[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 966 Introduced in Senate (IS)]

111th CONGRESS
  1st Session
                                 S. 966

     To improve the Federal infrastructure for health care quality 
                   improvement in the United States.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                               __________

    Mr. Reid (for Mr. Rockefeller (for himself and Mr. Whitehouse)) 
introduced the following bill; which was read twice and referred to the 
                          Committee on Finance

_______________________________________________________________________

                                 A BILL


 
     To improve the Federal infrastructure for health care quality 
                   improvement in the United States.

    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 ``National Health Care Quality Act''.

SEC. 2. DEFINITIONS.

    In this Act:
            (1) Health care quality.--The term ``health care quality'' 
        means the degree to which health services for individuals and 
        populations increase the likelihood of desired health outcomes 
        and are consistent with current professional knowledge, based 
        upon the following criteria:
                    (A) Effectiveness.--Health care services should be 
                provided based upon scientific knowledge of all who 
                could benefit.
                    (B) Efficiency.--Waste, including waste of 
                equipment, supplies, ideas, and energies, should be 
                avoided.
                    (C) Equity.--The provision of health care should 
                not vary in quality because of personal characteristics 
                of the individuals involved.
                    (D) Patient-centeredness.--Health care should be 
                responsive to, and respectful of, individual patient 
                preferences.
                    (E) Safety.--Injuries to patients from the health 
                care that is supposed to help them should be avoided.
                    (F) Timeliness.--Waiting times and harmful delays 
                in providing health care should be reduced.
            (2) Health care quality measure.--The term ``health care 
        quality measure'' means a national consensus standard for 
        measuring the performance and improvement of population health 
        or of institutional providers of services, physicians, and 
        other clinicians in the delivery of health care services, 
        consistent with the health care quality criteria described in 
        paragraph (1).
            (3) Multi-stakeholder group.--The term ``multi-stakeholder 
        group'' means, with respect to a health care quality measure, a 
        voluntary collaborative of public and private organizations 
        representing persons interested in, or affected by, the use of 
        such health care quality measure, including--
                    (A) health care providers and practitioners, 
                including providers and practitioners primarily serving 
                children and those with long-term health care needs;
                    (B) health care quality entities;
                    (C) health plans;
                    (D) patient advocates and consumer groups;
                    (E) employers;
                    (F) public and private purchasers of health care 
                items and services;
                    (G) labor organizations;
                    (H) relevant departments or agencies of the United 
                States;
                    (I) biopharmaceutical companies and manufacturers 
                of medical devices; and
                    (J) licensing, credentialing, and accrediting 
                bodies.

SEC. 3. DEPARTMENT AND AGENCY QUALITY REVIEW.

    Each relevant department and agency of the Federal Government shall 
review the statutory authority of such department or agency, effective 
on the date of enactment of this Act, administrative regulations, and 
policies and procedures for the purpose of determining whether there 
are any deficiencies or inconsistencies therein which prohibit full 
compliance with the purposes and provisions of this Act. Each 
department and agency shall, not later than July 1, 2010, propose to 
the President such measures as may be necessary to bring the authority 
and policies and procedures of such department or agency into 
conformity with the intent, purposes, and provisions set forth in this 
Act.

SEC. 4. NATIONAL HEALTH CARE QUALITY PRIORITIES.

