on the Internet website of the Centers for Medicare & Medicaid Services an operational plan for the development of quality measures for use under the applicable provisions. Such plan shall be updated as appropriate. The Secretary shall enter into contracts or other arrangements with entities for the purpose of developing, improving, updating, or expanding in accordance with the plan under paragraph

(1)quality measures for application under the applicable provisions. Such entities shall include organizations with quality measure development expertise. 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)(D). In selecting measures for development under this subsection, the Secretary shall consider— whether such measures would be electronically specified; and clinical practice guidelines to the extent that such guidelines exist. Not later than May 1, 2017, 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 subparagraph

(A)shall include the following: A description of the Secretary’s efforts to implement this paragraph. 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. 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 paragraph (1), 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)(D); prioritizing quality measure development to address such gaps; and other areas related to quality measure development determined appropriate by the Secretary. In this subsection, the term applicable provisions means the following provisions: Subsection (q)(2)(B)(i). Section 1833(z)(2)(C). 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 2015 through 2019. Amounts transferred under this paragraph shall remain available through the end of fiscal year 2022. Chapter 35 of title 44, United States Code, shall not apply to the collection of information for the development of quality measures. .

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42 USC 1395w–4

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Sec. 102

Priorities and funding for measure development

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