[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 441 Introduced in Senate (IS)]

111th CONGRESS
  1st Session
                                 S. 441

To encourage the development of coordinated quality reforms to improve 
  health care delivery and reduce the cost of care in the health care 
                                system.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           February 13, 2009

Mr. Whitehouse (for himself, Mr. Feingold, Mr. Leahy, Mr. Sanders, Mr. 
Tester, and Ms. Stabenow) introduced the following bill; which was read 
 twice and referred to the Committee on Health, Education, Labor, and 
                                Pensions

_______________________________________________________________________

                                 A BILL


 
To encourage the development of coordinated quality reforms to improve 
  health care delivery and reduce the cost of care in the health care 
                                system.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Quality Reform Expansion and Savings 
Act of 2009''.

SEC. 2. FINDINGS AND PURPOSE.

    (a) Findings.--Congress makes the following findings:
            (1) The United States health care system urgently needs 
        reform and improvement in the quality of care delivered, the 
        prevention and detection of illness, and the optimization of 
        investment in these areas.
            (2) The present system for payment of providers for health 
        care services often acts to deter or discourage optimal 
        investment in prevention or quality of care improvement.
            (3) Properly tailored health care reforms can lower medical 
        costs and improve quality of care.
            (4) The urgent need for reform of the American health care 
        system, to improve quality of care and health outcomes, to 
        lower costs, and to reduce waste and frustration, is not 
        presently met with a commensurate national effort to design and 
        implement those reforms.
            (5) Many initiatives underway at the State and local level 
        merit encouragement and support, as they depend upon and 
        inspire mutual trust and compromise within a community.
    (b) Purpose.--It is the purpose of this Act to establish a program 
to award grants to local, regional, or statewide organizations to--
            (1) encourage the coordinated development of local health 
        care quality reforms;
            (2) fund the development of practices beneficial to the 
        health care system;
            (3) expand information technology, electronic health 
        records, and interoperable data systems in the health care 
        system;
            (4) develop reimbursement practices that align financial 
        incentives with health and prevention reforms to identify and 
        encourage best practices;
            (5) lower the costs of health care delivery;
            (6) encourage reform initiatives in different regions of 
        the United States; and
            (7) reward cooperation among local entities engaged in 
        reforming the health care system.

SEC. 3. QUALITY REFORM GRANT INITIATIVE.