    (a) Establishment of the Office of National Health Care Quality 
Improvement.--There is established within the Executive Office of the 
President an Office of National Health Care Quality Improvement 
(``NHCQI'') (referred to in this section as the ``Office''). The Office 
shall be headed by a Director of National Health Care Quality (referred 
to in this section as the ``Director'') who shall be appointed by the 
President and shall report directly to the President.
    (b) Director.--
            (1) Responsibilities.--The Director shall perform the 
        duties of the Office, described in paragraph (3), in a manner 
        consistent with the development of a nationwide health care 
        quality infrastructure that--
                    (A) coordinates and implements health care quality 
                research, measurement, and data collection and 
                reporting across all Federal agencies involved in 
                purchasing, providing, studying, or regulating health 
                care services;
                    (B) incorporates proven public and private quality 
                improvement best practices;
                    (C) includes public and private quality improvement 
                strategies to address activities other than health care 
                quality measurement, such as provider payment models, 
                alternative care models, licensing, professional 
                certification, medical education, alternative staffing 
                models, and public reporting; and
                    (D) leads to improved health care outcomes for 
                patients across the United States.
            (2) Qualifications.--The President shall, by and with the 
        advice and consent of the Senate, appoint a Director. The 
        President shall select an individual who has--
                    (A) national recognition for expertise in health 
                care quality improvement;
                    (B) experience addressing health care quality 
                improvement in more than one health care setting, such 
                as inpatient care, outpatient care, long-term care, 
                public programs, and private programs; and
                    (C) experience addressing health care quality as it 
                applies to vulnerable populations, including children, 
                underserved populations, rural populations, individuals 
                with disabilities, the elderly, and racial and ethnic 
                minorities.
            (3) Duties of the director.--The Director shall--
                    (A) advise the President on the quality of health 
                care in the United States, including priorities and 
                goals for the future;
                    (B) in coordination with public and private 
                stakeholders, determine national priorities for 
                improving health care quality, in accordance with 
                subsection (c);
                    (C) establish annual benchmarks for each relevant 
                Federal department and agency to achieve national 
                priorities for health care quality improvement;
                    (D) develop an annual report card on the state of 
                the Nation's health as it relates to health care 
                quality;
                    (E) in coordination with the heads of other 
                relevant agencies and as part of the annual budget 
                request of Congress, submit funding requirements, in 
                accordance with subsection (d);
                    (F) serve as the chairperson of the Quality 
                Interagency Coordinating Council (QuICC), established 
                under section 4; and
                    (G) in consultation with the National Coordinator 
                of Health Information Technology, develop an open 
                source framework for Federal quality communication to 
                create and maintain a standardized, electronic language 
                or interface that enables all relevant Federal entities 
                to communicate information or make requests regarding 
                quality research, definitions, activities, or 
                regulations, or to provide any other functionality, as 
                the Director determines.
    (c) National Priorities for Health Care Quality Improvement.--
            (1) In general.--Not later than January 1, 2010, and at 
        least every 5 years thereafter, the Director, in coordination 
        with public and private stakeholders, shall establish national 
        priorities for health care quality improvement.
            (2) Development of priorities.--In establishing the 
        national priorities for health care quality improvement under 
        paragraph (1), the Director shall consider--
                    (A) health care outcomes in the United States in 
                comparison to health outcomes in other World Health 
                Organization member countries;
                    (B) the burden of disease, including the 
                prevalence, incidence, and cost of disease to the 
                United States;
                    (C) demographics;
                    (D) variability in practice norms;
                    (E) potential to eliminate harm to patients;
                    (F) improvements with the potential for the 
                greatest impact on morbidity, mortality, performance, 
                and a focus on the patient;
                    (G) quality measures that may be coordinated across 
                different health care settings, including impatient and 
                outpatient measures, primary care, and specialty care;
                    (H) the specific quality improvement needs and 
                challenges of rural areas; and
                    (I) the unique quality improvement needs 
                disparities and challenges of vulnerable populations, 
                including children, the elderly, individuals with 
                disabilities, individuals near the end of life, and 
                racial and ethnic minorities.
            (3) Initial priorities.--The first set of national 
        priorities established under this subsection shall include as a 
        priority pediatric health care quality improvement, for 
        children up to age 21.
            (4) Collaboration with multi-stakeholder groups.--
