scribed in such paragraph that had such quality 
measures to report for such year. 
(C) The rate of participation in such qual-
ity reporting system of eligible professionals de-
scribed in subparagraph (B) in each such cat-
egory. 
(D) The average administrative costs of 
medical practices of such eligible professionals 
for reporting such quality measures, as it re-
lates to the size of such practices. 
(2) REPORT.—Not later than June 1, 2008, the 
Secretary of Health and Human Services shall sub-
mit to Congress a report containing the findings of 
the evaluation under paragraph (1). 
(b) TRANSITIONAL QUALITY REPORTING AFTER DE-
CEMBER 31, 2007, AND BEFORE IMPLEMENTATION OF 
NEW VOLUNTARY MEDICARE QUALITY REPORTING PRO-
GRAM.— 
(1) IN
GENERAL.—Section 1848(k)(2)(B) of 
the Social Security Act (42 U.S.C. 1395w– 
4(k)(3)(B)) is amended to read as follows: 
‘‘(B) FOR 2008 AND 2009.—Eligible profes-
sionals may continue to report to the Secretary 
quality measures specified under subparagraph 
(A) after December 31, 2007, and before De-
VerDate Aug 31 2005 
01:44 Jun 19, 2007
Jkt 059200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H2749.IH
H2749
mstockstill on PROD1PC66 with BILLS
cember 31, 2009, in order for the Secretary to 
refine systems for reporting quality measures.’’. 
(2) PROHIBITING USE OF PHYSICIAN ASSIST-
ANCE AND QUALITY INITIATIVE FUND FOR QUALITY 
REPORTING
BONUS
PAYMENTS
IN
2008.—Section 
1848(l)(2)(B) of the Social Security Act (42 U.S.C. 
1395w–4(l)(2)(B)), as added by section 101(d) of di-
vision B of the Tax Relief and Health Care Act of 
2006 (Public Law 109–432), is amended by adding 
at the end the following new sentence: ‘‘The Sec-
retary shall not expend from the Fund any amounts 
for bonus incentive payments for quality reporting of 
data on quality measures with respect to services 
furnished during 2008.’’. 
SEC. 4. THE VOLUNTARY MEDICARE QUALITY REPORTING 
PROGRAM. 
(a) IN GENERAL.—Section 1848(k)(2) of the Social 
Security Act (42 U.S.C. 1395w–4(k)(2)) as added by sec-
tion 101(b) of Division B of the Tax Relief and Health 
Care Act of 2006 (Public Law 109–432; 120 Stat. 2975), 
is amended by adding at the end the following new sub-
paragraph: 
‘‘(C) FOR 2010 AND SUCCEEDING YEARS.— 
‘‘(i) IN
GENERAL.—For purposes of 
reporting data on quality measures for cov-
VerDate Aug 31 2005 
01:44 Jun 19, 2007
Jkt 059200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H2749.IH
H2749
mstockstill on PROD1PC66 with BILLS
ered professional services furnished during 
2010 and during succeeding years, the 
quality measures specified under this para-
graph for covered professional services are 
quality measures the Secretary has se-
lected in accordance with this subpara-
graph as part of the rulemaking process 
for payments under this section for 2010 
and succeeding years, respectively. 
‘‘(ii) CHARACTERISTICS
OF
MEAS-
URES.—The 
quality 
measures 
selected 
under clause (i) shall— 
‘‘(I) include a mixture of struc-
tural measures, process measures, and 
outcomes measures (as such terms are 
defined in clause (v)); 
‘‘(II) be evidence-based and clini-
cally valid; 
‘‘(III) be relevant to physicians, 
other eligible professionals, and indi-
viduals entitled to benefits under part 
A or enrolled under this part; and 
‘‘(IV) include measures that cap-
ture patients’ assessments of clinical 
care provided. 
