Sec. 401. Administration
756 words·~3 min read·
/bill/116/hr/1384/ih/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 items and services, consistent with subtitle B; a process for appealing or petitioning for a determination of coverage or noncoverage of items and services under this Act; 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 purposes 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 have the obligation to ensure the timely and accessible provision of items and services that all eligible individuals are entitled to under this Act. 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 items and services, the quality of such items and services, the outcomes of such items and services, and the equity of health among population groups.
Such database shall include, to the maximum extent feasible without compromising patient privacy, health outcome measures used under this Act, and to the maximum extent feasible without excessively burdening providers, a description of the standards and qualifications, levels of finding, and methods described in subparagraphs
(D)through
(F)of subsection (a)(1). In establishing reporting requirements and standards under subparagraph (A), the Secretary shall require a provider with an agreement in effect under section 301 to disclose to the Secretary, in a time and manner specified by the Secretary, the following (as applicable to the type of provider): Any data the provider is required to report or does report to any State or local agency, or, as of January 1, 2019, to the Secretary or any entity that is part of the Department of Health and Human Services, except data that are required under the programs terminated in section 903. Annual financial data that includes information on employees (including the number of employees, hours worked, and wage information) by job title and by each patient care unit or department within each facility (including outpatient units or departments); the number of registered nurses per staffed bed by each such unit or department; information on the dollar value and annual spending (including purchases, upgrades, and maintenance) for health information technology; and risk-adjusted and raw patient outcome data (including data on medical, surgical, obstetric, and other procedures). The Secretary shall regularly analyze information reported to the Secretary 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 2 years after the date of the enactment 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. 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 delivery of items and services as the Secretary may consider necessary or promising for the evaluation, or for the improvement, of the operation of this Act; and develop methodological standards for policymaking. The Comptroller General of the United States shall conduct an audit of the Department of Health and Human Services 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.