                    (A) In general.--The Director shall convene and 
                collaborate with multi-stakeholder groups in 
                establishing and updating the national priorities under 
                paragraph (1).
                    (B) Transparency.--All collaboration between the 
                Director and multi-stakeholder groups shall be 
                conducted through an open and transparent process.
                    (C) Statutory construction.--Notwithstanding any 
                other provision in this paragraph, the Director shall 
                have the final authority to decide whether to accept 
                the recommendations provided by such multi-stakeholder 
                groups.
            (5) Agency- and department-specific strategic plans.--Not 
        later than October 1, 2010, and annually thereafter, the 
        Director, in consultation with the heads of relevant Federal 
        agencies and departments, shall develop agency- and department-
        specific strategic plans for health care quality improvement to 
        achieve national priorities, including annual benchmarks.
    (d) Annual Budget Request for Resources.--As part of the annual 
budget request made by the President to Congress, beginning with such 
budget request made in calendar year 2011, the Director, in 
consultation with the heads of relevant Federal departments and 
agencies, shall include--
            (1) a description of the agency- and department-specific 
        strategic plans for health care quality improvement; and
            (2) the level of Federal funding required for implementing 
        or maintaining the quality improvement strategic plans 
        described under paragraph (1).
    (e) Monitoring.--
            (1) In general.--The Director shall institute mechanisms 
        for monitoring the progress on achieving national health care 
        quality priorities under subsection (c)(1) as well as 
        department- and agency-specific strategic plans under 
        subsection (c)(5), including objectives, metrics, and 
        benchmarks for the following:
                    (A) The benefits and drawbacks of specific quality 
                improvement efforts for public programs and for the 
                health care system at large.
                    (B) Coordination and communication of efforts to 
                achieve interagency goals, including information 
                exchange.
                    (C) Interagency coordination progress for national 
                quality efforts.
                    (D) Methods for ensuring awareness and recognition 
                among health care providers and the public at large of 
                the significance of health care quality improvement.
            (2) Reporting.--
                    (A) Reporting.--Not later than December 31, 2011, 
                and by the end of each calendar year thereafter, the 
                Director shall submit to the President and to Congress 
                a report regarding the progress of Federal agencies in 
                achieving the quality improvement priorities under 
                paragraphs (1) and (5) of subsection (c), and shall 
                make such report publicly available through the 
                Internet.
                    (B) Annual national health care quality report 
                card.--Not later than January 31, 2011, and annually 
                thereafter, the Director shall publish a national 
                health care quality report card, which shall include--
                            (i) the considerations for national health 
                        care quality priorities described in subsection 
                        (c)(2);
                            (ii) an analysis of the progress of the 
                        department- and agency-specific strategic plans 
                        under subsection (c)(5) in achieving the 
                        national health care quality priorities 
                        established under subsection (c)(1), and any 
                        gaps in such strategic plans;
                            (iii) the extent to which private sector 
                        strategies have informed Federal quality 
                        improvement efforts; and
                            (iv) a summary of consumer feedback 
                        regarding how well current quality improvement 
                        practices work for such consumers and 
                        additional ways to improve health care quality.
    (f) Website.--Not later than July 1, 2010, the Director shall 
create a website to make public information regarding--
            (1) the national priorities for health care quality 
        improvement established under subsection (c)(1);
            (2) the department- and agency-specific strategic plans for 
        health care quality described in subsection (c)(5);
            (3) the annual national health care quality report card 
        described in subsection (e)(2)(B);
            (4) ongoing health care quality research efforts;
            (5) new and innovative health care quality improvement 
        practices in the public and private sectors;
            (6) a consumer feedback mechanism; and
            (7) other information, as the Director determines to be 
        appropriate.
    (g) Staff; Experts and Consultants; Voluntary and Uncompensated 
Service.--
            (1) Staff.--The Director may employ such officers and 
        employees as may be necessary to enable the Office to carry out 
        its functions under this Act, and may employ and fix the 
        compensation of such officers and employees as may be necessary 
        to carry out its functions under this Act.
            (2) Experts and consultants.--The Director may employ and 
        fix the compensation of such experts and consultants as may be 
        necessary for the carrying out of its functions under this Act, 
        in accordance with section 3109 of title 5, United States Code 
        (without regard to the last sentence).
            (3) Voluntary and uncompensated service.--Notwithstanding 
        section 1342 of title 31, United States Code, the Office may 
        accept and use voluntary and uncompensated services, as the 
        Director determines necessary.
    (h) Authorization of Appropriations.--There are authorized to carry 
out this section $50,000,000 for fiscal years 2010 through 2014.

