Sec. 401. Administration
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/bill/115/s/1804/is/section-401·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
The Secretary shall develop policies, procedures, guidelines, and requirements to carry out this Act, including related to— eligibility for benefits; enrollment; benefits provided; provider participation standards and qualifications, as described in title III; levels of funding; methods for determining amounts of payments to providers of covered services, consistent with subtitle B; the determination of medical necessity and appropriateness with respect to coverage of certain services; planning for capital expenditures and service delivery; planning for health professional education funding; encouraging States to develop regional planning mechanisms; and any other regulations necessary to carry out the purpose of this Act.
Regulations authorized by this Act shall be issued by the Secretary in accordance with section 553 of title 5, United States Code. The Secretary shall establish uniform State reporting requirements and national standards to ensure an adequate national database containing information pertaining to health services practitioners, approved providers, the costs of facilities and practitioners providing such services, the quality of such services, the outcomes of such services, and the equity of health among population groups.
Such standards shall include, to the maximum extent feasible without compromising patient privacy, health outcome measures, and to the maximum extent feasible without excessively burdening providers, the measures described in subparagraphs
(D)through
(F)of subsection (a)(1). The Secretary shall regularly analyze information reported to it and shall define rules and procedures to allow researchers, scholars, health care providers, and others to access and analyze data for purposes consistent with quality and outcomes research, without compromising patient privacy. Beginning January 1 of the second year beginning after the effective date of this Act, the Secretary shall annually report to Congress on the following: The status of implementation of the Act. Enrollment under this Act. Benefits under this Act. Expenditures and financing under this Act. Cost-containment measures and achievements under this Act. Quality assurance. Health care utilization patterns, including any changes attributable to the program. Changes in the per-capita costs of health care. Differences in the health status of the populations of the different States, including income and racial characteristics, and other population health inequities. Progress on quality and outcome measures, and long-range plans and goals for achievements in such areas. Necessary changes in the education of health personnel. Plans for improving service to medically underserved populations. Transition problems as a result of implementation of this Act. Opportunities for improvements under this Act. The Secretary may, either directly or by contract— make statistical and other studies, on a nationwide, regional, State, or local basis, of any aspect of the operation of this Act; develop and test methods of payment or delivery as it may consider necessary or promising for the evaluation, or for the improvement, of the operation of this Act; and develop methodological standards for evidence-based policymaking. The Comptroller General of the United States shall conduct an audit of the Board every fifth fiscal year following the effective date of this Act to determine the effectiveness of the program in carrying out the duties under subsection (a). The Comptroller General of the United States shall submit a report to Congress concerning the results of each audit conducted under this subsection.