Sec. 10326. PILOT TESTING PAY-FOR-PERFORMANCE PROGRAMS FOR CERTAIN MEDICARE PROVIDERS
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## SEC. 10326 PILOT TESTING PAY-FOR-PERFORMANCE PROGRAMS FOR CERTAIN MEDICARE PROVIDERS **[**[42 U.S.C. 1395b–1 note](/us/usc/t42/s1395b–1)**]** ###
(a)In General Not later than January 1, 2016, the Secretary of Health and Human Services (in this section referred to as the “Secretary”) shall, for each provider described in subsection (b), conduct a separate pilot program under title XVIII of the Social Security Act to test the implementation of a value-based purchasing program for payments under such title for the provider. ###
(b)Providers Described The providers described in this paragraph are the following: ####
(1)Psychiatric hospitals (as described in clause
(i)of section 1886(d)(1)(B) of such Act (42 U.S.C. 1395ww(d)(1)(B))) and psychiatric units (as described in the matter following clause
(v)of such section). ####
(2)Long-term care hospitals (as described in clause
(iv)of such section). ####
(3)Rehabilitation hospitals (as described in clause
(ii)of such section). ####
(4)PPS-exempt cancer hospitals (as described in clause
(v)of such section). ####
(5)Hospice programs (as defined in section 1861(dd)(2) of such Act (42 U.S.C. 1395x(dd)(2))). ###
(c)Waiver Authority The Secretary may waive such requirements of titles XI and XVIII of the Social Security Act as may be necessary solely for purposes of carrying out the pilot programs under this section. ###
(d)No Additional Program Expenditures Payments under this section under the separate pilot program for value based purchasing (as described in subsection (a)) for each provider type described in paragraphs
(1)through
(5)of subsection
(b)for applicable items and services under title XVIII of the Social Security Act for a year shall be established in a manner that does not result in spending more under each such value based purchasing program for such year than would otherwise be expended for such provider type for such year if the pilot program were not implemented, as estimated by the Secretary. ###
(e)Expansion of Pilot Program The Secretary may, at any point after January 1, 2018, expand the duration and scope of a pilot program conducted under this subsection, to the extent determined appropriate by the Secretary, if— ####
(1)the Secretary determines that such expansion is expected to— #####
(A)reduce spending under title XVIII of the Social Security Act without reducing the quality of care; or #####
(B)improve the quality of care and reduce spending; ####
(2)the Chief Actuary of the Centers for Medicare & Medicaid Services certifies that such expansion would reduce program spending under such title XVIII; and ####
(3)the Secretary determines that such expansion would not deny or limit the coverage or provision of benefits under such title XIII for Medicare beneficiaries.
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- 42 USC 1395b–1
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Sec. 10326
PILOT TESTING PAY-FOR-PERFORMANCE PROGRAMS FOR CERTAIN MEDICARE PROVIDERS
Cite42 USC 1395b–1
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