H. R. 3590—265 
‘‘(J) other areas determined appropriate by the Sec-
retary. 
‘‘(3) ELIGIBLE ENTITIES.—To be eligible for a grant or con-
tract under this subsection, an entity shall— 
‘‘(A) have demonstrated expertise and capacity in the 
development and evaluation of quality measures; 
‘‘(B) have adopted procedures to include in the quality 
measure development process— 
‘‘(i) the views of those providers or payers whose 
performance will be assessed by the measure; and 
‘‘(ii) the views of other parties who also will use 
the quality measures (such as patients, consumers, 
and health care purchasers); 
‘‘(C) collaborate with the entity with a contract under 
section 1890(a) of the Social Security Act and other stake-
holders, as practicable, and the Secretary so that quality 
measures developed by the eligible entity will meet the 
requirements to be considered for endorsement by the 
entity with a contract under such section 1890(a); 
‘‘(D) have transparent policies regarding governance 
and conflicts of interest; and 
‘‘(E) submit an application to the Secretary at such 
time and in such manner, as the Secretary may require. 
‘‘(4) USE OF FUNDS.—An entity that receives a grant, con-
tract, or agreement under this subsection shall use such award 
to develop quality measures that meet the following require-
ments: 
‘‘(A) Such measures support measures required to be 
reported under the Social Security Act, where applicable, 
and in support of gaps and existing quality measures that 
need improvement, as described in subsection (b)(1)(A). 
‘‘(B) Such measures support measures developed under 
section 1139A of the Social Security Act and the Medicaid 
Quality Measurement Program under section 1139B of such 
Act, where applicable. 
‘‘(C) To the extent practicable, data on such quality 
measures is able to be collected using health information 
technologies. 
‘‘(D) Each quality measure is free of charge to users 
of such measure. 
‘‘(E) Each quality measure is publicly available on an 
Internet website. 
‘‘(d) OTHER ACTIVITIES BY THE SECRETARY.—The Secretary may 
use amounts available under this section to update and test, where 
applicable, quality measures endorsed by the entity with a contract 
under section 1890(a) of the Social Security Act or adopted by 
the Secretary. 
‘‘(e) COORDINATION OF GRANTS.—The Secretary shall ensure 
that grants or contracts awarded under this section are coordinated 
with grants and contracts awarded under sections 1139A(5) and 
1139B(4)(A) of the Social Security Act.’’. 
(b) SOCIAL SECURITY ACT.—Section 1890A of the Social Security 
Act, as added by section 3014(b), is amended by adding at the 
end the following new subsection: 
‘‘(e) DEVELOPMENT OF QUALITY MEASURES.—The Administrator 
of the Center for Medicare & Medicaid Services shall through 
contracts develop quality measures (as determined appropriate by
H. R. 3590—266 
the Administrator) for use under this Act. In developing such meas-
ures, the Administrator shall consult with the Director of the 
Agency for Healthcare Research and Quality.’’. 
(c) FUNDING.—There are authorized to be appropriated to the 
Secretary of Health and Human Services to carry out this section, 
$75,000,000 for each of fiscal years 2010 through 2014. Of the 
amounts appropriated under the preceding sentence in a fiscal 
year, not less than 50 percent of such amounts shall be used 
pursuant to subsection (e) of section 1890A of the Social Security 
Act, as added by subsection (b), with respect to programs under 
such Act. Amounts appropriated under this subsection for a fiscal 
year shall remain available until expended. 
SEC. 3014. QUALITY MEASUREMENT. 