VerDate Aug 31 2005 
01:44 Jun 19, 2007
Jkt 059200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H2749.IH
H2749
mstockstill on PROD1PC66 with BILLS
‘‘(iii) FAIRNESS.—The selection of 
quality measures under this subparagraph 
shall be conducted (and such quality meas-
ures shall be applied) in a manner that— 
‘‘(I) takes into account dif-
ferences in individual health status; 
‘‘(II) takes into account an indi-
vidual’s compliance with health care 
orders; 
‘‘(III) does not directly or indi-
rectly encourage patient selection or 
deselection; 
‘‘(IV) does not penalize eligible 
professionals who furnish services to 
individuals entitled to benefits under 
part A or enrolled under this part who 
are frail, low-income, of racial or eth-
nic minority groups, or of limited 
English language proficiency; 
‘‘(V) reduces health disparities 
across groups and areas; 
‘‘(VI) uses appropriate statistical 
techniques to ensure valid results; and 
‘‘(VII) assures that the Secretary 
is able to process data for the quality 
VerDate Aug 31 2005 
01:44 Jun 19, 2007
Jkt 059200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6201
E:\BILLS\H2749.IH
H2749
mstockstill on PROD1PC66 with BILLS
measures as written by the individual 
or organization that developed the 
measure. 
‘‘(iv) SELECTION PROCESS FOR MEAS-
URES
TO
BE
REPORTED.—The measures 
selected under clause (i) for 2010 (and 
each succeeding year) shall be measures 
that have been published by the Secretary 
in the Federal Register not later than No-
vember 1 before the year as endorsed qual-
ity measures that are applicable to covered 
professional services during the year. For 
purposes of this subparagraph, the Sec-
retary may publish quality measures for 
2010 (or a succeeding year) in the Federal 
Register only if such measures are selected 
and endorsed as follows: 
‘‘(I) 
RECOMMENDATIONS
FOR 
CLINICAL AREAS.—Not later than Oc-
tober 1, 2008 (and each succeeding 
October 1), the Secretary shall re-
quest, through notice in the Federal 
Register (without comment period), 
each physician specialty organization, 
each other eligible professional organi-
VerDate Aug 31 2005 
01:44 Jun 19, 2007
Jkt 059200
PO 00000
Frm 00010
Fmt 6652
Sfmt 6201
E:\BILLS\H2749.IH
H2749
mstockstill on PROD1PC66 with BILLS
zation, and each quality improvement 
organization to submit to the Physi-
cian Consortium for Performance Im-
provement of the American Medical 
Association (referred to in this sub-
paragraph as the ‘Consortium’) by not 
later than December 31, 2008 (and 
each succeeding December 31), rec-
ommendations of clinical areas for the 
development of quality measures for 
purposes of this subparagraph. Not 
later than December 31, 2008 (and 
each succeeding December 31), the 
Secretary shall also submit to the 
Consortium recommendations of clin-
ical areas for the development of such 
quality measures. 
‘‘(II) SELECTION
OF
CLINICAL 
AREAS.—Not later than March 31, 
2009 (and each subsequent March 
31), the Consortium is requested to 
submit to the Secretary the rec-
ommendations described in subclause 
(I). 
VerDate Aug 31 2005 
01:44 Jun 19, 2007
Jkt 059200
PO 00000
Frm 00011
Fmt 6652
Sfmt 6201
E:\BILLS\H2749.IH
H2749
mstockstill on PROD1PC66 with BILLS
‘‘(III) DEVELOPMENT
OF
PRO-
POSED
QUALITY
MEASURES.—Not 
later than June 1 of each year (begin-
ning with 2009), the Consortium, in 
collaboration with physician specialty 
organizations and other eligible pro-
fessional organizations, is requested to 
develop proposed quality measures for 
each clinical area identified under 
subclause (I). Such measures shall 
meet the requirements of clauses (ii) 
and (iii). 
