Section 10320

SEC. 10320. EXPANSION OF THE SCOPE OF, AND ADDITIONAL IMPROVEMENTS TO, THE INDEPENDENT MEDICARE ADVISORY BOARD.

[a] In General- Section 1899A of the Social Security Act, as added by section 3403, is amended--

[1] in subsection [c]--

[A] in paragraph [1][B], by adding at the end the following new sentence: 'In any year [beginning with 2014] that the Board is not required to submit a proposal under this section, the Board shall submit to Congress an advisory report on matters related to the Medicare program.';

[B] in paragraph [2][A]--

[i] in clause [iv], by inserting 'or the full premium subsidy under section 1860D-14[a]' before the period at the end of the last sentence; and

[ii] by adding at the end the following new clause:

'[vii] If the Chief Actuary of the Centers for Medicare & Medicaid Services has made a determination described in subsection [e][3][B][i][II] in the determination year, the proposal shall be designed to help reduce the growth rate described in paragraph [8] while maintaining or enhancing beneficiary access to quality care under this title.';

[C] in paragraph [2][B]--

[i] in clause [v], by striking 'and' at the end;

[ii] in clause [vi], by striking the period at the end and inserting '; and'; and

[iii] by adding at the end the following new clause:

'[vii] take into account the data and findings contained in the annual reports under subsection [n] in order to develop proposals that can most effectively promote the delivery of efficient, high quality care to Medicare beneficiaries.';

[D] in paragraph [3]--

[i] in the heading, by striking 'TRANSMISSION OF BOARD PROPOSAL TO PRESIDENT' and inserting 'SUBMISSION OF BOARD PROPOSAL TO CONGRESS AND THE PRESIDENT';

[ii] in subparagraph [A][i], by striking 'transmit a proposal under this section to the President' and insert 'submit a proposal under this section to Congress and the President'; and

[iii] in subparagraph [A][ii]--

[I] in subclause [I], by inserting 'or' at the end;

[II] in subclause [II], by striking '; or' and inserting a period; and

[III] by striking subclause [III];

[E] in paragraph [4]--

[i] by striking 'the Board under paragraph [3][A][i] or'; and

[ii] by striking 'immediately' and inserting 'within 2 days';

[F] in paragraph [5]--

[i] by striking 'to but' and inserting 'but'; and

[ii] by inserting 'Congress and' after 'submit a proposal to'; and

[G] in paragraph [6][B][i], by striking 'per unduplicated enrollee' and inserting '[calculated as the sum of per capita spending under each of parts A, B, and D]';

[2] in subsection [d]--

[A] in paragraph [1][A]--

[i] by inserting 'the Board or' after 'a proposal is submitted by'; and

[ii] by inserting 'subsection [c][3][A][i] or' after 'the Senate under'; and

[B] in paragraph [2][A], by inserting 'the Board or' after 'a proposal is submitted by';

[3] in subsection [e]--

[A] in paragraph [1], by inserting 'the Board or' after 'a proposal submitted by'; and

[B] in paragraph [3]--

[i] by striking 'EXCEPTION- The Secretary shall not be required to implement the recommendations contained in a proposal submitted in a proposal year by' and inserting 'EXCEPTIONS-

'[A] IN GENERAL- The Secretary shall not implement the recommendations contained in a proposal submitted in a proposal year by the Board or';

[ii] by redesignating subparagraphs [A] and [B] as clauses [i] and [ii], respectively, and indenting appropriately; and

[iii] by adding at the end the following new subparagraph:

'[B] LIMITED ADDITIONAL EXCEPTION-

'[i] IN GENERAL- Subject to clause [ii], the Secretary shall not implement the recommendations contained in a proposal submitted by the Board or the President to Congress pursuant to this section in a proposal year [beginning with proposal year 2019] if--

'[I] the Board was required to submit a proposal to Congress under this section in the year preceding the proposal year; and

'[II] the Chief Actuary of the Centers for Medicare & Medicaid Services makes a determination in the determination year that the growth rate described in subsection [c][8] exceeds the growth rate described in subsection [c][6][A][i].

'[ii] LIMITED ADDITIONAL EXCEPTION MAY NOT BE APPLIED IN TWO CONSECUTIVE YEARS- This subparagraph shall not apply if the recommendations contained in a proposal submitted by the Board or the President to Congress pursuant to this section in the year preceding the proposal year were not required to be implemented by reason of this subparagraph.

'[iii] NO AFFECT ON REQUIREMENT TO SUBMIT PROPOSALS OR FOR CONGRESSIONAL CONSIDERATION OF PROPOSALS- Clause [i] and [ii] shall not affect--

'[I] the requirement of the Board or the President to submit a proposal to Congress in a proposal year in accordance with the provisions of this section; or

'[II] Congressional consideration of a legislative proposal [described in subsection [c][3][B][iv]] contained such a proposal in accordance with subsection [d].';

[4] in subsection [f][3][B]--

[A] by striking 'or advisory reports to Congress' and inserting ', advisory reports, or advisory recommendations'; and

[B] by inserting 'or produce the public report under subsection [n]' after 'this section'; and

[5] by adding at the end the following new subsections:

'[n] Annual Public Report-

'[1] IN GENERAL- Not later than July 1, 2014, and annually thereafter, the Board shall produce a public report containing standardized information on system-wide health care costs, patient access to care, utilization, and quality-of-care that allows for comparison by region, types of services, types of providers, and both private payers and the program under this title.

'[2] REQUIREMENTS- Each report produced pursuant to paragraph [1] shall include information with respect to the following areas:

'[A] The quality and costs of care for the population at the most local level determined practical by the Board [with quality and costs compared to national benchmarks and reflecting rates of change, taking into account quality measures described in section 1890[b][7][B]].

'[B] Beneficiary and consumer access to care, patient and caregiver experience of care, and the cost-sharing or out-of-pocket burden on patients.

'[C] Epidemiological shifts and demographic changes.

'[D] The proliferation, effectiveness, and utilization of health care technologies, including variation in provider practice patterns and costs.

'[E] Any other areas that the Board determines affect overall spending and quality of care in the private sector.

'[o] Advisory Recommendations for Non-Federal Health Care Programs-

'[1] IN GENERAL- Not later than January 15, 2015, and at least once every two years thereafter, the Board shall submit to Congress and the President recommendations to slow the growth in national health expenditures [excluding expenditures under this title and in other Federal health care programs] while preserving or enhancing quality of care, such as recommendations--

'[A] that the Secretary or other Federal agencies can implement administratively;

'[B] that may require legislation to be enacted by Congress in order to be implemented;

'[C] that may require legislation to be enacted by State or local governments in order to be implemented;

'[D] that private sector entities can voluntarily implement; and

'[E] with respect to other areas determined appropriate by the Board.

'[2] COORDINATION- In making recommendations under paragraph [1], the Board shall coordinate such recommendations with recommendations contained in proposals and advisory reports produced by the Board under subsection [c].

'[3] AVAILABLE TO PUBLIC- The Board shall make recommendations submitted to Congress and the President under this subsection available to the public.'.

[b] Name Change- Any reference in the provisions of, or amendments made by, section 3403 to the 'Independent Medicare Advisory Board' shall be deemed to be a reference to the 'Independent Payment Advisory Board'.

[c] Rule of Construction- Nothing in the amendments made by this section shall preclude the Independent Medicare Advisory Board, as established under section 1899A of the Social Security Act [as added by section 3403], from solely using data from public or private sources to carry out the amendments made by subsection [a][4].