    (a) Grants.--The Secretary of Health and Human Services (referred 
to in this section as the ``Secretary'') shall award quality reform 
grants to eligible entities to enhance, encourage, and expedite 
implementation of quality reform plans to carry out the purposes of 
this Act.
    (b) Eligibility of State, Local, and Regional Entities.--To be 
eligible to receive a grant under subsection (a), a qualifying entity 
shall be a State, local, or regional organization, including an 
organization newly formed for the purpose of carrying out plans under 
such a grant, dedicated to improving the quality of health care through 
broad participation of the local health care community, with a focus on 
quality improvement and reporting, expansion of health information 
technology, cost-effective prevention, and restructuring of the 
reimbursement system to enhance these goals.
    (c) Quality Reform Committee.--
            (1) Establishment.--Not later than 180 days after the date 
        of the enactment of this Act, the Secretary shall establish a 
        Quality Reform Committee (referred to in this Act as the 
        ``Committee'') in accordance with this subsection.
            (2) Membership.--The Committee shall be composed of not 
        less than 7 members, of which--
                    (A) one member shall be appointed by the 
                Administrator of the Centers for Medicare & Medicaid 
                Services;
                    (B) one member shall be appointed by the Director 
                of the National Institutes of Health;
                    (C) one member shall be appointed by the Director 
                of the Agency for Healthcare Research and Quality;
                    (D) one member shall be appointed by the National 
                Coordinator for Health Information Technology;
                    (E) one member shall be appointed by the President 
                of the Institute of Medicine;
                    (F) one member shall be appointed by the Secretary 
                from among candidates recommended by the National 
                Governors Association; and
                    (G) one member shall be appointed by the Secretary 
                from among candidates recommended by the United States 
                Conference of Mayors.
            (3) General duties.--The Committee shall--
                    (A) formally approve the application of an eligible 
                entity for a grant under this section and recommend to 
                the Secretary that such a grant be awarded to such 
                entity;
                    (B) facilitate communication among eligible 
                entities and other organizations;
                    (C) evaluate and exchange best practices relating 
                to activities carried out under the grants;
                    (D) share research and expertise relating to 
                activities under the grants;
                    (E) encourage collaboration and cooperation with 
                and among grantees under this section;
                    (F) recognize the achievements of grantees under 
                this section in a public manner;
                    (G) assist grantees under this section by serving 
                as an advocate and ombudsman to overcome bureaucratic 
                and other obstacles within the Federal Government that 
                hinder the achievement of this effort;
                    (H) encourage integration of activities under this 
                section with the private sector;
                    (I) study, identify, and report on market failures 
                and anomalies that create economic incentives adverse 
                to achievement of the goals of quality reform, cost 
                reduction, health information technology expansion, and 
                illness prevention;
                    (J) assist with coordinating information technology 
                infrastructure; and
                    (K) assign personnel to serve as facilitators for 
                local programs and as primary Federal points of contact 
                with grantees under this section.
            (4) Period of appointment.--Members shall be appointed to 
        serve for a term as determined appropriate by the appointing 
        authority, as the case may be, and each member shall serve 
        until a successor is appointed.
            (5) Chairperson; meetings.--
                    (A) Chairperson.--The Committee shall select a 
                Chairperson from among its members.
                    (B) Quorum.--A majority of the members of the 
                Committee shall constitute a quorum, but a lesser 
                number of members may hold hearings.
                    (C) Meetings.--Not later than 30 days after the 
                date on which all members of the Committee have been 
                appointed under paragraph (2), the Committee shall hold 
                its first meeting. The Committee shall meet at the call 
                of the Chairperson.
            (6) Powers.--
                    (A) Hearings.--The Committee may hold hearings, if 
                determined necessary by the Committee to carry out the 
                purposes of this Act, sit and act at such times and 
                places, take such testimony, and receive such evidence 
                as the Committee determines appropriate to carry out 
                the purposes of this Act.
                    (B) Annual public meetings.--In addition to other 
                meetings the Committee may hold, the Committee shall 
                hold an annual public meeting for grantees under this 
                section in order that grantees may report progress 
                toward achieving the purposes in section 2(b) and in 
                the exchange of information with one another and with 
                the Committee.
                    (C) Information.--The Committee may obtain 
                information directly from any Federal department or 
                agency as the Committee determines is necessary to 
                carry out this section. Upon the request of the 
                Chairperson of the Committee, the head of such 
                department or agency shall furnish such information to 
                the Committee.
                    (D) Contracting.--The Committee may enter into 
                contracts with qualified independent organizations to 
                obtain information necessary to assist grantees with 