SEC. 5. NATIONAL HEALTH CARE QUALITY COORDINATION.

    (a) Establishment.--As of the date of enactment of this Act, there 
is established within the Office of National Health Care Quality 
Improvement, the Quality Interagency Coordinating Council (referred to 
in this section as the ``QuICC'').
    (b) Purpose.--The purpose of the QuICC is to coordinate health care 
quality improvement efforts across all Federal agencies involved in 
purchasing, providing, studying, or regulating health care services in 
order to achieve the common goal of improving patient health outcomes.
    (c) Organization of the QuICC.--
            (1) Co-chairpersons.--The Director of National Health Care 
        Quality (referred to in this section as the ``Director'') and 
        the Secretary of Health and Human Services shall serve as co-
        chairpersons of the QuICC, and the Director shall manage day-
        to-day operations of the QuICC.
            (2) Federal members.--The Federal members of the QuICC, 
        each of whom shall have equal standing in the QuICC, shall 
        include--
                    (A) the Administrator of the Centers for Medicare & 
                Medicaid Services;
                    (B) the Director of the National Institutes of 
                Health;
                    (C) the Director of the Centers for Disease Control 
                and Prevention;
                    (D) the Commissioner of Food and Drugs;
                    (E) the Administrator of the Health Resources and 
                Services Administration;
                    (F) the Director of the Agency for Healthcare 
                Research and Quality;
                    (G) the Assistant Secretary of the Administration 
                for Children and Families;
                    (H) the Secretary of Labor;
                    (I) the Secretary of Defense;
                    (J) the Secretary of Veterans Affairs;
                    (K) the Under Secretary for Health of the Veterans 
                Health Administration;
                    (L) the Secretary of Commerce;
                    (M) the Director of the Office of Personnel 
                Management;
                    (N) the Director of the Office of Management and 
                Budget;
                    (O) the Commandant of the United States Coast 
                Guard;
                    (P) the Director of the Federal Bureau of Prisons;
                    (Q) the Administrator of the National Highway 
                Traffic Safety Administration;
                    (R) the Chairman of the Federal Trade Commission; 
                and
                    (S) the Commissioner of the Social Security 
                Administration.
    (d) Goals.--The goals of the QuICC shall be to achieve the 
following:
            (1) Collaboration between Federal departments and agencies 
        with respect to developing goals, models, and timetables that 
        are consistent with--
                    (A) reducing the underlying causes of illness, 
                injury, and disability;
                    (B) reducing health care errors;
                    (C) ensuring the appropriate use of health care 
                services;
                    (D) expanding research on effectiveness of 
                treatments;
                    (E) addressing over-supply and under-supply of 
                health care resources; and
                    (F) increasing patient participation in their care.
            (2) Collaboration between Federal departments and agencies 
        with respect to the development and utilization of quality 
        improvement strategies, including quality measurement, for 
        public sector programs that are flexible enough to respond to 
        changing health care needs, technology, and information, while 
        being sufficiently standardized to be comparably measured.
            (3) Cooperation between Federal departments and agencies in 
        the development and dissemination of evidence-based health care 
        information to help guide practitioners' actions in ways that 
        will improve quality and potentially reduce costs.
            (4) Cooperation between Federal departments and agencies in 
        the development and dissemination of user-friendly information 
        for both consumer and business purchasers that facilitates 
        meaningful comparisons of quality performances of health care 
        plans, facilities and practitioners.
            (5) Consultation with multi-stakeholder groups, where 
        appropriate, in order to develop interdepartmental and 
        interagency models for quality improvement.
            (6) Avoidance of inefficient duplication of ongoing health 
        care quality improvement efforts and resources, where feasible 
        and appropriate.
            (7) Coordination and implementation by Federal departments 
        and agencies of a streamlined process for quality reporting and 
        compliance requirements to reduce administrative burdens on 
        private entities who administer, oversee, or participate in the 
        Federal health programs.
    (e) Workgroups.--
            (1) In general.--Not later than 30 days after the 
        establishment of the QuICC, the Director shall establish within 
        the QuICC workgroups for each of the national health care 
        priorities established under section 4(c)(1).
            (2) Purpose.--Each such workgroup shall focus on achieving 
        the goals of the QuICC (described in subsection (d)) for one 
        such priority and shall--
                    (A) coordinate the implementation of such priority 
                across all relevant Federal agencies and departments; 
                and
                    (B) identify opportunities to improve the process 
                of implementing such health care priority.
            (3) Membership.--
                    (A) Leadership.--Each workgroup shall be led by 2 
                relevant Federal departments or agencies, as determined 
                by the Director.
                    (B) Representation.--Each of the Federal members 
                listed in subsection (c)(2) may appoint 1 or more 
                representatives to each workgroup.
            (4) Reporting.--
                    (A) Report.--Not later than December 31, 2010, and 
                annually thereafter, the co-chairpersons of the QuICC 
                shall submit a report to the relevant committees of 
                Congress describing--
                            (i) the QuICC's progress in meeting the 
                        goals described in subsection (d);
                            (ii) recommendations for legislation to 
                        improve the processes of health care quality 
                        coordination and prioritization; and
                            (iii) recommendations for new and 
                        innovative quality initiatives.
                    (B) Publication.--Not later than December 31, 2010, 
                and annually thereafter, the co-chairpersons shall 
                publish the report described in subparagraph (A) on the 
                website of the Office of National Health Care Quality 
                Improvement.
    (f) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $5,000,000 for fiscal years 2011 
through 2014.

SEC. 6. INCREASED AUTHORITY OF THE AGENCY FOR HEALTHCARE RESEARCH AND 
              QUALITY WITHIN THE DEPARTMENT OF HEALTH AND HUMAN 
              SERVICES.

    (a) Director of the Agency for Healthcare Research and Quality.--
Section 901(a) of the Public Health Service Act (42 U.S.C. 299(a)) is 
amended by striking ``by the Secretary'' and inserting ``by the 
President, by and with the advice and consent of the Senate''.
    (b) National Health Care Quality Priorities.--Title IX of the 
Public Health Service Act (42 U.S.C. 299 et seq.) is amended by adding 
at the end the following:

           ``PART E--NATIONAL HEALTH CARE QUALITY PRIORITIES

``SEC. 940. DEFINITIONS.

