are appropriate for the measurement of health 
outcomes and other indices of quality, including 
data necessary for the operation of the contin-
uous quality improvement initiative under this 
subsection. Such data shall be submitted in a 
form and manner, and at a time, specified by 
the Secretary for purposes of this subsection. 
‘‘(C) ATTESTATION REGARDING DATA.—In 
order for a facility, provider, or physician to be 
eligible for a quality incentive payment under 
this subsection for a year, the facility, provider, 
or physician must have provided the Secretary 
(under procedures established by the Secretary 
in consultation with the ESRD Advisory Com-
mittee) with an attestation that the data sub-
mitted under this subsection for the year are 
complete and accurate. 
‘‘(7) PAYMENT METHODS AND TIMING OF PAY-
MENT.— 
‘‘(A) IN
GENERAL.—Subject to subpara-
graph (B), the payment of quality incentive 
payments shall be based on such method as the 
Secretary, in consultation with the ESRD Advi-
sory Committee, determines appropriate. 
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‘‘(B) TIMING.—The Secretary shall ensure 
that quality incentive payments with respect to 
a year are made by no later than June 30 of 
the subsequent year. 
‘‘(8) FEEDBACK.—The Secretary shall provide 
quality incentive payments and feedback to facilities, 
providers, and physicians as frequently as possible 
and as close to the date on which such facilities, pro-
viders, and physicians submitted quality data. 
‘‘(9) TECHNICAL ASSISTANCE.—The Secretary 
shall identify or establish an appropriately skilled 
group or organization, such as the ESRD Networks, 
to provide technical assistance to consistently low- 
performing facilities, providers, or physicians that 
are in the bottom quintile. 
‘‘(10) STREAMLINE
REPORTING.—The Sec-
retary shall— 
‘‘(A) evaluate the current data systems 
used by facilities, providers, and physicians to 
submit data; and 
‘‘(B) eliminate redundant reporting by con-
solidating all current data reporting into a new 
web-based system in order to minimize redun-
dancy and reduce regulatory and administrative 
demands. 
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‘‘(11) PUBLIC REPORTING.— 
‘‘(A) AVAILABILITY TO THE PUBLIC.—The 
Secretary shall establish procedures for making 
weighted composite scores calculated under this 
subsection available to the public in a clear and 
understandable form, including through its 
website and the Medicare.gov comparison tool. 
Such procedures shall ensure that a facility, 
provider, or physician has the opportunity to re-
view the data that is to be made public with re-
spect to the facility, provider, or physician prior 
to such data being made public. 
‘‘(B) CERTIFICATES.—The Secretary shall 
provide certificates to facilities, providers, and 
physicians who provide services to individuals 
with end-stage renal disease under this title to 
display in patient areas. The certificate shall in-
dicate the weighted composite score obtained by 
the facility, provider, or physician under the 
quality initiative. 
‘‘(C) WEB-BASED
QUALITY
LIST.—The 
Secretary shall establish a web-based quality 
list for facilities, providers, and physicians who 
provide items and services to individuals with 
end-stage renal disease who are enrolled under 
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part B that indicates whether measures were 
met or not. 
‘‘(12) EVALUATIONS.— 
‘‘(A) EVALUATION BY THE SECRETARY.— 
‘‘(i) RECOGNIZING
PART
A
SAVINGS 
FROM
CONTINUOUS
QUALITY
IMPROVE-
MENT INITIATIVE.—Not later than Janu-
ary 1, 2010, the Secretary shall evaluate 
and make recommendations to Congress 
regarding the feasibility of continuing the 
quality initiative by funding an annual in-
crease to the composite rate by the ESRD 
market basket amount under subsection 
(b)(12)(G) through reduced expenditures 
under the Federal Hospital Insurance 
Trust Fund as a result of the quality ini-
tiative. 
‘‘(ii) RECOMMENDATIONS FOR AN AN-
NUAL
UPDATE
MECHANISM.—Not later 
than 12 months after the date of enact-
ment of this subsection, the Secretary, act-
ing through the Administrator of the Cen-
ters for Medicare & Medicaid Services, 
shall submit a report to Congress using the 
data collected as part of the quality initia-
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tive to make recommendations about estab-
lishing a permanent update mechanism for 
the composite rate under this section. 
