‘‘(iii) payment to the contracting enti-
ty for carrying out its duties under this 
section; and 
‘‘(iv) for otherwise carrying out this 
subsection. 
‘‘(C) LIMITATION.—The amounts appro-
priated under subparagraph (A) are the only 
amounts authorized or appropriated to carry 
out the purposes described in subparagraph 
(B). 
‘‘(f) IMPLEMENTATION OF RECOMMENDED MODELS 
AS ELIGIBLE APMS.— 
‘‘(1) IN GENERAL.—Not later than the applica-
ble date under paragraph (2), the Secretary shall, 
implement an Alternative Payment Model rec-
ommended 
under 
subsection 
(d)(1)(A)(ii) 
or 
(e)(4)(E)(ii)(I) as an eligible APM only if— 
‘‘(A) the Secretary determines that such 
model is expected to— 
‘‘(i) reduce spending under this title 
without reducing the quality of care; or 
‘‘(ii) improve the quality of patient 
care without increasing spending; 
‘‘(B) the Chief Actuary of the Centers for 
Medicare & Medicaid Services certifies that 
VerDate Mar 15 2010 
21:23 Jul 29, 2013
Jkt 029200
PO 00000
Frm 00053
Fmt 6652
Sfmt 6201
E:\BILLS\H2810.IH
H2810
mstockstill on DSK4VPTVN1PROD with BILLS
such model would reduce (or would not result 
in any increase in) program spending under 
this title; and 
‘‘(C) the Secretary determines that such 
model would not deny or limit the coverage or 
provision of benefits under this title for applica-
ble individuals. 
Not later than 90 days after the date of issuance of 
a proposed rule, with respect to an Alternative Pay-
ment Model, the Medicare Payment Advisory Com-
mission shall submit comments to Congress and the 
Secretary evaluating the reports from the con-
tracting entity and independent evaluation entity on 
such model regarding the model’s impact on expend-
itures and quality of care under this title. 
‘‘(2) APPLICABLE
DATE.—For purposes of 
paragraph (1), the applicable date under this para-
graph— 
‘‘(A) for an Alternative Payment Model 
recommended under subsection (d)(1)(A)(ii) is 
90 days after the date of submission of such 
recommendation; and 
‘‘(B) for an Alternative Payment Model 
recommended under subsection (e)(4)(E)(ii)(I) 
VerDate Mar 15 2010 
21:23 Jul 29, 2013
Jkt 029200
PO 00000
Frm 00054
Fmt 6652
Sfmt 6201
E:\BILLS\H2810.IH
H2810
mstockstill on DSK4VPTVN1PROD with BILLS
is 90 days after the date of submission of such 
recommendation 
‘‘(3) JUSTIFICATION
FOR
DISAPPROVALS.—In 
the case that an Alternative Payment Model rec-
ommended 
under 
subsection 
(d)(1)(A)(ii) 
or 
(e)(4)(E)(ii)(I) is not implemented as an eligible 
APM under this subsection, the Secretary shall 
make publicly available the rational, in detail, for 
such decision. 
‘‘(g) PERIODIC REVIEW AND TERMINATION.— 
‘‘(1) PERIODIC REVIEW.—In the case of an Al-
ternative Payment Model that has been imple-
mented, the Secretary and the Chief Actuary of the 
Centers for Medicare & Medicaid Services shall re-
view such model every 3 years to determine (and 
certify, in the case of the Chief Actuary and spend-
ing under this title), for the previous 3 years, wheth-
er the model has— 
‘‘(A) reduced the quality of care, or 
‘‘(B) increased spending under this title, 
compared to the quality of care or spending that 
would have resulted if the model had not been imple-
mented. 
‘‘(2) TERMINATION.— 
VerDate Mar 15 2010 
21:23 Jul 29, 2013
Jkt 029200
PO 00000
Frm 00055
Fmt 6652
Sfmt 6201
E:\BILLS\H2810.IH
H2810
mstockstill on DSK4VPTVN1PROD with BILLS
‘‘(A) QUALITY OF CARE REDUCTION TER-
MINATION.—If based upon such review the Sec-
retary determines under paragraph (1)(A) that 
the model has reduced the quality of care, the 
Secretary may terminate such model. 
‘‘(B) 
SPENDING
INCREASE
TERMI-
NATION.—Unless such Chief Actuary certifies 
under paragraph (1)(B) that the expenditures 
under this title under the model do not exceed 
the expenditures that would otherwise have 
been made if the model had not been imple-
mented for the period involved, the Secretary 
shall terminate such model. 
‘‘(h) DISSEMINATION OF ELIGIBLE APMS.—Under 
this section there shall be established a process for speci-
fying, and making publicly available a list of, all eligible 
APMs, which shall include at least those implemented 
under subsection (f) and demonstrations carried out with 
respect to payments under section 1848 through authority 
in existence as of the day before the date of the enactment 
of this section. Under such process such list shall be peri-
odically updated and, beginning with January 1, 2015, 
and annually thereafter, such list shall be published in the 
Federal Register.’’. 
VerDate Mar 15 2010 
21:23 Jul 29, 2013
Jkt 029200
PO 00000
Frm 00056
Fmt 6652
Sfmt 6201
E:\BILLS\H2810.IH
H2810
mstockstill on DSK4VPTVN1PROD with BILLS
(2) 
CONFORMING
AMENDMENT.—Section 
1848(a)(1) of the Social Security Act (42 U.S.C. 
1395w–4(a)(1)) is amended by striking ‘‘shall in-
stead’’ and inserting ‘‘shall, subject to section 
1848A, instead’’. 
SEC. 3. EXPANDING AVAILABILITY OF MEDICARE DATA. 
(a) EXPANDING USES
OF MEDICARE DATA
BY 
QUALIFIED ENTITIES.— 
(1) IN
GENERAL.—To the extent consistent 
with applicable information, privacy, security, and 
disclosure laws, beginning with 2014, notwith-
standing the second sentence of paragraph (4)(D) of 
section 1874(e) of the Social Security Act (42 
U.S.C. 1395kk(e)), a qualified entity may use data 
received by such entity under such section, and in-
formation derived from the evaluation described in 
such paragraph (4)(D), for additional analyses (as 
determined appropriate by the Secretary of Health 
and Human Services) that such entity may provide 
or sell to providers of services and suppliers (includ-
ing for the purposes of assisting providers of services 
and suppliers to develop and participate in quality 
and patient care improvement activities, including 
developing new models of care). 
(2) DEFINITIONS.—In this section: 
VerDate Mar 15 2010 
21:23 Jul 29, 2013
Jkt 029200
PO 00000
Frm 00057
Fmt 6652
Sfmt 6201
E:\BILLS\H2810.IH
H2810
mstockstill on DSK4VPTVN1PROD with BILLS