Social Security Act (42 U.S.C. 1395c et seq.) and who 
are inpatients of the hospitals. 
(b) CONSIDERATION.—The Secretary shall consider 
innovative methods of measuring and rewarding quality 
inpatient hospital services furnished by small hospitals, in-
cluding critical access hospitals, which may be difficult to 
quantify due to the low volume of services provided by 
such hospitals for which quality measures have been devel-
oped. 
(c) REPORT
TO CONGRESS.—Not later than two 
years after the date of enactment of this Act, the Sec-
retary shall submit to Congress a report on the consulta-
tion required under this section. The report shall include 
recommendations of the Secretary with respect to the ap-
propriate application of performance-based payment and 
payment incentive programs to small hospitals, including 
critical access hospitals, for the provision of quality inpa-
tient hospital services. 
SEC. 4. PRIORITY OF ASSISTANCE FROM QUALITY IM-
PROVEMENT ORGANIZATIONS AND OTHER 
QUALITY ORGANIZATIONS FOR HOSPITALS 
WITH 
RESULTS 
BELOW 
PERFORMANCE- 
BASED PAYMENT BENCHMARKS. 
(a) PRIORITY OF ASSISTANCE TO LOW-PERFORMING 
HOSPITALS.—Section 1154(a) of the Social Security Act 
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(42 U.S.C. 1320c–3(a)) is amended by adding at the end 
the following new paragraph: 
‘‘(18)(A) The organization shall give priority in 
the provision of quality improvement assistance to 
subsection (d) hospitals that fail to meet quality 
benchmarks established under section 1886A(f). 
‘‘(B) In this paragraph, the term ‘quality im-
provement assistance’ includes the following: 
‘‘(i) Education on quality improvement ini-
tiatives, strategies, and techniques. 
‘‘(ii) Instruction on how to collect, submit, 
aggregate, and interpret data on measures used 
for quality improvement, public reporting, and 
payment under section 1886A. 
‘‘(iii) Technical assistance to support qual-
ity improvement. 
‘‘(iv) Technical assistance and instruction 
in the conduct of root-cause analyses. 
‘‘(v) Facilitating adoption of procedures 
that encourage timely candid feedback from pa-
tients and their families concerning perceived 
problems. 
‘‘(vi) Guidance on redesigning clinical proc-
esses, including the adoption and effective use 
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of health information technology, to improve the 
coordination, effectiveness, and safety of care.’’. 
(b) EVALUATION OF QUALITY IMPROVEMENT ORGA-
NIZATIONS.—Section 1153(c)(2) of such Act (42 U.S.C. 
1320c–2(c)(2)) is amended by inserting before the semi-
colon at the end the following: ‘‘, including the effective-
ness of the organization in improving the ability of a hos-
pital referred to in section 1154(a)(18)(A) to meet quality 
benchmarks established under section 1886A(f)’’. 
(c) ASSISTANCE FROM ALTERNATIVE QUALITY OR-
GANIZATIONS.—Section 1886A of the Social Security Act, 
as inserted by section 2(a), is amended— 
(1) by redesignating subsection (j) as sub-
section (k); and 
(2) by inserting after subsection (i) the fol-
lowing new subsection (j): 
‘‘(j) ASSISTANCE FROM ALTERNATIVE QUALITY OR-
GANIZATIONS.— 
‘‘(1) PRIVATE QUALITY ORGANIZATIONS.—The 
Secretary shall establish a program under which a 
hospital seeking to improve the quality of the provi-
sion of inpatient hospital services based on the re-
sults of a performance evaluation under this section 
may apply to the Secretary to receive quality im-
provement assistance from a private quality organi-
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zation with expertise in supporting improvement in 
the quality of the provision of inpatient hospital 
services. 
‘‘(2) ACCREDITATION.—Before entering into ar-
rangements with a private quality organization for 
the provision of assistance under paragraph (1), the 
Secretary shall ensure that the organization has 
been accredited or certified by a recognized accredi-
tation or certification agency or body. 
‘‘(3) PAYMENT.—The rate of payment for qual-
ity assistance services provided by a private quality 
organization under paragraph (1) shall be negotiated 
by the Secretary. Payment shall be made by the Sec-
retary from funds made available under part B of 
title XI title for the payment of organizations with 
contracts with the Secretary under such part.’’. 
(d) NQF FUNDING AUTHORIZATION.—There are au-
thorized to be appropriated to the Secretary of Health and 
Human Services $10,000,000 for each of 5 fiscal years 
to enter into arrangements with the National Quality 
Forum for the development of quality measures that may 
be applied under section 1886A of the Social Security Act, 
as inserted by section 2(a). 
Æ 
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