                the development of best evidence-based practices and 
                outcomes measurements or any other matters determined 
                by the Committee to be appropriate and reasonable to 
                carry out this section.
                    (E) Postal services.--The Committee may use the 
                United States mails in the same manner and under the 
                same conditions as other departments and agencies of 
                the Federal Government.
            (7) Personnel matters.--
                    (A) Compensation.--Each member of the Committee who 
                is not an officer or employee of the Federal Government 
                shall be compensated at a rate equal to the daily 
                equivalent of the annual rate of basic pay prescribed 
                for level IV of the Executive Schedule under section 
                5315 of title 5, United States Code, for each day 
                (including travel time) during which such member is 
                engaged in the performance of the duties of the 
                Committee. All members of the Committee who are 
                officers or employees of the United States shall serve 
                without compensation in addition to that received for 
                their services as officers or employees of the United 
                States.
                    (B) Travel expenses.--The members of the Committee 
                shall be allowed travel expenses, including per diem in 
                lieu of subsistence, at rates authorized for employees 
                of agencies under subchapter I of chapter 57 of title 
                5, United States Code, while away from their homes or 
                regular places of business in the performance of 
                services for the Committee.
                    (C) Staff.--The Chairperson of the Committee may, 
                without regard to the civil service laws and 
                regulations, appoint and terminate personnel as may be 
                necessary to enable the Committee to perform its 
                duties.
                    (D) Detail of governmental employees.--Any Federal 
                Government employee may be detailed to the Committee 
                without reimbursement upon the request of the 
                Committee, and such detail shall be without 
                interruption or loss of civil service status or 
                privilege.
                    (E) Temporary and intermittent services.--The 
                Chairperson of the Committee may procure temporary and 
                intermittent services under section 3109(b) of title 5, 
                United States Code, at rates for individuals which do 
                not exceed the daily equivalent of the annual rate of 
                basic pay prescribed for level V of the Executive 
                Schedule under section 5316 of such title.
            (8) Funding.--For the purpose of carrying out this 
        subsection, there are authorized to be appropriated $2,000,000 
        for fiscal year 2010 and each subsequent fiscal year.
    (d) Quality Reform Plan.--
            (1) In general.--To be eligible to receive a grant under 
        this section, an entity shall prepare and submit to the 
        Committee, as part of the application under subsection (b), a 
        plan to seek to improve quality of care, which is encouraged to 
        include the following elements:
                    (A) Involvement and leadership of the local health 
                care community in the area to be served under the 
                grant.
                    (B) Strategies to achieve cost-saving quality 
                improvements in service delivery as a result of 
                activities carried out under the grant.
                    (C) Development and implementation of electronic 
                health record keeping, health information systems, 
                interoperability, evidence-based clinical decision 
                support, or electronic prescription of pharmaceuticals.
                    (D) Methods to optimize evidence-based investment 
                in early prevention and detection of illness.
                    (E) Restructuring of provider reimbursement 
                provisions to assist in accomplishing the objectives of 
                the plan.
                    (F) Efforts to use savings to expand health care 
                coverage to the uninsured.
            (2) Grant period.--The period of a grant awarded under this 
        section shall not exceed 2 years and may be renewed for 
        subsequent 2-year periods upon reapplication to the Committee. 
        Nothing in this paragraph shall be construed to prohibit a 
        grantee from requesting an extension for a period of less than 
        2 years.
    (e) Waivers.--A State in which a grantee under this section is 
located shall receive expedited and priority consideration of waiver 
requests from the Centers for Medicare & Medicaid Services when 
necessary or appropriate to achieve the purposes for which the grant 
was awarded.
    (f) Amount of Grant.--The amount of a grant awarded to an entity 
under this section shall be determined based upon the recommendations 
of the Committee, subject to appropriations, but is intended to be an 
unrestricted grant to eligible entities with qualifying plans.
    (g) Report.--
            (1) By entities.--An entity that is awarded a grant under 
        this section shall submit to the Committee an annual report for 
        the period representing the entity's fiscal year, that shall 
        contain a description of the results of activities carried out 
        under the project.
            (2) By committee.--Not later than the end of the 5-year 
        period beginning on the date on which the first grant is 
        awarded under this section, the Committee shall prepare and 
        submit to the appropriate committees of Congress, a report on 
        the progress made by grantees in achieving the purposes of this 
        Act.
    (h) Sense of the Senate.--It is the sense of the Senate that, not 
later than 45 days after receiving the report submitted under 
subsection (g)(2), each Committee to which such report is submitted 
should hold at least 1 hearing concerning such report and the 
recommendations contained in such report.
    (i) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this Act, $100,000,000 for the 10-fiscal year 
period beginning in fiscal year 2010.
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