H. R. 3590—388 
‘‘(l) DEFINITIONS.—In this section: 
‘‘(1) BOARD; CHAIRPERSON; MEMBER.—The terms ‘Board’, 
‘Chairperson’, and ‘Member’ mean the Independent Medicare 
Advisory Board established under subsection (a) and the Chair-
person and any Member thereof, respectively. 
‘‘(2) MEDICARE.—The term ‘Medicare’ means the program 
established under this title, including parts A, B, C, and D. 
‘‘(3) MEDICARE
BENEFICIARY.—The term ‘Medicare bene-
ficiary’ means an individual who is entitled to, or enrolled 
for, benefits under part A or enrolled for benefits under part 
B. 
‘‘(4) MEDICARE PROGRAM SPENDING.—The term ‘Medicare 
program spending’ means program spending under parts A, 
B, and D net of premiums. 
‘‘(m) FUNDING.— 
‘‘(1) IN GENERAL.—There are appropriated to the Board 
to carry out its duties and functions— 
‘‘(A) for fiscal year 2012, $15,000,000; and 
‘‘(B) for each subsequent fiscal year, the amount appro-
priated under this paragraph for the previous fiscal year 
increased by the annual percentage increase in the Con-
sumer Price Index for All Urban Consumers (all items; 
United States city average) as of June of the previous 
fiscal year. 
‘‘(2) FROM TRUST FUNDS.—Sixty percent of amounts appro-
priated under paragraph (1) shall be derived by transfer from 
the Federal Hospital Insurance Trust Fund under section 1817 
and 40 percent of amounts appropriated under such paragraph 
shall be derived by transfer from the Federal Supplementary 
Medical Insurance Trust Fund under section 1841.’’. 
(2) LOBBYING COOLING-OFF PERIOD FOR MEMBERS OF THE 
INDEPENDENT
MEDICARE
ADVISORY
BOARD.—Section 207(c) of 
title 18, United States Code, is amended by inserting at the 
end the following: 
‘‘(3) MEMBERS OF THE INDEPENDENT MEDICARE ADVISORY 
BOARD.— 
‘‘(A) IN
GENERAL.—Paragraph (1) shall apply to a 
member of the Independent Medicare Advisory Board under 
section 1899A. 
‘‘(B) AGENCIES AND CONGRESS.—For purposes of para-
graph (1), the agency in which the individual described 
in subparagraph (A) served shall be considered to be the 
Independent Medicare Advisory Board, the Department of 
Health and Human Services, and the relevant committees 
of jurisdiction of Congress, including the Committee on 
Ways and Means and the Committee on Energy and Com-
merce of the House of Representatives and the Committee 
on Finance of the Senate.’’. 
(b) GAO STUDY
AND
REPORT
ON
DETERMINATION
AND 
IMPLEMENTATION OF PAYMENT AND COVERAGE POLICIES UNDER THE 
MEDICARE PROGRAM.— 
(1) INITIAL STUDY AND REPORT.— 
(A) STUDY.—The Comptroller General of the United 
States (in this section referred to as the ‘‘Comptroller Gen-
eral’’) shall conduct a study on changes to payment policies, 
methodologies, and rates and coverage policies and meth-
odologies under the Medicare program under title XVIII
H. R. 3590—389 
of the Social Security Act as a result of the recommenda-
tions contained in the proposals made by the Independent 
Medicare Advisory Board under section 1899A of such Act 
(as added by subsection (a)), including an analysis of the 
effect of such recommendations on— 
(i) Medicare beneficiary access to providers and 
items and services; 
(ii) the affordability of Medicare premiums and 
cost-sharing (including deductibles, coinsurance, and 
copayments); 
(iii) the potential impact of changes on other 
government or private-sector purchasers and payers 
of care; and 
(iv) quality of patient care, including patient 
experience, outcomes, and other measures of care. 
(B) REPORT.—Not later than July 1, 2015, the Comp-
troller General shall submit to Congress a report containing 
the results of the study conducted under subparagraph 
(A), together with recommendations for such legislation 
and administrative action as the Comptroller General 
determines appropriate. 
(2) SUBSEQUENT STUDIES AND REPORTS.—The Comptroller 
General shall periodically conduct such additional studies and 
submit reports to Congress on changes to Medicare payments 
policies, methodologies, and rates and coverage policies and 
methodologies as the Comptroller General determines appro-
priate, in consultation with the Committee on Ways and Means 
and the Committee on Energy and Commerce of the House 
of Representatives and the Committee on Finance of the Senate. 
(c) CONFORMING AMENDMENTS.—Section 1805(b) of the Social 
Security Act (42 U.S.C. 1395b–6(b)) is amended— 
(1) by redesignating paragraphs (4) through (8) as para-
graphs (5) through (9), respectively; and 
(2) by inserting after paragraph (3) the following: 
‘‘(4) REVIEW AND COMMENT ON THE INDEPENDENT MEDICARE 
ADVISORY
BOARD
OR
SECRETARIAL
PROPOSAL.—If the Inde-
pendent Medicare Advisory Board (as established under sub-
section (a) of section 1899A) or the Secretary submits a proposal 
to the Commission under such section in a year, the Commis-
sion shall review the proposal and, not later than March 1 
of that year, submit to the Committee on Ways and Means 
and the Committee on Energy and Commerce of the House 
of Representatives and the Committee on Finance of the Senate 
written comments on such proposal. Such comments may 
include such recommendations as the Commission deems appro-
priate.’’. 