‘‘(IV) ENDORSEMENT OF QUAL-
ITY MEASURES.—Not later than June 
15 of each year (beginning with 
2009), the Consortium is requested to 
submit the proposed quality measures 
developed under subclause (III) to a 
consensus organization for endorse-
ment. Not later than September 30 of 
each year (beginning with 2009), the 
consensus organization is requested to 
submit to the Secretary the quality 
measures that have been endorsed by 
the consensus organization. 
VerDate Aug 31 2005 
01:44 Jun 19, 2007
Jkt 059200
PO 00000
Frm 00012
Fmt 6652
Sfmt 6201
E:\BILLS\H2749.IH
H2749
mstockstill on PROD1PC66 with BILLS
‘‘(v) DEFINITIONS
FOR
TYPES
OF 
MEASURES.—In this subparagraph: 
‘‘(I) STRUCTURAL
MEASURE.— 
The term ‘structural measure’ means 
a measure that reflects the organiza-
tional, technological, and human re-
sources infrastructure of a system 
necessary for the delivery of quality 
health care (such as the use of health 
information technology for submission 
of measures). 
‘‘(II) PROCESS
MEASURE.—The 
term ‘process measure’ means a meas-
ure associated with the practice of 
health care or the furnishing of a 
service that is known to be effective. 
‘‘(III) OUTCOME MEASURE.—The 
term ‘outcome measure’ means a 
measure that provides information on 
how health care affects patients. 
‘‘(vi) CONSENSUS ORGANIZATION DE-
FINED.—In this subparagraph, the term 
‘consensus organization’ means an organi-
zation, such as the National Quality 
Forum, that the Secretary identifies as— 
VerDate Aug 31 2005 
01:44 Jun 19, 2007
Jkt 059200
PO 00000
Frm 00013
Fmt 6652
Sfmt 6201
E:\BILLS\H2749.IH
H2749
mstockstill on PROD1PC66 with BILLS
‘‘(I) having experience in using a 
process for reaching a group con-
sensus with respect to quality meas-
ures relating to the performance of 
those providing health care services; 
and 
‘‘(II) including in such process 
practicing 
physicians, 
practitioners 
with experience in the care of the frail 
elderly and individuals with multiple 
complex chronic conditions, organiza-
tions and individuals representative of 
the specialty involved, individuals enti-
tled to benefits under part A or en-
rolled under this part, experts in 
health care quality, individuals with 
experience in the delivery of health 
care in urban, rural, and frontier 
areas and to underserved populations, 
and representatives of the Secretary.’’. 
(b) USE OF REGISTRY-BASED REPORTING.—Section 
1848(k) of the Social Security Act (42 U.S.C. 1395w– 
4(k)) as added by section 101(b) of Division B of the Tax 
Relief and Health Care Act of 2006 (Public Law 109– 
432; 120 Stat. 2975) is amended to read as follows: 
VerDate Aug 31 2005 
01:44 Jun 19, 2007
Jkt 059200
PO 00000
Frm 00014
Fmt 6652
Sfmt 6201
E:\BILLS\H2749.IH
H2749
mstockstill on PROD1PC66 with BILLS
‘‘(4) USE OF REGISTRY-BASED REPORTING.— 
As part of the process for reporting quality meas-
ures under subparagraphs (B) and (C) of paragraph 
(2), the Secretary shall address a mechanism where-
by an eligible professional may provide data on qual-
ity measures through an appropriate medical reg-
istry, as identified by the Secretary. The Secretary 
shall require that any such mechanism be for pur-
poses of reporting data only to the Secretary. The 
Secretary shall treat such data as confidential and 
shall not make such data available to any other 
party or person. Any data obtained by the Secretary 
under this paragraph shall not be subject to dis-
covery or admitted into evidence in any Federal or 
State civil judicial or administrative proceeding.’’. 
Æ 
VerDate Aug 31 2005 
01:44 Jun 19, 2007
Jkt 059200
PO 00000
Frm 00015
Fmt 6652
Sfmt 6301
E:\BILLS\H2749.IH
H2749
mstockstill on PROD1PC66 with BILLS