    ``In this part:
            ``(1) Health care quality.--The term `health care quality' 
        means the degree to which health services for individuals and 
        populations increase the likelihood of desired health outcomes 
        and are consistent with current professional knowledge, based 
        upon the following criteria:
                    ``(A) Effectiveness.--Health care services should 
                be provided based upon scientific knowledge of all who 
                could benefit.
                    ``(B) Efficiency.--Waste, including waste of 
                equipment, supplies, ideas, and energies, should be 
                avoided.
                    ``(C) Equity.--The provision of health care should 
                not vary in quality because of personal characteristics 
                of the individuals involved.
                    ``(D) Patient-centeredness.--Health care should be 
                responsive to, and respectful of, individual patient 
                preferences.
                    ``(E) Safety.--Injuries to patients from the health 
                care that is supposed to help them should be avoided.
                    ``(F) Timeliness.--Waiting times and harmful delays 
                in providing health care should be reduced.
            ``(2) Health care quality measure.--The term `health care 
        quality measure' means a national consensus standard for 
        measuring the performance and improvement of population health 
        or of institutional providers of services, physicians, and 
        other clinicians in the delivery of health care services, 
        consistent with the health care quality criteria described in 
        paragraph (1).
            ``(3) Multi-stakeholder group.--The term `multi-stakeholder 
        group' means, with respect to a health care quality measure, a 
        voluntary collaborative of public and private organizations 
        representing persons interested in, or affected by, the use of 
        such health care quality measure, including--
                    ``(A) health care providers and practitioners, 
                including providers and practitioners primarily serving 
                children and those with long-term health care needs;
                    ``(B) health care quality entities;
                    ``(C) health plans;
                    ``(D) patient advocates and consumer groups;
                    ``(E) employers;
                    ``(F) public and private purchasers of health care 
                items and services;
                    ``(G) labor organizations;
                    ``(H) relevant departments or agencies of the 
                United States;
                    ``(I) biopharmaceutical companies and manufacturers 
                of medical devices; and
                    ``(J) licensing, credentialing, and accrediting 
                bodies.
            ``(4) the term `health care quality measure' means a 
        national consensus standard for measuring the performance and 
        improvement of population health or of institutional providers 
        of services, physicians, and other clinicians in the delivery 
        of health care services; and
            ``(5) the term `multi-stakeholder group' means, with 
        respect to a health care quality measure, a voluntary 
        collaborative of public and private organizations representing 
        persons interested in, or affected by, the use of such health 
        care quality measure, including--
                    ``(A) hospitals and other health care settings;
                    ``(B) physicians, including pediatricians;
                    ``(C) health care quality alliances;
                    ``(D) nurses and other health care practitioners;
                    ``(E) health plans;
                    ``(F) patient advocates and consumer groups;
                    ``(G) employers;
                    ``(H) public and private purchasers of health care 
                items and services;
                    ``(I) labor organizations;
                    ``(J) relevant departments or agencies of the 
                United States;
                    ``(K) biopharmaceutical companies and manufacturers 
                of medical devices; and
                    ``(L) licensing, credentialing, and accrediting 
                bodies.

``SEC. 941. RESEARCH PRIORITIES.

    ``The Director, in consultation with the heads of agencies within 
the Department of Health and Human Services shall ensure that the 
health care quality improvement priorities identified by the Director 
of the Office of National Health Care Quality Improvement, established 
under section 4 of the National Health Care Quality Act, are taken into 
consideration in all applicable research conducted under the Department 
of Health and Human Services, including the National Institutes of 
Health and the demonstration projects.

``SEC. 942. QUALITY MEASURES.

    ``(a) Application of Quality Measures to Programs Under the 
Department of Health and Human Services.--
            ``(1) In general.--The Director, in consultation with the 
        Administrator of the Centers for Medicare & Medicaid Services, 
        the Director of the Centers for Disease Control and Prevention, 
        the Director of the National Institutes of Health, and a 
        consensus-based entity (as such term is used in section 1890 of 
        the Social Security Act), shall define uniform health care 
        quality measures, which shall apply to Federal health programs 
        under the Department of Health and Human Services, including 
        the following Federal programs, in order of priority:
                    ``(A) The Medicare program under title XVIII of the 
                Social Security Act, the rural health and pharmacy 
                programs of the Health Resources and Services 
                Administration, and the health programs of the 
                Administration on Aging.
                    ``(B) The Medicaid program under title XIX of the 
                Social Security Act, the Children's Health Insurance 
                program under title XXI of such Act, the health 
                programs of the Administration for Children and 
                Families, and the maternal and child health programs of 
                the Health Resources and Services Administration.
                    ``(C) The Indian Health Service.
                    ``(D) The Substance Abuse and Mental Health 
                Services Administration.
                    ``(E) Programs of the Health Resources and Services 
                Administration other than those described in 
                subparagraph (B).
                    ``(F) Centers of the Food and Drug Administration.
            ``(2) Prioritization.--The Director shall apply the health 
        care quality measures under this section to the Federal 
        programs in the order of priority described in paragraph (1).
            ``(3) Considerations regarding quality measure 
        application.--Before applying the health care quality measures 
        described in paragraph (1), the Director shall consider--
                    ``(A) the potential of such measures to improve 
                patient outcomes;
                    ``(B) the ease of integration as a factor in health 
                care provider reimbursement;
                    ``(C) the applicability of such measures across 
                health care settings;
                    ``(D) the unique quality improvement needs of 
                vulnerable populations, including children, the 
                elderly, individuals with disabilities, individuals 
                near the end of life, and racial and ethnic minorities;
                    ``(E) the burden of disease, including the 
                prevalence, incidence, and cost of disease to the 
                United States; and
                    ``(F) payment distortions that encourage certain 
                practice norms which may not lead to greater patient 
                health outcomes.
            ``(4) Updating of the application of quality measures.--The 
        Director, in consultation with the Administrator of the Centers 
        for Medicare & Medicaid Services, the Director of the Centers 
        for Disease Control and Prevention, the Director of the 
        National Institutes of Health, and a consensus-based entity (as 
        such term is used in section 1890 of the Social Security Act), 
        shall develop a process for updating the health care quality 
        measures defined under paragraph (1) as new research and 
        evidence become available.
    ``(b) Quality Measure Reporting to Federal Health Programs.--The 
Director, in cooperation with the Administrator of the Centers for 
Medicare & Medicaid Services, the National Coordinator for Health 
Information Technology, the Administrator of the Health Resources and 
Services Administration, the Director of the Centers for Disease 
Control and Prevention, and the Commissioner of Food and Drugs, shall 
create a streamlined process for health care providers to report 
quality measures to the heads of relevant agencies and departments for 
the purpose of quality improvement in the Federal health programs 
described in subsection (a)(1).
    ``(c) Development of Additional Quality Improvement Strategies.--
The Director, in consultation with the Administrator of the Centers for 
Medicare & Medicaid Services, the Director of the Centers for Disease 
Control and Prevention, the Director of the National Institutes of 
Health, and multi-stakeholder groups, shall develop quality improvement 
strategies to address activities other than health care quality 
measurement that lead to improved patient outcomes, such as alternative 
care models, licensing, professional certification, medical education, 
alternative staffing models, and public reporting.

