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Section 3014

SEC. 3014. QUALITY MEASUREMENT.

[a] New Duties for Consensus-based Entity-

[1] MULTI-STAKEHOLDER GROUP INPUT- Section 1890[b] of the Social Security Act [42 U.S.C. 1395aaa[b]], as amended by section 3003, is amended by adding at the end the following new paragraphs:

'[7] CONVENING MULTI-STAKEHOLDER GROUPS-

'[A] IN GENERAL- The entity shall convene multi-stakeholder groups to provide input on--

'[i] the selection of quality measures described in subparagraph [B], from among--

'[I] such measures that have been endorsed by the entity; and

'[II] such measures that have not been considered for endorsement by such entity but are used or proposed to be used by the Secretary for the collection or reporting of quality measures; and

'[ii] national priorities [as identified under section 399HH of the Public Health Service Act] for improvement in population health and in the delivery of health care services for consideration under the national strategy established under section 399HH of the Public Health Service Act.

'[B] QUALITY MEASURES-

'[i] IN GENERAL- Subject to clause [ii], the quality measures described in this subparagraph are quality measures--

'[I] for use pursuant to sections 1814[i][5][D], 1833[i][7], 1833[t][17], 1848[k][2][C], 1866[k][3], 1881[h][2][A][iii], 1886[b][3][B][viii], 1886[j][7][D], 1886[m][5][D], 1886[o][2], and 1895[b][3][B][v];

'[II] for use in reporting performance information to the public; and

'[III] for use in health care programs other than for use under this Act.

'[ii] EXCLUSION- Data sets [such as the outcome and assessment information set for home health services and the minimum data set for skilled nursing facility services] that are used for purposes of classification systems used in establishing payment rates under this title shall not be quality measures described in this subparagraph.

'[C] REQUIREMENT FOR TRANSPARENCY IN PROCESS-

'[i] IN GENERAL- In convening multi-stakeholder groups under subparagraph [A] with respect to the selection of quality measures, the entity shall provide for an open and transparent process for the activities conducted pursuant to such convening.

'[ii] SELECTION OF ORGANIZATIONS PARTICIPATING IN MULTI-STAKEHOLDER GROUPS- The process described in clause [i] shall ensure that the selection of representatives comprising such groups provides for public nominations for, and the opportunity for public comment on, such selection.

'[D] MULTI-STAKEHOLDER GROUP DEFINED- In this paragraph, the term 'multi-stakeholder group' means, with respect to a quality measure, a voluntary collaborative of organizations representing a broad group of stakeholders interested in or affected by the use of such quality measure.

'[8] TRANSMISSION OF MULTI-STAKEHOLDER INPUT- Not later than February 1 of each year [beginning with 2012], the entity shall transmit to the Secretary the input of multi-stakeholder groups provided under paragraph [7].'.

[2] ANNUAL REPORT- Section 1890[b][5][A] of the Social Security Act [42 U.S.C. 1395aaa[b][5][A]] is amended--

[A] in clause [ii], by striking 'and' at the end;

[B] in clause [iii], by striking the period at the end and inserting a semicolon; and

[C] by adding at the end the following new clauses:

'[iv] gaps in endorsed quality measures, which shall include measures that are within priority areas identified by the Secretary under the national strategy established under section 399HH of the Public Health Service Act, and where quality measures are unavailable or inadequate to identify or address such gaps;

'[v] areas in which evidence is insufficient to support endorsement of quality measures in priority areas identified by the Secretary under the national strategy established under section 399HH of the Public Health Service Act and where targeted research may address such gaps; and

'[vi] the matters described in clauses [i] and [ii] of paragraph [7][A].'.

[b] Multi-stakeholder Group Input Into Selection of Quality Measures- Title XVIII of the Social Security Act [42 U.S.C. 1395 et seq.] is amended by inserting after section 1890 the following:

'QUALITY MEASUREMENT

'Sec. 1890A. [a] Multi-stakeholder Group Input Into Selection of Quality Measures- The Secretary shall establish a pre-rulemaking process under which the following steps occur with respect to the selection of quality measures described in section 1890[b][7][B]:

'[1] INPUT- Pursuant to section 1890[b][7], the entity with a contract under section 1890 shall convene multi-stakeholder groups to provide input to the Secretary on the selection of quality measures described in subparagraph [B] of such paragraph.

'[2] PUBLIC AVAILABILITY OF MEASURES CONSIDERED FOR SELECTION- Not later than December 1 of each year [beginning with 2011], the Secretary shall make available to the public a list of quality measures described in section 1890[b][7][B] that the Secretary is considering under this title.

'[3] TRANSMISSION OF MULTI-STAKEHOLDER INPUT- Pursuant to section 1890[b][8], not later than February 1 of each year [beginning with 2012], the entity shall transmit to the Secretary the input of multi-stakeholder groups described in paragraph [1].

'[4] CONSIDERATION OF MULTI-STAKEHOLDER INPUT- The Secretary shall take into consideration the input from multi-stakeholder groups described in paragraph [1] in selecting quality measures described in section 1890[b][7][B] that have been endorsed by the entity with a contract under section 1890 and measures that have not been endorsed by such entity.

'[5] RATIONALE FOR USE OF QUALITY MEASURES- The Secretary shall publish in the Federal Register the rationale for the use of any quality measure described in section 1890[b][7][B] that has not been endorsed by the entity with a contract under section 1890.

'[6] ASSESSMENT OF IMPACT- Not later than March 1, 2012, and at least once every three years thereafter, the Secretary shall--

'[A] conduct an assessment of the quality impact of the use of endorsed measures described in section 1890[b][7][B]; and

'[B] make such assessment available to the public.

'[b] Process for Dissemination of Measures Used by the Secretary-

'[1] IN GENERAL- The Secretary shall establish a process for disseminating quality measures used by the Secretary. Such process shall include the following:

'[A] The incorporation of such measures, where applicable, in workforce programs, training curricula, and any other means of dissemination determined appropriate by the Secretary.

'[B] The dissemination of such quality measures through the national strategy developed under section 399HH of the Public Health Service Act.

'[2] EXISTING METHODS- To the extent practicable, the Secretary shall utilize and expand existing dissemination methods in disseminating quality measures under the process established under paragraph [1].

'[c] Review of Quality Measures Used by the Secretary-

'[1] IN GENERAL- The Secretary shall--

'[A] periodically [but in no case less often than once every 3 years] review quality measures described in section 1890[b][7][B]; and

'[B] with respect to each such measure, determine whether to--

'[i] maintain the use of such measure; or

'[ii] phase out such measure.

'[2] CONSIDERATIONS- In conducting the review under paragraph [1], the Secretary shall take steps to--

'[A] seek to avoid duplication of measures used; and

'[B] take into consideration current innovative methodologies and strategies for quality improvement practices in the delivery of health care services that represent best practices for such quality improvement and measures endorsed by the entity with a contract under section 1890 since the previous review by the Secretary.

'[d] Rule of Construction- Nothing in this section shall preclude a State from using the quality measures identified under sections 1139A and 1139B.'.

[c] Funding- For purposes of carrying out the amendments made by this section, the Secretary shall provide for the transfer, from the Federal Hospital Insurance Trust Fund under section 1817 of the Social Security Act [42 U.S.C. 1395i] and the Federal Supplementary Medical Insurance Trust Fund under section 1841 of such Act [42 U.S.C. 1395t], in such proportion as the Secretary determines appropriate, of $20,000,000, to the Centers for Medicare & Medicaid Services Program Management Account for each of fiscal years 2010 through 2014. Amounts transferred under the preceding sentence shall remain available until expended.