Sec. 51003. TECHNICAL AMENDMENTS TO PUBLIC LAW 114–10

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## SEC. 51003 TECHNICAL AMENDMENTS TO PUBLIC LAW 114–10 ###

(a)MIPS Transition Section 1848 of the Social Security Act (42 U.S.C. 1395w–4) is amended— ####

(1)in subsection (q)— #####

(A)in paragraph (1)— ######

(i)in subparagraph (B), by striking “items and services” and inserting “covered professional services (as defined in subsection (k)(3)(A))”; and ######

(ii)in subparagraph (C)(iv)— ######

(I)by amending subclause

(I)to read as follows: > > ###### “(I) > > The minimum number (as determined by the Secretary) of— > > > ###### “(aa) > > for performance periods beginning before January 1, 2018, individuals enrolled under this part who are treated by the eligible professional for the performance period involved; and > > > ###### “(bb) > > for performance periods beginning on or after January 1, 2018, individuals enrolled under this part who are furnished covered professional services (as defined in subsection (k)(3)(A)) by the eligible professional for the performance period involved.” > ; ######

(II)in subclause (II), by striking “items and services” and inserting “covered professional services (as defined in subsection (k)(3)(A))”; and ######

(III)by amending subclause

(III)to read as follows: > > ###### “(III) > > The minimum amount (as determined by the Secretary) of— > > > ###### “(aa) > > for performance periods beginning before January 1, 2018, allowed charges billed by such professional under this part for such performance period; and > > > ###### “(bb) > > for performance periods beginning on or after January 1, 2018, allowed charges for covered professional services (as defined in subsection (k)(3)(A)) billed by such professional for such performance period.” > ; #####

(B)in paragraph (5)(D)— ######

(i)in clause (i)(I), by inserting “subject to clause (iii),” after “clauses

(i)and

(ii)of paragraph (2)(A),”; and ######

(ii)by adding at the end the following new clause: > > ###### “(iii) Transition years > > For each of the second, third, fourth, and fifth years for which the MIPS applies to payments, the performance score for the performance category described in paragraph (2)(A)(ii) shall not take into account the improvement of the professional involved.” > ; #####

(C)in paragraph (5)(E)— ######

(i)in clause (i)(I)(bb)— ######

(I)in the heading by striking “First 2 years” and inserting “First 5 years”; and ######

(II)by striking “the first and second years” and inserting “each of the first through fifth years”; ######

(ii)in clause (i)(II)(bb)— ######

(I)in the heading, by striking “2 years” and inserting “5 years”; and ######

(II)by striking the second sentence and inserting the following new sentences: “For each of the second, third, fourth, and fifth years for which the MIPS applies to payments, not less than 10 percent and not more than 30 percent of such score shall be based on performance with respect to the category described in clause

(ii)of paragraph (2)(A). Nothing in the previous sentence shall be construed, with respect to a performance period for a year described in the previous sentence, as preventing the Secretary from basing 30 percent of such score for such year with respect to the category described in such clause (ii), if the Secretary determines, based on information posted under subsection (r)(2)(I) that sufficient resource use measures are ready for adoption for use under the performance category under paragraph (2)(A)(ii) for such performance period.”; #####

(D)in paragraph (6)(D)— ######

(i)in clause (i), in the second sentence, by striking “Such performance threshold” and inserting “Subject to clauses

(iii)and (iv), such performance threshold”; ######

(ii)in clause (ii)— ######

(I)in the first sentence, by inserting “(beginning with 2019 and ending with 2024)” after “for each year of the MIPS”; and ######

(II)in the second sentence, by inserting “subject to clause (iii),” after “For each such year,”; ######

(iii)in clause (iii)— ######

(I)in the heading, by striking “2” and inserting “5”; and ######

(II)in the first sentence, by striking “two years” and inserting “five years”; and ######

(iv)by adding at the end the following new clause: > > ###### “(iv) Additional special rule for third, fourth and fifth years of mips > > For purposes of determining MIPS adjustment factors under subparagraph (A), in addition to the requirements specified in clause (iii), the Secretary shall increase the performance threshold with respect to each of the third, fourth, and fifth years to which the MIPS applies to ensure a gradual and incremental transition to the performance threshold described in clause

(i)(as estimated by the Secretary) with respect to the sixth year to which the MIPS applies.” > ; #####

(E)in paragraph (6)(E)— ######

(i)by striking “In the case of items and services” and inserting “In the case of covered professional services (as defined in subsection (k)(3)(A))”; and ######

(ii)by striking “under this part with respect to such items and services” and inserting “under this part with respect to such covered professional services”; and #####

(F)in paragraph (7), in the first sentence, by striking “items and services” and inserting “covered professional services (as defined in subsection (k)(3)(A))”; ####

(2)in subsection (r)(2), by adding at the end the following new subparagraph: > > ##### “(I) Information > > The Secretary shall, not later than December 31st of each year (beginning with 2018), post on the Internet website of the Centers for Medicare & Medicaid Services information on resource use measures in use under subsection (q), resource use measures under development and the time-frame for such development, potential future resource use measure topics, a description of stakeholder engagement, and the percent of expenditures under part A and this part that are covered by resource use measures.” > ; and ####

(3)in subsection (s)(5)(B), by striking “section 1833(z)(2)(C)” and inserting “section 1833(z)(3)(D)”. ###

(b)Physician-focused Payment Model Technical Advisory Committee Provision of Initial Proposal Feedback Section 1868(c)(2)(C) of the Social Security Act (42 U.S.C. 1395ee(c)(2)(C)) is amended to read as follows: > > ##### “(C) Committee review of models submitted > > The Committee, on a periodic basis— > > > ###### “(i) > > shall review models submitted under subparagraph (B); > > > ###### “(ii) > > may provide individuals and stakeholder entities who submitted such models with— > > > ###### “(I) > > initial feedback on such models regarding the extent to which such models meet the criteria described in subparagraph (A); and > > > ###### “(II) > > an explanation of the basis for the feedback provided under subclause (I); and > > > ###### “(iii) > > shall prepare comments and recommendations regarding whether such models meet the criteria described in subparagraph

(A)and submit such comments and recommendations to the Secretary.” > .

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