[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3406 Introduced in House (IH)]
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116th CONGRESS
1st Session
H. R. 3406
To amend title XVIII of the Social Security Act to improve measurements
under the skilled nursing facility value-based purchasing program under
the Medicare program, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
June 21, 2019
Mr. Neal (for himself and Mr. Brady) 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
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A BILL
To amend title XVIII of the Social Security Act to improve measurements
under the skilled nursing facility value-based purchasing program under
the Medicare program, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. IMPROVING MEASUREMENTS UNDER THE SKILLED NURSING FACILITY
VALUE-BASED PURCHASING PROGRAM UNDER THE MEDICARE
PROGRAM.
(a) In General.--Section 1888(h) of the Social Security Act (42
U.S.C. 1395yy(h)) is amended--
(1) in paragraph (1), by adding at the end the following
new subparagraph:
``(C) Exclusions.--With respect to payments for
services furnished on or after October 1, 2021, this
subsection shall not apply to a facility for which
there are not a minimum number (as determined by the
Secretary) of--
``(i) cases for the measures that apply to
the facility for the performance period for the
applicable fiscal year; or
``(ii) measures that apply to the facility
for the performance period for the applicable
fiscal year.'';
(2) in paragraph (2)(A)--
(A) by striking ``The Secretary shall apply'' and
inserting ``The Secretary--
``(i) shall apply'';
(B) by striking the period at the end and inserting
``; and''; and
(C) by adding at the end the following:
``(ii) may, with respect to payments for
services furnished on or after October 1, 2022,
apply additional measures determined
appropriate by the Secretary, which may include
measures of functional status, patient safety,
care coordination, or patient experience.
Subject to the succeeding sentence, in the case that
the Secretary applies additional measures under clause
(ii), the Secretary shall consider and apply, as
appropriate, quality measures specified under section
1899B(c)(1). In no case may the Secretary apply more
than 10 measures under this subparagraph.'';
(3) in subparagraph (A) of each of paragraphs (3) and (4),
by striking ``measure'' and inserting ``measures''; and
(4) by adding at the end the following new paragraph:
``(12) Validation.--
``(A) In general.--The Secretary shall apply to the
measures applied under this subsection and the data
submitted under subsection (e)(6) a process to validate
such measures and data, as appropriate, which may be
similar to the process specified in section
1886(b)(3)(B)(viii)(XI) for validating inpatient
hospital measures.
``(B) Funding.--For purposes of carrying out this
paragraph, the Secretary shall provide for the
transfer, from the Federal Hospital Insurance Trust
Fund established under section 1817, of $5,000,000 to
the Centers for Medicare & Medicaid Services Program
Management Account for each of fiscal years 2022
through 2024.''.
(b) Report by MedPAC.--Not later than March 15, 2021, the Medicare
Payment Advisory Commission shall submit to Congress a report on
establishing a prototype value-based payment program under a unified
prospective payment system for post-acute care services under the
Medicare program under title XVIII of the Social Security Act (42
U.S.C. 1395 et seq.). Such report--
(1) shall--
(A) consider design elements such as--
(i) measures that are important to the
Medicare program and to beneficiaries under
such program;
(ii) methodologies for scoring provider
performance and effects on payment; and
(iii) other elements determined appropriate
by the Commission; and
(B) analyze the effects of implementing such
prototype program; and
(2) may--
(A) discuss the possible effects, with respect to
the Medicare program, on program spending, post-acute
care providers, patient outcomes, and other effects
determined appropriate by the Commission; and
(B) include recommendations with respect to such
prototype program, as determined appropriate by the
Commission, to Congress and the Secretary of Health and
Human Services.
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