``SEC. 943. PUBLIC EDUCATION CAMPAIGNS.

    ``(a) In General.--The Director shall conduct a public education 
campaign, designed to educate health care providers and consumers of 
health care about health care quality improvement.
    ``(b) Consumer Education Campaigns.--
            ``(1) In general.--The Director, in coordination with the 
        Administrator of the Centers for Medicare & Medicaid Services 
        and the Director of the Centers for Disease Control and 
        Prevention, shall create a consumer education campaign to 
        develop accurate and reliable information about health care 
        quality. In compiling the information for the consumer 
        education campaign, the Secretary may use mechanisms and 
        sources of information that are available through other Federal 
        agencies.
            ``(2) Requirements.--The consumer education campaign shall 
        include information regarding--
                    ``(A) the importance of quality in health care 
                decisions;
                    ``(B) the ways in which health care experts define 
                and identify quality in health care;
                    ``(C) the variance of quality among health 
                insurance plans, health care facilities, health care 
                organizations, and health care providers; and
                    ``(D) the role of consumers in improving the 
                quality of health care.
            ``(3) Publication.--The Director shall make the information 
        described in paragraph (1) available to the public through the 
        Internet.
            ``(4) Grant program.--The Director shall award grants to 
        States and private nonprofit organizations to assist with the 
        creation and dissemination of the information described in 
        paragraph (1).
    ``(c) Quality Resource Center for Health Care Providers.--
            ``(1) In general.--The Director, in coordination with the 
        Administrator of the Centers for Medicare & Medicaid Services, 
        shall create a National Quality Resource Center (referred to in 
        this subsection as the `NQRC') for health care providers to 
        assist with the understanding and implementation of quality 
        improvement initiatives for health care providers.
            ``(2) Duties.--The national resource center developed under 
        paragraph (1) shall--
                    ``(A) inform providers about quality improvement 
                techniques and the value of such techniques to 
                improving quality;
                    ``(B) accelerate the transfer of lessons learned 
                from other initiatives in the public and private 
                sectors, including those initiatives receiving Federal 
                financial support;
                    ``(C) provide a forum for exchange of knowledge and 
                experience among health care providers;
                    ``(D) provide technical assistance to health care 
                providers for implementing quality improvement efforts; 
                and
                    ``(E) provide a forum for feedback from health care 
                providers concerning the effect of the efforts under 
                subparagraphs (A) through (D).
            ``(3) National quality support extension grant program.--
                    ``(A) In general.--The Director, in coordination 
                with the NQRC, shall award National Quality Support 
                Extension grants (referred to in this paragraph as 
                `NQSE grants' or the `NQSE grant program'), on a 
                competitive basis, to eligible entities for the purpose 
                of supporting and facilitating local health care 
                quality improvement efforts throughout the United 
                States.
                    ``(B) Purposes.--The purposes of the NQSE grant 
                program are--
                            ``(i) to assist qualified eligible entities 
                        in carrying out projects related to health care 
                        quality improvement activities among the 
                        provider community to help test and acclimate 
                        to new, innovative quality improvement 
                        activities;
                            ``(ii) to facilitate communication among 
                        local health care quality groups regarding the 
                        best practices in the area of quality 
                        improvement and prevention in the clinical 
                        setting; and
                            ``(iii) to enable, empower, support, and 
                        assist local health care quality improvement 
                        efforts, particularly those that facilitate 
                        collaboration between independent providers.
                    ``(C) Eligible entities.--An entity desiring a 
                grant under this paragraph shall--
                            ``(i) be a public or private nonprofit 
                        entity engaged in health care quality 
                        improvement;
                            ``(ii) submit to the Director a program 
                        design that describes the purpose of the plan 
                        for which the entity seeks a grant and the 
                        community leadership that will support the 
                        entity in carrying out such plan; and
                            ``(iii) submit to the Director an 
                        application at such time, in such manner, and 
                        containing such information as the Director may 
                        require.
            ``(4) Implementation assistance.--The Health Information 
        Technology regional extension centers under section 3012(c) 
        shall operate as extension centers for the NQRC, for the 
        purposes of implementation assistance.
            ``(5) Technical assistance for health care providers 
        working with vulnerable populations.--In carrying out this 
        subsection, the Director shall give particular attention to the 
        technical assistance that health care providers who serve 
        vulnerable populations need.

