[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7253 Introduced in House (IH)]

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115th CONGRESS
  2d Session
                                H. R. 7253

 To amend title XVIII of the Social Security Act to minimize costs and 
 burdens under the Medicare program by providing for consideration of 
 the removal of certain measures applicable to inpatient hospitals and 
   post-acute care inpatient providers and providing for meaningful 
                               measures.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           December 11, 2018

Mr. Smith of Missouri introduced the following bill; which was referred 
to the Committee on Ways and Means, and in addition to the Committee on 
Energy and Commerce, for a period to be subsequently determined by the 
  Speaker, in each case for consideration of such provisions as fall 
           within the jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
 To amend title XVIII of the Social Security Act to minimize costs and 
 burdens under the Medicare program by providing for consideration of 
 the removal of certain measures applicable to inpatient hospitals and 
   post-acute care inpatient providers and providing for meaningful 
                               measures.

    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 ``Remove Extraneous Measures that 
Obstruct Value and Efficiency Act'' or the ``REMOVE Act''.

SEC. 2. REMOVAL OF CERTAIN QUALITY MEASURES APPLICABLE TO INPATIENT 
              HOSPITALS AND POST-ACUTE CARE PROVIDERS INPATIENT 
              PROVIDERS; PROVIDING FOR MEANINGFUL MEASURES.

    (a) Removal for Inpatient Hospitals.--
            (1) In general.--Section 1886(b)(3)(B)(viii) of the Social 
        Security Act (42 U.S.C. 1395ww(b)(3)(B)(viii)) is amended by 
        adding at the end the following new subclause:
                    ``(XII) For purposes of this clause, in considering 
                the removal of a quality measure, the Secretary shall 
                base such consideration on factors such as the 
                following:
                            ``(aa) Measure performance is so high and 
                        unvarying that meaningful distinctions in 
                        improvements in performance can no longer be 
                        made.
                            ``(bb) Performance or improvement on such 
                        measure does not result in better patient 
                        outcomes.
                            ``(cc) Such measure does not align with 
                        clinical guidelines or practice.
                            ``(dd) Another measure is available that, 
                        with respect to a particular topic, is more 
                        broadly applicable (across settings, 
                        populations, or conditions) than the measure 
                        that is being considered for removal for the 
                        particular topic.
                            ``(ee) Another measure is available that, 
                        with respect to a particular topic, is more 
                        proximal in time to desired patient outcomes 
                        than the measure that is being considered for 
                        removal for the particular topic.
                            ``(ff) Another measure is available that, 
                        with respect to a particular topic, is more 
                        strongly associated with desired patient 
                        outcomes than the measure that is being 
                        considered for removal for the particular 
                        topic.
                            ``(gg) Collection or public reporting of 
                        the measure leads to negative unintended 
                        consequences.
                            ``(hh) The costs (including costs 
                        associated with administrative burden to 
                        providers of services and suppliers) associated 
                        with the measure outweigh the benefit of the 
                        continued use of the measure.
                            ``(ii) Such other factors determined 
                        appropriate by the Secretary.''.
            (2) Value-based purchasing program.--Section 1886(o)(2)(D) 
        of the Social Security Act (42 U.S.C. 1395ww(o)(2)(D)) is 
        amended--
                    (A) in the heading, by inserting ``and removal of'' 
                after ``Replacing'';
                    (B) by striking ``Subclause (VI)'' and inserting 
                ``Subclauses (VI) and (XII)''; and
                    (C) by striking ``such subclause applies'' and 
                inserting ``such subclauses apply''.
    (b) Removal for Post-Acute Care Providers.--Section 1899B(h) of the 
Social Security Act (42 U.S.C. 1395lll(h)) is amended by adding at the 
end the following new paragraph:
            ``(3) Measure removal factors.--
                    ``(A) In general.--In carrying out paragraph (1) 
                and the provisions specified in subparagraph (B), for 
                purposes of evaluating quality measures described in 
                such paragraph or such subparagraph, respectively, the 
                Secretary shall consider removal of such a measure 
                based on factors such as those described in section 
                1886(b)(3)(B)(viii)(XII).
                    ``(B) Reporting provisions and measures 
                described.--For purposes of subparagraph (A), the 
                provisions and measures described in this subparagraph 
                are the following:
                            ``(i) In the case of inpatient 
                        rehabilitation facilities, section 1886(j)(7) 
                        and the measures described in such section.
                            ``(ii) In the case of long-term care 
                        hospitals, section 1886(m)(5) and the measures 
                        described in such section.
                            ``(iii) In the case of skilled nursing 
                        facilities, section 1888(e)(6) and the measures 
                        described in such section.
                            ``(iv) In the case of home health agencies, 
                        section 1895(b)(3)(B)(v) and the measures 
                        described in such section.''.
    (c) Providing for Meaningful Measures.--Section 1890A(a) of the 
Social Security Act (42 U.S.C. 1395aaa-1(a)) is amended by adding at 
the end the following new paragraph:
            ``(7) Meaningful measures.--In selecting and updating 
        quality measures for use under this title, the Secretary shall, 
        as practicable, consider the extent to which such measures 
        satisfy the following factors:
                    ``(A) The measures are patient-centered and 
                meaningful to patients, clinicians, and providers.
                    ``(B) The measures address high-impact measure 
                areas that safeguard public health.
                    ``(C) The measures are outcome-based where 
                possible.
                    ``(D) The measures minimize the level of burden for 
                providers.
                    ``(E) The measures create significant opportunity 
                for improvement;
                    ``(F) The measures align across programs and with 
                other payors.
                    ``(G) The measures satisfy any other factor 
                specified by the Secretary.''.
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