Subtitle F—Health Care Quality 
Improvements 
SEC. 3501. HEALTH CARE DELIVERY SYSTEM RESEARCH; QUALITY 
IMPROVEMENT TECHNICAL ASSISTANCE. 
Part D of title IX of the Public Health Service Act, as amended 
by section 3013, is further amended by adding at the end the 
following:
H. R. 3590—390 
‘‘Subpart II—Health Care Quality Improvement 
Programs 
‘‘SEC. 933. HEALTH CARE DELIVERY SYSTEM RESEARCH. 
‘‘(a) PURPOSE.—The purposes of this section are to— 
‘‘(1) enable the Director to identify, develop, evaluate, 
disseminate, and provide training in innovative methodologies 
and strategies for quality improvement practices in the delivery 
of health care services that represent best practices (referred 
to as ‘best practices’) in health care quality, safety, and value; 
and 
‘‘(2) ensure that the Director is accountable for imple-
menting a model to pursue such research in a collaborative 
manner with other related Federal agencies. 
‘‘(b) GENERAL FUNCTIONS
OF
THE CENTER.—The Center for 
Quality Improvement and Patient Safety of the Agency for 
Healthcare Research and Quality (referred to in this section as 
the ‘Center’), or any other relevant agency or department designated 
by the Director, shall— 
‘‘(1) carry out its functions using research from a variety 
of disciplines, which may include epidemiology, health services, 
sociology, psychology, human factors engineering, biostatistics, 
health economics, clinical research, and health informatics; 
‘‘(2) conduct or support activities consistent with the pur-
poses described in subsection (a), and for— 
‘‘(A) best practices for quality improvement practices 
in the delivery of health care services; and 
‘‘(B) that include changes in processes of care and 
the redesign of systems used by providers that will reliably 
result in intended health outcomes, improve patient safety, 
and reduce medical errors (such as skill development for 
health care providers in team-based health care delivery 
and rapid cycle process improvement) and facilitate adop-
tion of improved workflow; 
‘‘(3) identify health care providers, including health care 
systems, single institutions, and individual providers, that— 
‘‘(A) deliver consistently high-quality, efficient health 
care services (as determined by the Secretary); and 
‘‘(B) employ best practices that are adaptable and scal-
able to diverse health care settings or effective in improving 
care across diverse settings; 
‘‘(4) assess research, evidence, and knowledge about what 
strategies and methodologies are most effective in improving 
health care delivery; 
‘‘(5) find ways to translate such information rapidly and 
effectively into practice, and document the sustainability of 
those improvements; 
‘‘(6) create strategies for quality improvement through the 
development of tools, methodologies, and interventions that 
can successfully reduce variations in the delivery of health 
care; 
‘‘(7) identify, measure, and improve organizational, human, 
or other causative factors, including those related to the culture 
and system design of a health care organization, that contribute 
to the success and sustainability of specific quality improvement 
and patient safety strategies;
H. R. 3590—391 
‘‘(8) provide for the development of best practices in the 
delivery of health care services that— 
‘‘(A) have a high likelihood of success, based on struc-
tured review of empirical evidence; 
‘‘(B) are specified with sufficient detail of the individual 
processes, steps, training, skills, and knowledge required 
for implementation and incorporation into workflow of 
health care practitioners in a variety of settings; 
‘‘(C) are designed to be readily adapted by health care 
providers in a variety of settings; and 
‘‘(D) where applicable, assist health care providers in 
working with other health care providers across the con-
tinuum of care and in engaging patients and their families 
in improving the care and patient health outcomes; 
‘‘(9) provide for the funding of the activities of organizations 
with recognized expertise and excellence in improving the 
delivery of health care services, including children’s health 
care, by involving multiple disciplines, managers of health care 
entities, broad development and training, patients, caregivers 
and families, and frontline health care workers, including activi-
ties for the examination of strategies to share best quality 
improvement practices and to promote excellence in the delivery 
of health care services; and 
‘‘(10) build capacity at the State and community level to 
lead quality and safety efforts through education, training, 
and mentoring programs to carry out the activities under para-
graphs (1) through (9). 
‘‘(c) RESEARCH FUNCTIONS OF CENTER.— 
‘‘(1) IN
GENERAL.—The Center shall support, such as 
through a contract or other mechanism, research on health 
care delivery system improvement and the development of tools 
to facilitate adoption of best practices that improve the quality, 
safety, and efficiency of health care delivery services. Such 
support may include establishing a Quality Improvement Net-
work Research Program for the purpose of testing, scaling, 
and disseminating of interventions to improve quality and effi-
ciency in health care. Recipients of funding under the Program 
may include national, State, multi-State, or multi-site quality 
improvement networks. 
‘‘(2) RESEARCH
REQUIREMENTS.—The research conducted 
pursuant to paragraph (1) shall— 
‘‘(A) address the priorities identified by the Secretary 
in the national strategic plan established under section 
399HH; 
‘‘(B) identify areas in which evidence is insufficient 
to identify strategies and methodologies, taking into consid-
eration areas of insufficient evidence identified by the 
entity with a contract under section 1890(a) of the Social 
Security Act in the report required under section 399JJ; 
‘‘(C) address concerns identified by health care institu-
tions and providers and communicated through the Center 
pursuant to subsection (d); 
‘‘(D) reduce preventable morbidity, mortality, and asso-
ciated costs of morbidity and mortality by building capacity 
for patient safety research; 
‘‘(E) support the discovery of processes for the reliable, 
safe, efficient, and responsive delivery of health care, taking