I 
111TH CONGRESS 
1ST SESSION H. R. 2858 
To amend titles XI and XVIII of the Social Security Act to modernize 
the quality improvement organization (QIO) program. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 12, 2009 
Mr. KIND (for himself, Mr. BURGESS, and Ms. BALDWIN) introduced the fol-
lowing bill; which was referred to the Committee on Energy and Com-
merce, and in addition to the Committee on Ways and Means, for a pe-
riod to be subsequently determined by the Speaker, in each case for con-
sideration of such provisions as fall within the jurisdiction of the com-
mittee concerned 
A BILL 
To amend titles XI and XVIII of the Social Security Act 
to modernize the quality improvement organization (QIO) 
program. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Medicare Quality Improvement Organization Moderniza-
tion Act of 2009’’. 
(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
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Sec. 1. Short title; table of contents. 
Sec. 2. Quality improvement activities. 
Sec. 3. Improved program administration. 
Sec. 4. Use of evaluation and competition. 
Sec. 5. Quality improvement funding. 
Sec. 6. Qualifications for QIOs. 
Sec. 7. Coordination with Medicaid. 
Sec. 8. Conforming name to ‘‘quality improvement organizations’’. 
SEC. 2. QUALITY IMPROVEMENT ACTIVITIES. 
(a) INCLUSION OF QUALITY IMPROVEMENT FUNC-
TIONS.— 
(1) IN GENERAL.—Section 1154(a) of the So-
cial Security Act (42 U.S.C. 1320c–3(a)) is amended 
by adding at the end the following new paragraph: 
‘‘(18) The organization shall offer quality im-
provement assistance to providers, practitioners, 
Medicare Advantage organizations offering Medicare 
Advantage plans under part C of title XVIII, and 
prescription drug sponsors offering prescription drug 
plans under part D of such title, including the fol-
lowing: 
‘‘(A) Education on quality improvement 
initiatives, strategies, and techniques. 
‘‘(B) Instruction on how to collect, submit, 
aggregate, and interpret data on measures that 
may be used for quality improvement, public re-
porting, and payment. 
‘‘(C) Instruction on how to conduct root- 
cause analyses. 
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‘‘(D) Technical assistance for providers 
and practitioners in beneficiary education to fa-
cilitate patient self-management. 
‘‘(E) Facilitating cooperation among local 
stakeholders in quality improvement. 
‘‘(F) Facilitating adoption of procedures 
that encourage timely candid feedback from pa-
tients and their families concerning perceived 
problems. 
‘‘(G) Guidance on redesigning clinical proc-
esses, including the adoption and effective use 
of health information technology, to improve the 
coordination, effectiveness, efficiency, and safe-
ty of care. 
‘‘(H) Assistance in improving the quality 
of care delivered in rural and frontier areas and 
reducing health care disparities among racial 
and ethnic minorities, as well as gender dispari-
ties, including efforts to prevent or address any 
inconsistencies or delays in the rate of adoption 
of health information technology and in the ef-
fective use of such technology among such enti-
ties that treat racial and ethnic minorities or 
individuals dually eligible for benefits under this 
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title and title XVIII or that furnish such serv-
ices in rural areas. 
‘‘(I) Assistance in improving coordination 
of care as patients transition between providers 
and practitioners, including developing the ca-
pacity to securely exchange electronic health in-
formation and helping providers and practi-
tioners to effectively use secure electronic health 
information to improve quality. 
‘‘(J) Preparation of confidential reports 
comparing the performance of primary care 
physician practices using standardized perform-
ance measures and distribution of such reports 
to primary care practices, subject to the fol-
lowing requirements: 
‘‘(i) The organization shall consult 
with stakeholders in the State to select 
clinical topic areas to address in such re-
ports. 
‘‘(ii) Performance measures must 
have been endorsed by a consensus-based 
national entity. 
‘‘(iii) The report given to each pri-
mary care practice shall identify that prac-
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tice, but shall not identify the other prac-
tices in the comparison. 
‘‘(iv) The organization shall offer as-
sistance to primary care practices in im-
proving performance on the measures.’’. 
(2) 
PERMITTING
DISCLOSURE
OF 
DEIDENTIFIED INFORMATION.— 
(A) IN GENERAL.—Section 1160 of such 
Act (42 U.S.C. 1320c–9) is amended— 
(i) in subsection (a)(2), by inserting 
‘‘(including the case described in sub-
section (f))’’ after ‘‘in such cases’’; and 
(ii) by adding at the end the following 
new subsection: 
‘‘(f) An organization with a contract under this part 
may provide de-identified patient data to providers treat-
ing the same population of patients for the purpose of 
measuring and improving the safety, quality, and effec-
tiveness of transitions of such patients from one provider 
of services to another. Nothing in this subsection shall be 
construed to limit, alter, or affect the requirements im-
posed pursuant to the HIAA privacy regulations (as de-
fined in section 1180(b)(3)).’’. 
(B) PROMULGATION OF REGULATIONS.— 
Not later than 180 days after the date of the 
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