1.This Act may be cited as
the National Health Care Quality
Act
.
2.In this Act:
(1)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)Health
care services should be provided based upon scientific knowledge of all who
could benefit.
(B)Waste,
including waste of equipment, supplies, ideas, and energies, should be
avoided.
(C)The
provision of health care should not vary in quality because of personal
characteristics of the individuals involved.
(D)Health
care should be responsive to, and respectful of, individual patient
preferences.
(E)Injuries
to patients from the health care that is supposed to help them should be
avoided.
(F)Waiting
times and harmful delays in providing health care should be reduced.
(2)Health care
quality measureThe 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)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.
3.Department and
agency quality reviewEach
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.
4.National health
care quality priorities
(a)Establishment
of the Office of National Health Care Quality ImprovementThere
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)
(1)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)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)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)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
prioritiesIn 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)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)The Director shall convene and collaborate with
multi-stakeholder groups in establishing and updating the national priorities
under paragraph (1).
(B)All
collaboration between the Director and multi-stakeholder groups shall be
conducted through an open and transparent process.
(C)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 plansNot 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 resourcesAs 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)
(1)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)
(A)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 cardNot 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)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)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)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 serviceNotwithstanding 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 appropriationsThere are authorized to carry out this section
$50,000,000 for fiscal years 2010 through 2014.
5.National health
care quality coordination
(a)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)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)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)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)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)
(1)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)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)
(A)Each
workgroup shall be led by 2 relevant Federal departments or agencies, as
determined by the Director.
(B)Each
of the Federal members listed in subsection (c)(2) may appoint 1 or more
representatives to each workgroup.
(4)
(A)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)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 appropriationsThere are authorized to be appropriated to
carry out this section $5,000,000 for fiscal years 2011 through 2014.
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 QualitySection 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 prioritiesTitle
IX of the Public Health Service Act (42 U.S.C. 299 et seq.) is amended by
adding at the end the following:
ENational health
care quality priorities
940.In this part:
(1)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)Health
care services should be provided based upon scientific knowledge of all who
could benefit.
(B)Waste,
including waste of equipment, supplies, ideas, and energies, should be
avoided.
(C)The
provision of health care should not vary in quality because of personal
characteristics of the individuals involved.
(D)Health
care should be responsive to, and respectful of, individual patient
preferences.
(E)Injuries
to patients from the health care that is supposed to help them should be
avoided.
(F)Waiting
times and harmful delays in providing health care should be reduced.
(2)Health care
quality measureThe 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)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.
941.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.
942.
(a)Application of
quality measures to programs under the Department of Health and Human
Services
(1)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)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 applicationBefore 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 measuresThe 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 programsThe 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 strategiesThe 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.
943.Public
education campaigns
(a)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)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)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)The
Director shall make the information described in paragraph (1) available to the
public through the Internet.
(4)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)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)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)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)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)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
assistanceThe 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
populationsIn carrying out this subsection, the Director shall
give particular attention to the technical assistance that health care
providers who serve vulnerable populations need.
944.
(a)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 fundsAt 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 FundsFor 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)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)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)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 congressSection 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)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.
7.
(a)Evaluation of
the consumer education campaignNot 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 strategiesNot 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)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)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 appropriationsThere are authorized to be appropriated such
sums as may be necessary to carry out this subsection.
(d)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.
.
8.
(a)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)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 appropriationsThere are authorized to be appropriated to
carry out this section $1,000,000 for fiscal years 2010 through 2014.