(c) PERFORMANCE MEASUREMENTS.—Not later than 
1 year after the date specified in subsection (a), and not 
less frequently than annually thereafter, the Secretary, 
from data in the database established under this section, 
shall prepare practitioner performance measurements. 
Such measurements shall—
(1) be based on performance measures endorsed 
by the National Quality Forum; 
(2) measure—
(A) the performance of individual physi-
cians, physician groups (if any), and hospitals; 
or 
(B) if records are not available for meas-
uring such performance, the performance of the 
smallest practitioner unit for which records are 
available; and 
(3) be presented in such manner as the Sec-
retary determines will accurately and clearly rep-
resent the comparative performance quality and effi-
ciency of physicians, physician groups, and hospitals. 
(d) PRIVACY PROTECTIONS.—The Secretary shall en-
sure that—
(1) any patient identifier is encrypted or omit-
ted in a consistent fashion;
(2) the data omits the name, date of birth, 
street address and the last two applicable postal 
codes of each patient; and 
(3) the amount of the charge for services fur-
nished is omitted. 
(e) REQUIREMENT FOR SUBMISSION OF DATA BY 
ALL GROUP HEALTH PLANS.—Not later than four years 
after the date referred to in subsection (a), each group 
health plan shall contribute de-indentified claims data nec-
essary for performance measurement to the practitioner 
performance database established under subsection (a). As 
soon as practicable, the Secretary shall make available an-
nual performance measures to the public. 
(f) TERMINATION.—Beginning on the date that is 10 
years after the date referred to in subsection (a), the Sec-
retary shall discontinue the collection of data under this 
section. 
SEC. 304. CLINICAL-BASED PRACTITIONER PERFORMANCE 
DATABASE. 
(a) ESTABLISHMENT.—Not later than 18 months 
after the date of the enactment of this Act, the Secretary 
shall establish a practitioner performance database that 
comprises data from any health care practitioner that vol-
untarily submits de-indentified health care data to the 
Secretary for such purpose.
(b) PRIVACY PROTECTIONS.—The Secretary shall re-
quire health care practitioners to encrypt or omit all indi-
vidually identifiable patient information from data sub-
mitted to the Secretary under this section, including by 
ensuring that—
(1) any patient identifier is encrypted or omit-
ted in a consistent fashion; 
(2) the data omits the name, date of birth, 
street address, and the last 2 applicable postal codes 
of each patient; and 
(3) the amount of the charge for services fur-
nished is omitted. 
(c) PERFORMANCE MEASUREMENTS.—Not later than 
1 year after the date specified in subsection (a), and not 
less frequently than annually thereafter, the Secretary, 
from data in the database established under this section, 
shall prepare practitioner performance measurements. 
Such measurements shall—
(1) be based on performance measures endorsed 
by the National Quality Forum; 
(2) measure—
(A) the performance of individual physi-
cians, physician groups (if any), and hospitals; 
or
(B) if records are not available for meas-
uring such performance, the performance of the 
smallest practitioner unit for which records are 
available; and 
(3) be presented in such manner as the Sec-
retary determines will accurately and clearly rep-
resent the comparative performance quality and effi-
ciency of physicians, physician groups, and hospitals. 
(d) CERTAIN PRACTITIONERS.—As a condition on 
any grant or subgrant awarded to a health information 
infrastructure organization under section 102, the Sec-
retary shall require the organization to agree that the or-
ganization will not allow any health care practitioner to 
participate in a health information exchange established 
or implemented with the grant unless the practitioner sub-
mits claims data to the Secretary in accordance with this 
section. 
SEC. 305. AVAILABILITY OF PERFORMANCE MEASURE-
MENTS AND DATA. 
(a) PERFORMANCE MEASURES.—The Secretary shall 
make publicly available the practitioner performance 
measurements prepared under sections 303 and 304. 
(b) DATA.—The Secretary shall restrict access to the 
data in the databases under sections 303 and 304 to indi-
viduals requesting such information in connection with re-
search conducted or supported by the Agency for 
Healthcare Research and Quality. 
SEC. 306. USE OF HEALTH CARE PROVIDER PERFORM-
ANCES MEASURE FOR PAY FOR PERFORM-
ANCE. 
(a) IN GENERAL.—The Secretary may provide for 
adjustments to payment systems under title XVIII of the 
Social Security Act based on performance measurements 
of physicians, physician groups, and institutional providers 
of services. Insofar as the Secretary exercises the author-
ity under the preceding sentence, in the case of providers 
with both claims-based and clinical-based measurements, 
the Secretary shall use the clinical-based measurements 
for any pay-for-performance unless the provider elects to 
use claims-based measurements. In no case may an elec-
tion under the preceding sentence be in effect after the 
date that is 6 years after the date of the enactment of 
this Act. 
(b) MEDPAC RECOMMENDATIONS.—The Medicare 
Payment Advisory Commission shall include in the March 
2007 report to Congress, and annually thereafter, specific 
recommendations for the amount of adjustments to pay-
ment systems and beneficiary cost-sharing under title 
XVIII of the Social Security Act based on performance 
measurements in order to share savings under such title