‘‘(B) EVALUATION BY MEDPAC.— 
‘‘(i) STUDY.—The Medicare Payment 
Advisory Commission shall conduct a study 
on the advisability and feasibility of mak-
ing the quality initiative permanent. 
‘‘(ii) REPORT.—Not later than June 
1, 2009, the Commission shall submit a re-
port to Congress and the Secretary on the 
study conducted under clause (i) together 
with recommendations for such legislation 
and administrative actions as the Commis-
sion considers appropriate, including the 
need for establishing an annual update 
mechanism for the composite rate under 
this section. 
‘‘(C) EVALUATION BY THE INSTITUTE OF 
MEDICINE.— 
‘‘(i) IN GENERAL.—Not later than 2 
years after the date of enactment of this 
subsection, the Secretary shall enter into 
an arrangement under which the Institute 
of Medicine of the National Academy of 
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Sciences (in this section referred to as the 
‘Institute’) shall conduct an evaluation of 
the effectiveness of the quality initiative. 
‘‘(ii) SCOPE OF REVIEW.—The Insti-
tute shall consider a variety of perspec-
tives, including the perspectives of facili-
ties, providers, physicians, nurses, other 
health care professionals, and patients. 
‘‘(iii) REPORT.—Not later than 3 
years after the date of enactment of this 
subsection, the Institute shall submit to 
the Secretary and to Congress a report on 
the evaluation conducted under clause (i). 
Such report shall contain a detailed de-
scription of the findings of such evaluation 
and recommendations for implementing on 
an ongoing basis the quality initiative. 
‘‘(iv) AUTHORIZATION OF APPROPRIA-
TIONS.—There are authorized to be appro-
priated such sums as may be necessary for 
the purpose of conducting the evaluation 
and preparing the report required by this 
subparagraph.’’. 
SEC. 204. EXTENSION OF MEDICARE SECONDARY PAYER. 
(a) EXTENSION.— 
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(1) IN GENERAL.—Section 1862(b)(1)(C) of the 
Social Security Act (42 U.S.C. 1395y(b)(1)(C)) is 
amended— 
(A) in the last sentence, by inserting ‘‘, 
and before January 1, 2008’’ after ‘‘prior to 
such date)’’; and 
(B) by adding at the end the following new 
sentence: ‘‘Effective for items and services fur-
nished on or after January 1, 2008 (with re-
spect to periods beginning on or after the date 
that is 42 months prior to such date), clauses 
(i) and (ii) shall be applied by substituting ‘42- 
month’ for ‘12-month’ each place it appears in 
the first sentence.’’. 
(2) EFFECTIVE DATE.—The amendments made 
by this subsection shall take effect on the date of en-
actment of this Act. For purposes of determining an 
individual’s status under section 1862(b)(1)(C) of 
the Social Security Act (42 U.S.C. 1395y(b)(1)(C)), 
as amended by paragraph (1), an individual who is 
within the coordinating period as of the date of en-
actment of this Act shall have that period extended 
to the full 42 months described in the last sentence 
of such section, as added by the amendment made 
by paragraph (1)(B). 
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(b) OIG STUDY AND REPORT.— 
(1) STUDY.—The Inspector General of the De-
partment of Health and Human Services shall con-
duct a study on— 
(A) the enforcement of the provisions of 
section 1862(b)(1)(C)(ii) of the Social Security 
Act (42 U.S.C. 1395y(b)(1)(C)(ii)); and 
(B) how effective such provisions are at 
protecting individuals on dialysis from receiving 
differential treatment by health plans once the 
individual is diagnosed with end stage renal dis-
ease. 
(2) REPORT.—Not later than 1 year after the 
date of enactment of this Act, the Inspector General 
of the Department of Health and Human Services 
shall submit to Congress a report on the study con-
ducted under paragraph (1), together with such rec-
ommendations as the Inspector General determines 
appropriate. 
Æ 
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