(a) NEW DUTIES FOR CONSENSUS-BASED ENTITY.— 
(1) MULTI-STAKEHOLDER GROUP INPUT.—Section 1890(b) of 
the Social Security Act (42 U.S.C. 1395aaa(b)), as amended 
by section 3003, is amended by adding at the end the following 
new paragraphs: 
‘‘(7) CONVENING MULTI-STAKEHOLDER GROUPS.— 
‘‘(A) IN
GENERAL.—The entity shall convene multi- 
stakeholder groups to provide input on— 
‘‘(i) the selection of quality measures described in 
subparagraph (B), from among— 
‘‘(I) such measures that have been endorsed 
by the entity; and 
‘‘(II) such measures that have not been consid-
ered for endorsement by such entity but are used 
or proposed to be used by the Secretary for the 
collection or reporting of quality measures; and 
‘‘(ii) national priorities (as identified under section 
399HH of the Public Health Service Act) for improve-
ment in population health and in the delivery of health 
care services for consideration under the national 
strategy established under section 399HH of the Public 
Health Service Act. 
‘‘(B) QUALITY MEASURES.— 
‘‘(i) IN GENERAL.—Subject to clause (ii), the quality 
measures described in this subparagraph are quality 
measures— 
‘‘(I) for use pursuant to sections 1814(i)(5)(D), 
1833(i)(7), 1833(t)(17), 1848(k)(2)(C), 1866(k)(3), 
1881(h)(2)(A)(iii), 1886(b)(3)(B)(viii), 1886(j)(7)(D), 
1886(m)(5)(D), 1886(o)(2), and 1895(b)(3)(B)(v); 
‘‘(II) for use in reporting performance informa-
tion to the public; and 
‘‘(III) for use in health care programs other 
than for use under this Act. 
‘‘(ii) EXCLUSION.—Data sets (such as the outcome 
and assessment information set for home health serv-
ices and the minimum data set for skilled nursing 
facility services) that are used for purposes of classifica-
tion systems used in establishing payment rates under 
this title shall not be quality measures described in 
this subparagraph. 
‘‘(C) REQUIREMENT FOR TRANSPARENCY IN PROCESS.—
H. R. 3590—267 
‘‘(i) IN GENERAL.—In convening multi-stakeholder 
groups under subparagraph (A) with respect to the 
selection of quality measures, the entity shall provide 
for an open and transparent process for the activities 
conducted pursuant to such convening. 
‘‘(ii) SELECTION OF ORGANIZATIONS PARTICIPATING 
IN
MULTI-STAKEHOLDER
GROUPS.—The 
process 
described in clause (i) shall ensure that the selection 
of representatives comprising such groups provides for 
public nominations for, and the opportunity for public 
comment on, such selection. 
‘‘(D) MULTI-STAKEHOLDER
GROUP
DEFINED.—In this 
paragraph, the term ‘multi-stakeholder group’ means, with 
respect to a quality measure, a voluntary collaborative 
of organizations representing a broad group of stakeholders 
interested in or affected by the use of such quality measure. 
‘‘(8) TRANSMISSION
OF
MULTI-STAKEHOLDER
INPUT.—Not 
later than February 1 of each year (beginning with 2012), 
the entity shall transmit to the Secretary the input of multi- 
stakeholder groups provided under paragraph (7).’’. 
(2) ANNUAL REPORT.—Section 1890(b)(5)(A) of the Social 
Security Act (42 U.S.C. 1395aaa(b)(5)(A)) is amended— 
(A) in clause (ii), by striking ‘‘and’’ at the end; 
(B) in clause (iii), by striking the period at the end 
and inserting a semicolon; and 
(C) by adding at the end the following new clauses: 
‘‘(iv) gaps in endorsed quality measures, which 
shall include measures that are within priority areas 
identified by the Secretary under the national strategy 
established under section 399HH of the Public Health 
Service Act, and where quality measures are unavail-
able or inadequate to identify or address such gaps; 
‘‘(v) areas in which evidence is insufficient to sup-
port endorsement of quality measures in priority areas 
identified by the Secretary under the national strategy 
established under section 399HH of the Public Health 
Service Act and where targeted research may address 
such gaps; and 
‘‘(vi) the matters described in clauses (i) and (ii) 
of paragraph (7)(A).’’. 
