Sec. 10327. IMPROVEMENTS TO THE PHYSICIAN QUALITY REPORTING SYSTEM

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## SEC. 10327 IMPROVEMENTS TO THE PHYSICIAN QUALITY REPORTING SYSTEM ###

(a)In General Section 1848(m) of the Social Security Act (42 U.S.C. 1395w–4(m)) is amended by adding at the end the following new paragraph: > > #### “(7) Additional incentive payment > > > ##### “(A) In general > > For 2011 through 2014, if an eligible professional meets the requirements described in subparagraph (B), the applicable quality percent for such year, as described in clauses

(iii)and

(iv)of paragraph (1)(B), shall be increased by 0.5 percentage points. > > > ##### “(B) Requirements described > > In order to qualify for the additional incentive payment described in subparagraph (A), an eligible professional shall meet the following requirements: > > > ###### “(i) > > The eligible professional shall— > > > ###### “(I) > > satisfactorily submit data on quality measures for purposes of paragraph

(1)for a year; and > > > ###### “(II) > > have such data submitted on their behalf through a Maintenance of Certification Program (as defined in subparagraph (C)(i)) that meets— > > > ###### “(aa) > > the criteria for a registry (as described in subsection (k)(4)); or > > > ###### “(bb) > > an alternative form and manner determined appropriate by the Secretary. > > > ###### “(ii) > > The eligible professional, more frequently than is required to qualify for or maintain board certification status— > > > ###### “(I) > > participates in such a Maintenance of Certification program for a year; and > > > ###### “(II) > > successfully completes a qualified Maintenance of Certification Program practice assessment (as defined in subparagraph (C)(ii)) for such year. > > > ###### “(iii) > > A Maintenance of Certification program submits to the Secretary, on behalf of the eligible professional, information— > > > ###### “(I) > > in a form and manner specified by the Secretary, that the eligible professional has successfully met the requirements of clause

(ii)(which may be in the form of a structural measure); > > > ###### “(II) > > if requested by the Secretary, on the survey of patient experience with care (as described in subparagraph (C)(ii)(II)); and > > > ###### “(III) > > as the Secretary may require, on the methods, measures, and data used under the Maintenance of Certification Program and the qualified Maintenance of Certification Program practice assessment. > > > ##### “(C) Definitions > > For purposes of this paragraph: > > > ###### “(i) > > The term ‘**Maintenance of Certification Program**’ means a continuous assessment program, such as qualified American Board of Medical Specialties Maintenance of Certification program or an equivalent program (as determined by the Secretary), that advances quality and the lifelong learning and self-assessment of board certified specialty physicians by focusing on the competencies of patient care, medical knowledge, practice-based learning, interpersonal and communication skills and professionalism. Such a program shall include the following: > > > ###### “(I) > > The program requires the physician to maintain a valid, unrestricted medical license in the United States. > > > ###### “(II) > > The program requires a physician to participate in educational and self-assessment programs that require an assessment of what was learned. > > > ###### “(III) > > The program requires a physician to demonstrate, through a formalized, secure examination, that the physician has the fundamental diagnostic skills, medical knowledge, and clinical judgment to provide quality care in their respective specialty. > > > ###### “(IV) > > The program requires successful completion of a qualified Maintenance of Certification Program practice assessment as described in clause (ii). > > > ###### “(ii) > > The term ‘**qualified Maintenance of Certification Program practice assessment**’ means an assessment of a physician's practice that— > > > ###### “(I) > > includes an initial assessment of an eligible professional's practice that is designed to demonstrate the physician's use of evidence-based medicine; > > > ###### “(II) > > includes a survey of patient experience with care; and > > > ###### “(III) > > requires a physician to implement a quality improvement intervention to address a practice weakness identified in the initial assessment under subclause

(I)and then to remeasure to assess performance improvement after such intervention.” > . * * * * * * * ###

(c)Elimination of MA Regional Plan Stabilization Fund ####

(1)In general Section 1858 of the Social Security Act (42 U.S.C. 1395w–27a) is amended by striking subsection (e). ####

(2)Transition **[**[42 U.S.C. 1395w–27a note](/us/usc/t42/s1395w–27a)**]** Any amount contained in the MA Regional Plan Stabilization Fund as of the date of the enactment of this Act shall be transferred to the Federal Supplementary Medical Insurance Trust Fund.

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42 USC 1395w–4(m)
42 USC 1395w–27a

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Sec. 10327

IMPROVEMENTS TO THE PHYSICIAN QUALITY REPORTING SYSTEM

Cite42 USC 1395w–4(m)

Cite42 USC 1395w–27a

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