level, income, insurance status, and any other 
category specified by the Secretary. 
‘‘(e) PUBLIC DISCLOSURE.—Under the system, the 
Secretary shall establish procedures to require that infor-
mation with respect to the quality demonstrated by a spec-
ified health care provider of treatment furnished for breast 
cancer during a period (based on the performance meas-
ures data submitted pursuant to subsection (c)(1) by the 
provider for such period) is made available on the official 
public Internet site of the Department of Health and 
Human Services in a clear and understandable form. Such 
procedures shall ensure that a specified health care pro-
vider has the opportunity to review the information that 
is to be made public with respect to the provider at least 
30 days prior to such data being made public and shall 
provide for an appeals process in the case a provider 
claims such information to be incorrect or incomplete. 
‘‘(f) VALUE-BASED PURCHASING FOR PERIODS BE-
GINNING OCTOBER 1, 2017.— 
‘‘(1) IN GENERAL.—Under the system, for peri-
ods beginning on or after October 1, 2017, and end-
ing before October 1, 2020, the Secretary shall es-
tablish and implement, a value-based purchasing 
program, with respect to specified health care pro-
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viders that furnish treatment for breast cancer dur-
ing such a period, under which— 
‘‘(A) in the case of such a provider that 
does not submit data in accordance with the re-
porting process under subsection (d)(1) for 
such treatment furnished during such period, 
the Secretary shall reduce the amount that 
would otherwise be paid to such provider under 
this title for such treatment by an amount spec-
ified by the Secretary; and 
‘‘(B) in the case of such a provider that 
submits data in accordance with the reporting 
process under subsection (d)(1) for such treat-
ment furnished during such period— 
‘‘(i) subject to clause (ii), if the Sec-
retary determines such provider furnished 
low quality care (in accordance with a 
method specified by the Secretary) for 
such treatment, the Secretary shall reduce 
the amount that would otherwise be paid 
to such provider under this title for such 
treatment by an amount specified by the 
Secretary; 
‘‘(ii) if the Secretary determines such 
provider furnished low quality care (in ac-
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cordance with the method specified under 
clause (i)) for such treatment, but the 
quality of care has improved as compared 
to the quality of care the provider fur-
nished during the previous period, the Sec-
retary shall reduce the amount that would 
otherwise be paid to such provider under 
this title for such treatment in accordance 
with an incremental method established by 
the Secretary that ensures that the amount 
of such reduction— 
‘‘(I) is less than the amount 
specified by the Secretary under 
clause (i); and 
‘‘(II) is based on the extent of 
improvement in the quality of care; 
and 
‘‘(iii) if the Secretary determines such 
provider did not furnish low quality care 
(in accordance with the method specified 
under clause (i)) for such treatment, the 
Secretary shall provide to such provider 
the amount to be paid to such provider 
under this title for such treatment. 
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‘‘(2) RESULTS-BASED PAYMENTS.—The amount 
of a reduction under subparagraph (A) or (B)(i) of 
paragraph (1) shall be determined in accordance 
with a method established by the Secretary. 
‘‘(g) REPORTS.—Not later than October 1, 2015, and 
for each 6-month period thereafter (before fiscal year 
2021), the Secretary shall submit to Congress a report 
that evaluates the development and implementation of the 
system, including— 
‘‘(1) an evaluation of the number of specified 
health care providers that submit data pursuant to 
subsection (c)(1); 
‘‘(2) an analysis of the effect of such system on 
reducing disparities in the provision of breast cancer 
treatment to patients based on race, level of edu-
cation, income, and health insurance status of such 
patients; and 
‘‘(3) recommendations on whether (and to what 
extent) to extend the system under this section. 
‘‘(h) APPLICATION TO PART C.—The Secretary shall 
provide for a method to apply the provisions of this section 
to treatment furnished under a plan under part C.’’. 
Æ 
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