Sec. 302. Improve patient decision making and transparency by consolidating and modernizing quality programs
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Section 1881(h)(2) of the Social Security Act ( 42 U.S.C. 1395rr(h)(2) ) is amended by adding at the end the following new subparagraphs: No single measure specified by the Secretary or individual measure within a composite measure so specified may be weighted less than 10 percent of the total performance score. In specifying measures under subparagraph (A), the Secretary shall only specify measures that have been shown to be statistically valid and reliable through testing. .
Section 1881(h)(2)(B) of the Social Security Act ( 42 U.S.C. 1395rr(h)(2)(B) ) is amended— in clause (ii), by adding at the end the following new sentence: The exception under the preceding sentence shall not apply to a measure that the entity with a contract under section 1890(a) (or a similar entity) considered but failed to endorse. ; and by adding at the end the following new clause: Clauses
(i)and
(ii)shall apply to composite measures in the same manner as such clauses apply to individual measures. . Section 1881(h)(6) of the Social Security Act ( 42 U.S.C. 1395rr(h)(6) ) is amended by adding at the end the following new subparagraph: To the extent that the Secretary maintains a dialysis facility compare star rating program, under such a program the Secretary— shall assign stars using the same methodology and total performance score results from the quality incentive program under this subsection; shall determine the stars using the same methodology used under such quality incentive program; and shall not use a forced bell curve when determining the stars or rebaselining the stars. . Section 1881 of the Social Security Act ( 42 U.S.C. 1395rr ) is amended by adding at the end the following new subsection: The Secretary shall establish a process under which a hospital or a critical access hospital shall provide a renal dialysis facility with health and treatment information with respect to an individual who is discharged from the hospital or critical access hospital and who subsequently receives treatment at facility. Under the process established under paragraph (1)— the request for the health information may be initiated by the individual prior to discharge or upon request by the renal dialysis facility after the patient is discharged; and the information must be provided to the facility within 7 days of the request being made. . Section 1881(h)(1) of the Social Security Act ( 42 U.S.C. 1395rr(h)(1) ) is amended by adding at the end the following new subparagraph: In the case of a provider of services or a renal dialysis facility that the Secretary determines exceeds the attainment performance standards under paragraph
(4)with respect to a year, the Secretary may make a bonus payment to the provider or facility (pursuant to a process established by the Secretary). The total amount of bonus payments under clause
(i)in a year shall be equal to the total amount of reduced payments in a year under subparagraph (A). The provisions of subparagraph
(C)shall apply to a bonus payment under this subparagraph in the same manner subparagraph
(C)applies to a reduction under such subparagraph. . The amendments made by this section shall apply to items and services furnished on or after January 1, 2019.
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Sec. 302
Improve patient decision making and transparency by consolidating and modernizing quality programs
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