``SEC. 944. FUNDING.

    ``(a) Trust Funds.--For purposes of funding the activities under 
this part, 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 Insurance 
Trust Fund under section 1841 of the Social Security Act (42 U.S.C. 
1395t), including the Medicare Prescription Drug Account in such Trust 
Fund, in such proportion as determined appropriate by the Secretary, of 
$150,000,000 for each of fiscal years 2010 through 2014.
    ``(b) American Recovery and Reinvestment Funds.--At the end of the 
recession adjustment period (as defined in section 5001(h)(3) of the 
American Recovery and Reinvestment Act (Public Law 111-5; 123 Stat. 
496), the Secretary of the Treasury shall transfer any funds 
appropriated under such Act and not otherwise expended to the Agency 
for purposes of carrying out this part.
    ``(c) Medicaid and Medicare Improvement Funds.--For purposes of 
funding the activities under this part for fiscal year 2014, the 
Secretary shall provide for the transfer of $100,000,000 from the 
Medicaid Improvement Fund under section 1898 of the Social Security Act 
(42 U.S.C. 1395iii), and $100,000,000 from the Medicare Improvement 
Fund under section 1941 of such Act (42 U.S.C 1396w-1).''.
    (c) Technical Amendment.--Section 937(b) of the Public Health 
Service Act (42 U.S.C. 299c-6(b)) is amended by inserting ``except for 
part E,'' after ``this title''.
    (d) Development of Quality Measures for Federal Health Programs.--
            (1) Period of contract.--Section 1890(a)(3) of the Social 
        Security Act (42 U.S.C. 1395aaa(a)(3)) is amended--
                    (A) by striking ``4 years'' and inserting ``4 
                years, in the case of the first contract entered into 
                under such paragraph, and 3 years in the case of each 
                subsequent contract entered into under such 
                paragraph''; and
                    (B) by inserting ``for a period of 3 years'' after 
                ``renewed''.
            (2) Priority setting process.--Section 1890(b)(1) of the 
        Social Security Act (42 U.S.C. 1395aaa(b)(1)) is amended--
                    (A) in the matter preceding subparagraph (A)--
                            (i) by striking ``an integrated national 
                        strategy and priorities for''; and
                            (ii) by inserting ``in a manner consistent 
                        with the national priorities for health care 
                        quality improvement (as defined in section 
                        4(c)(1))'' after ``settings''; and
                    (B) in subparagraph (A)--
                            (i) by redesignating clauses (i) through 
                        (iii) as clauses (ii) through (iv), 
                        respectively; and
                            (ii) by inserting before clause (ii), as so 
                        redesignated, the following new clause:
                            ``(i) that are consistent with such 
                        national priorities for health care quality 
                        improvement;''.
            (3) Annual report to congress.--Section 1890(b)(5) of the 
        Social Security Act (42 U.S.C. 1395aaa(b)(5)) is amended--
                    (A) by redesignating clauses (i) through (iii) as 
                clauses (ii) through (iv); and
                    (B) by inserting before clause (ii), as so 
                redesignated, the following new clause:
                            ``(i) the extent to which the priorities 
                        set and the quality improvement measures 
                        endorsed by the entity under paragraphs (1) and 
                        (2), respectively, are consistent with the 
                        national priorities for health care quality 
                        improvement (as so defined);''.
            (4) Funding.--Section 1890(d) of the Social Security Act 
        (42 U.S.C. 1395aaa(d)) is amended by inserting ``and, for 
        purposes of carrying out this section under a new or renewed 
        contract, there are authorized to be appropriated such sums as 
        are necessary, taking into consideration the results of the 
        study contained in the 18 month report submitted to Congress 
        under section 183(b)(2) of the Medicare Improvements for 
        Patients and Providers Act of 2008 (Public Law 110-275), for 
        each of fiscal years 2013 through 2015'' before the period at 
        the end.

