(II) in subclause (II), by striking 
‘‘items and services’’ and inserting 
‘‘covered professional services (as de-
fined in subsection (k)(3)(A))’’; and 
(III) by amending subclause (III) 
to read as follows: 
‘‘(III) The minimum amount (as 
determined by the Secretary) of— 
‘‘(aa) for performance peri-
ods beginning before January 1, 
2018, allowed charges billed by 
such professional under this part 
for such performance period; and 
‘‘(bb) for performance peri-
ods beginning on or after Janu-
ary 1, 2018, allowed charges for 
covered professional services (as 
defined in subsection (k)(3)(A)) 
billed by such professional for 
such performance period.’’; 
(B) in paragraph (5)(D)— 
(i) in clause (i)(I), by inserting ‘‘sub-
ject to clause (iii),’’ after ‘‘clauses (i) and 
(ii) of paragraph (2)(A),’’; and 
VerDate Sep 11 2014 
00:22 Feb 13, 2018
Jkt 079200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H4987.IH
H4987
dlhill on DSK3GLQ082PROD with BILLS
(ii) by adding at the end the following 
new clause: 
‘‘(iii) TRANSITION YEARS.—For each 
of the second, third, fourth, and fifth years 
for which the MIPS applies to payments, 
the performance score for the performance 
category described in paragraph (2)(A)(ii) 
shall not take into account the improve-
ment of the professional involved.’’; 
(C) in paragraph (5)(E)— 
(i) in clause (i)(I)(bb)— 
(I) in the heading by striking 
‘‘FIRST
YEARS’’ 
and 
inserting 
‘‘FIRST 5 YEARS’’; and 
(II) by striking ‘‘the first and 
second years’’ and inserting ‘‘each of 
the first through fifth years’’; and 
(ii) in clause (i)(II)(bb)— 
(I) in the heading, by striking ‘‘2 
YEARS’’ and inserting ‘‘5 YEARS’’; and 
(II) by striking the second sen-
tence and inserting the following new 
sentences: ‘‘For each of the second, 
third, fourth, and fifth years for 
which the MIPS applies to payments, 
VerDate Sep 11 2014 
00:22 Feb 13, 2018
Jkt 079200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H4987.IH
H4987
dlhill on DSK3GLQ082PROD with BILLS
not less than 10 percent and not more 
than 30 percent of such score shall be 
based on performance with respect to 
the category described in clause (ii) of 
paragraph (2)(A). Nothing in the pre-
vious sentence shall be construed, with 
respect to a performance period for a 
year described in the previous sen-
tence, as preventing the Secretary 
from basing 30 percent of such score 
for such year with respect to the cat-
egory described in such clause (ii), if 
the Secretary determines, based on in-
formation posted under subsection 
(r)(2)(I) that sufficient resource use 
measures are ready for adoption for 
use under the performance category 
under paragraph (2)(A)(ii) for such 
performance period.’’; 
(D) in paragraph (6)(D)— 
(i) in clause (i), in the second sen-
tence, by striking ‘‘Such performance 
threshold’’ and inserting ‘‘Subject to 
clauses (iii) and (iv), such performance 
threshold’’; 
VerDate Sep 11 2014 
00:22 Feb 13, 2018
Jkt 079200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H4987.IH
H4987
dlhill on DSK3GLQ082PROD with BILLS
(ii) in clause (ii)— 
(I) in the first sentence, by in-
serting ‘‘(beginning with 2019 and 
ending with 2024)’’ after ‘‘for each 
year of the MIPS’’; and 
(II) in the second sentence, by 
inserting ‘‘subject to clause (iii),’’ 
after ‘‘For each such year,’’; 
(iii) in clause (iii)— 
(I) in the heading, by striking 
‘‘2’’ and inserting ‘‘5’’; and 
(II) in the first sentence, by 
striking ‘‘two years’’ and inserting 
‘‘five years’’; and 
(iv) by adding at the end the following 
new clause: 
‘‘(iv) ADDITIONAL SPECIAL RULE FOR 
THIRD, FOURTH
AND
FIFTH
YEARS
OF 
MIPS.—For purposes of determining MIPS 
adjustment factors under subparagraph 
(A), in addition to the requirements speci-
fied in clause (iii), the Secretary shall in-
crease the performance threshold with re-
spect to each of the third, fourth, and fifth 
years to which the MIPS applies to ensure 
VerDate Sep 11 2014 
00:22 Feb 13, 2018
Jkt 079200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H4987.IH
H4987
dlhill on DSK3GLQ082PROD with BILLS
a gradual and incremental transition to the 
performance threshold described in clause 
(i) (as estimated by the Secretary) with re-
spect to the sixth year to which the MIPS 
applies.’’; 
(E) in paragraph (6)(E)— 
(i) by striking ‘‘In the case of items 
and services’’ and inserting ‘‘In the case of 
covered professional services (as defined in 
subsection (k)(3)(A))’’; and 
(ii) by striking ‘‘under this part with 
respect to such items and services’’ and in-
serting ‘‘under this part with respect to 
such covered professional services’’; and 
(F) in paragraph (7), in the first sentence, 
by striking ‘‘items and services’’ and inserting 
‘‘covered professional services (as defined in 
subsection (k)(3)(A))’’; 
(2) in subsection (r)(2), by adding at the end 
the following new subparagraph: 
‘‘(I) INFORMATION.—The Secretary shall, 
not later than December 31st of each year (be-
ginning with 2018), post on the Internet 
website of the Centers for Medicare & Medicaid 
Services information on resource use measures 
VerDate Sep 11 2014 
00:22 Feb 13, 2018
Jkt 079200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H4987.IH
H4987
dlhill on DSK3GLQ082PROD with BILLS
in use under subsection (q), resource use meas-
ures under development and the time-frame for 
such development, potential future resource use 
measure topics, a description of stakeholder en-
gagement, and the percent of expenditures 
under part A and this part that are covered by 
resource use measures.’’; and 
(3) in subsection (s)(5)(B), by striking ‘‘section 
1833(z)(2)(C)’’ 
and 
inserting 
‘‘section 
1833(z)(3)(D)’’. 
(b) PHYSICIAN-FOCUSED PAYMENT MODEL TECH-
NICAL ADVISORY COMMITTEE PROVISION
OF INITIAL 
PROPOSAL FEEDBACK.—Section 1868(c)(2)(C) of the So-
cial Security Act (42 U.S.C. 1395ee(c)(2)(C)) is amended 
to read as follows: 
‘‘(C) COMMITTEE
REVIEW
OF
MODELS 
SUBMITTED.—The Committee, on a periodic 
basis— 
‘‘(i) shall review models submitted 
under subparagraph (B); 
‘‘(ii) may provide individuals and 
stakeholder entities who submitted such 
models with— 
‘‘(I) initial feedback on such 
models regarding the extent to which 
VerDate Sep 11 2014 
00:22 Feb 13, 2018
Jkt 079200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H4987.IH
H4987
dlhill on DSK3GLQ082PROD with BILLS