Sec. 4. Quality measurement development and implementation
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Section 1890(b) of the Social Security Act ( 42 U.S.C. 1395aaa(b) ) is amended by inserting after paragraph
(3)the following new paragraph: The entity shall facilitate increased coordination and alignment between the public and private sector with respect to quality measures regarding advanced illness, palliative, and end-of-life care across the care settings and programs described in this section and across other services and care settings under this title, as appropriate. The entity shall conduct an environmental scan of measures, measure concepts, and preferred practices for advanced illness, palliative, and end-of-life care used in both the private and public sectors and from multiple settings of care. Such scan shall include a review of the following: The process of eliciting and documenting patient (and, where relevant and appropriate, family caregiver or legally authorized representative) goals, preferences, and values regarding care and treatment, including the articulation of goals for end-of-life care that adequately reflect how the patient wants to live. The effectiveness, patient-centeredness (and, where relevant, family caregiver-centeredness), and adequacy of care plans, including documentation of individual goals, preferences, and values. Agreement and consistency among— the patient’s goals, preferences, and values; any documented care plan; and the care delivered. Timely and appropriate referral to hospice care. The entity shall, based on the scan conducted under subparagraph (B), identify and prioritize measures, measure concepts, and preferred practices, that are aligned across settings of care, condition, and patient population. Not later than 18 months after the date of enactment of this paragraph, the entity shall submit to the Secretary a report containing the findings of the entity with respect to the environmental scan under subparagraph
(B)and the identification and prioritization of measures, measure concepts, and preferred practices under subparagraph (C). . Section 1890A of the Social Security Act ( 42 U.S.C. 1395aaa–1 ) is amended by adding at the end the following new subsection: The Secretary, in consultation with the Palliative Care Research Cooperative Group, the National Institute of Nursing Research, and the Office of End-of-Life and Palliative Care Research of the National Institutes of Health shall conduct a study regarding the development of measures related to— concordance of care between the wishes of an individual and the treatment received by the individual, including documentation of such wishes in the medical record; understanding the population with serious, chronic progressive, or advanced illness that would benefit from palliative care and advance care planning services; and appropriate transitions to hospice care. Not later than December 31, 2019, the Secretary shall submit to Congress a report containing the results of the study conducted under paragraph (1). . Section 1848(s)(1) of the Social Security Act ( 42 U.S.C. 1395w–4(s)(1) ) is amended by adding at the end the following new subparagraph: Beginning after the completion of the environmental scan under section 1890(b)(4)(B), within one or more appropriate quality domains, the Secretary shall, in consultation with the entity with a contract under section 1890(a), establish appropriate clinical care measures relating to palliative and end-of-life care, including at least one measure for each of the areas studied under subparagraphs (A), (B), and
(C)of section 1890A(g)(1). . Section 1899B of the Social Security Act ( 42 U.S.C. 1395lll ) is amended— in subsection (a)(2)(E)(i)— in subclause (IV), by striking and at the end; in subclause (V), by striking the period at the end and inserting ; and ; and by adding at the end the following new subclause: with respect to the domain described in subsection (c)(1)(F) (relating to end-of-life care)— for PAC providers described in clauses (ii), (iii), and
(iv)of paragraph (2)(A), October 1, 2020; and for PAC providers described in clauses
(i)of such paragraph, January 1, 2021. ; and in subsection (c)(1), by adding at the end the following new subparagraph: The effectiveness, patient-centeredness (and, where relevant, family caregiver-centeredness), and adequacy of care plans and communications relating to such plans, including— documentation of a patient’s goals, preferences, and values; agreement and consistency with respect to care among— the patient’s goals, preferences, and values; any documented care plan; and the care delivered; and timely and appropriate referral to hospice care. . Section 1852(e)(3) of the Social Security Act ( 42 U.S.C. 1395w–22(e)(3) ) is amended by adding at the end the following new subparagraph: The Secretary, in consultation with the National Committee for Quality Assurance, shall prioritize the development of standards for palliative and end-of-life care, including transition to hospice care, with respect to Medicare Advantage organizations under this part for use under the quality improvement program under paragraph
(1)that are the equivalent of such standards in quality programs applicable to providers of services and suppliers under the original Medicare fee-for-service program under parts A and B. . Section 1899(b)(3)(C) of the Social Security Act ( 42 U.S.C. 1395jjj(b)(3)(C) ) is amended— by striking and inserting “ standards .—The Secretary standards .— The Secretary ; and by adding at the end the following new clause: The Secretary, in consultation with the entity with a contract under section 1890(a), shall ensure that quality performance standards established under this subparagraph include measures that apply to palliative and end-of-life care, including transition to hospice care. .
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- 42 USC 1395aaa–1
- 42 USC 1395w–4(s)(1)
- 42 USC 1395w–22(e)(3)
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Sec. 4
Quality measurement development and implementation
Cite42 USC 1395aaa–1
Cite42 USC 1395w–4(s)(1)
Cite42 USC 1395w–22(e)(3)
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