SEC. 7. REPORTS TO CONGRESS.

    (a) Evaluation of the Consumer Education Campaign.--Not later than 
18 months after the establishment of the quality resource center under 
section 943(c) of the Public Health Service Act (as added by section 
6), the Comptroller General of the United States shall submit to 
Congress a report describing--
            (1) the effectiveness of the quality resource center for 
        health care providers under such section 943(c); and
            (2) the effectiveness of the consumer education program 
        under section 943(b) of such Act (as added by section 6).
    (b) Quality Dissemination Strategies.--Not later than 18 months 
after the date of enactment of this Act, the Secretary of Health and 
Human Services, acting through the Director of the Agency for 
Healthcare Research and Quality, shall submit a report to Congress that 
includes--
            (1) a description of the efforts made to translate clinical 
        information regarding health care quality improvement into 
        reasonable clinical practice;
            (2) the processes through which the Secretary disseminated 
        the information described in paragraph (1); and
            (3) recommendations for the most effective methods for 
        translating and disseminating information concerning health 
        care quality, and required statutory changes to implement the 
        recommended methods.
    (c) IOM Report to Congress Regarding the Value of Quality Measure 
Reporting.--
            (1) In general.--The Secretary of Health and Human Services 
        shall enter into a contract with the Director of the Institute 
        of Medicine requiring that, not later than 18 months after the 
        date of enactment of this Act, the Director submit to Congress 
        a report regarding the value of quality measure reporting in 
        improving patient health outcomes.
            (2) Considerations.--In preparing the report described in 
        paragraph (1), the Director of the Institutes of Medicine shall 
        consider--
                    (A) specific instances in the history of existing 
                public health care programs within the Federal 
                Government in which quality measure reporting has been 
                shown, through peer-reviewed studies or literature, to 
                result in improved patient health outcomes; and
                    (B) instances in which quality measure reporting 
                has been shown to improve existing health disparities 
                among vulnerable populations, including children, 
                underserved populations, rural populations, individuals 
                with disabilities, the elderly, and racial and ethnic 
                minorities.
            (3) Authorization of appropriations.--There are authorized 
        to be appropriated such sums as may be necessary to carry out 
        this subsection.
    (d) GAO Study and Reports.--Section 183(b)(1) of the Medicare 
Improvements for Patients and Providers Act of 2008 (Public Law 110-
275; 122 Stat. 2586) is amended--
            (1) in subparagraph (A), by striking ``and'' after the 
        semicolon;
            (2) in subparagraph (B), by striking the period at the end 
        and inserting a semicolon; and
            (3) by inserting after subparagraph (B) the following:
                    ``(C) any negative effect on patients, particularly 
                on patients in underserved or vulnerable populations; 
                and
                    ``(D) any negative effect on health care providers, 
                particularly health care providers in rural and 
                underserved areas.''.

SEC. 8. DATA COLLECTION.

    (a) In General.--Not later than January 1, 2011, and at least every 
5 years thereafter, the Comptroller General of the United States 
(referred to in this section as the ``Comptroller General'') shall 
conduct evaluations of the implementation of the data collection 
processes for quality measures used by the Federal health programs 
administered through the Department of Health and Human Services.
    (b) Considerations.--In conducting the evaluations under subsection 
(a), the Comptroller General shall consider--
            (1) whether the system for the collection of data for 
        quality measures provides for validation of data in a manner 
        that is relevant, fair, and scientifically credible;
            (2) whether data collection efforts under the system--
                    (A) use the most efficient and cost-effective means 
                in a manner that minimizes administrative burden on 
                persons required to collect data;
                    (B) adequately protects the privacy the personal 
                health information of patients; and
                    (C) provides data security;
            (3) whether standards under the system provide for an 
        opportunity for health care providers and institutional 
        providers of services to review and correct any inaccuracies 
        with regard to the findings; and
            (4) the extent to which quality measures--
                    (A) assess outcomes and the functional status of 
                patients;
                    (B) assess the continuity and coordination of care 
                and care transitions, including episodes of care, for 
                patients across providers and health care settings;
                    (C) assess patient experience and patient 
                engagement;
                    (D) assess the safety, effectiveness, and 
                timeliness of care;
                    (E) assess health disparities, including 
                disparities associated with race, ethnicity, age, 
                gender, place of residence, or language;
                    (F) assess the efficiency and use of resources in 
                the provision of care;
                    (G) are designed to be collected as part of health 
                information technologies supporting better delivery of 
                health care services; and
                    (H) result in direct or indirect costs to users of 
                such measures.
    (c) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $1,000,000 for fiscal years 2010 
through 2014.
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