(b) MULTI-STAKEHOLDER GROUP INPUT INTO SELECTION
OF 
QUALITY MEASURES.—Title XVIII of the Social Security Act (42 
U.S.C. 1395 et seq.) is amended by inserting after section 1890 
the following: 
‘‘QUALITY MEASUREMENT 
‘‘SEC. 1890A. (a) MULTI-STAKEHOLDER
GROUP
INPUT
INTO 
SELECTION OF QUALITY MEASURES.—The Secretary shall establish 
a pre-rulemaking process under which the following steps occur 
with respect to the selection of quality measures described in section 
1890(b)(7)(B): 
‘‘(1) INPUT.—Pursuant to section 1890(b)(7), the entity with 
a contract under section 1890 shall convene multi-stakeholder 
groups to provide input to the Secretary on the selection of 
quality measures described in subparagraph (B) of such para-
graph.
H. R. 3590—268 
‘‘(2) PUBLIC AVAILABILITY OF MEASURES CONSIDERED FOR 
SELECTION.—Not later than December 1 of each year (beginning 
with 2011), the Secretary shall make available to the public 
a list of quality measures described in section 1890(b)(7)(B) 
that the Secretary is considering under this title. 
‘‘(3) TRANSMISSION OF MULTI-STAKEHOLDER INPUT.—Pursu-
ant to section 1890(b)(8), not later than February 1 of each 
year (beginning with 2012), the entity shall transmit to the 
Secretary the input of multi-stakeholder groups described in 
paragraph (1). 
‘‘(4) CONSIDERATION OF MULTI-STAKEHOLDER INPUT.—The 
Secretary shall take into consideration the input from multi- 
stakeholder groups described in paragraph (1) in selecting 
quality measures described in section 1890(b)(7)(B) that have 
been endorsed by the entity with a contract under section 
1890 and measures that have not been endorsed by such entity. 
‘‘(5) RATIONALE FOR USE OF QUALITY MEASURES.—The Sec-
retary shall publish in the Federal Register the rationale for 
the use of any quality measure described in section 
1890(b)(7)(B) that has not been endorsed by the entity with 
a contract under section 1890. 
‘‘(6) ASSESSMENT
OF
IMPACT.—Not later than March 1, 
2012, and at least once every three years thereafter, the Sec-
retary shall— 
‘‘(A) conduct an assessment of the quality impact of 
the use of endorsed measures described in section 
1890(b)(7)(B); and 
‘‘(B) make such assessment available to the public. 
‘‘(b) PROCESS FOR DISSEMINATION OF MEASURES USED BY THE 
SECRETARY.— 
‘‘(1) IN GENERAL.—The Secretary shall establish a process 
for disseminating quality measures used by the Secretary. Such 
process shall include the following: 
‘‘(A) The incorporation of such measures, where 
applicable, in workforce programs, training curricula, and 
any other means of dissemination determined appropriate 
by the Secretary. 
‘‘(B) The dissemination of such quality measures 
through the national strategy developed under section 
399HH of the Public Health Service Act. 
‘‘(2) EXISTING
METHODS.—To the extent practicable, the 
Secretary shall utilize and expand existing dissemination 
methods in disseminating quality measures under the process 
established under paragraph (1). 
‘‘(c) REVIEW OF QUALITY MEASURES USED BY THE SECRETARY.— 
‘‘(1) IN GENERAL.—The Secretary shall— 
‘‘(A) periodically (but in no case less often than once 
every 3 years) review quality measures described in section 
1890(b)(7)(B); and 
‘‘(B) with respect to each such measure, determine 
whether to— 
‘‘(i) maintain the use of such measure; or 
‘‘(ii) phase out such measure. 
‘‘(2) CONSIDERATIONS.—In conducting the review under 
paragraph (1), the Secretary shall take steps to— 
‘‘(A) seek to avoid duplication of measures used; and