being sufficiently standardized to be comparably 
measured. 
(3) Cooperation between Federal departments 
and agencies in the development and dissemination 
of evidence-based health care information to help 
guide practitioners’ actions in ways that will improve 
quality and potentially reduce costs. 
(4) Cooperation between Federal departments 
and agencies in the development and dissemination 
of user-friendly information for both consumer and 
business purchasers that facilitates meaningful com-
parisons of quality performances of health care 
plans, facilities and practitioners. 
(5) Consultation with multi-stakeholder groups, 
where appropriate, in order to develop interdepart-
mental and interagency models for quality improve-
ment. 
(6) Avoidance of inefficient duplication of ongo-
ing health care quality improvement efforts and re-
sources, where feasible and appropriate. 
(7) Coordination and implementation by Fed-
eral departments and agencies of a streamlined proc-
ess for quality reporting and compliance require-
ments to reduce administrative burdens on private 
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entities who administer, oversee, or participate in 
the Federal health programs. 
(e) WORKGROUPS.— 
(1) IN GENERAL.—Not later than 30 days after 
the establishment of the QuICC, the Director shall 
establish within the QuICC workgroups for each of 
the national health care priorities established under 
section 4(c)(1). 
(2) PURPOSE.—Each such workgroup shall 
focus on achieving the goals of the QuICC (described 
in subsection (d)) for one such priority and shall— 
(A) coordinate the implementation of such 
priority across all relevant Federal agencies and 
departments; and 
(B) identify opportunities to improve the 
process of implementing such health care pri-
ority. 
(3) MEMBERSHIP.— 
(A) LEADERSHIP.—Each workgroup shall 
be led by 2 relevant Federal departments or 
agencies, as determined by the Director. 
(B) REPRESENTATION.—Each of the Fed-
eral members listed in subsection (c)(2) may 
appoint 1 or more representatives to each 
workgroup. 
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(4) REPORTING.— 
(A) REPORT.—Not later than December 
31, 2010, and annually thereafter, the co-chair-
persons of the QuICC shall submit a report to 
the relevant committees of Congress describ-
ing— 
(i) the QuICC’s progress in meeting 
the goals described in subsection (d); 
(ii) recommendations for legislation to 
improve the processes of health care qual-
ity coordination and prioritization; and 
(iii) recommendations for new and in-
novative quality initiatives. 
(B) PUBLICATION.—Not later than De-
cember 31, 2010, and annually thereafter, the 
co-chairpersons shall publish the report de-
scribed in subparagraph (A) on the website of 
the Office of National Health Care Quality Im-
provement. 
(f) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
$5,000,000 for fiscal years 2011 through 2014. 
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SEC. 6. INCREASED AUTHORITY OF THE AGENCY FOR 
HEALTHCARE 
RESEARCH 
AND 
QUALITY 
WITHIN THE DEPARTMENT OF HEALTH AND 
HUMAN SERVICES. 
(a) DIRECTOR OF THE AGENCY FOR HEALTHCARE 
RESEARCH AND QUALITY.—Section 901(a) of the Public 
Health Service Act (42 U.S.C. 299(a)) is amended by 
striking ‘‘by the Secretary’’ and inserting ‘‘by the Presi-
dent, by and with the advice and consent of the Senate’’. 
(b) NATIONAL
HEALTH
CARE
QUALITY
PRIOR-
ITIES.—Title IX of the Public Health Service Act (42 
U.S.C. 299 et seq.) is amended by adding at the end the 
following: 
‘‘PART E—NATIONAL HEALTH CARE QUALITY 
PRIORITIES 
‘‘SEC. 940. DEFINITIONS. 
‘‘In this part: 
‘‘(1) HEALTH
CARE
QUALITY.—The term 
‘health care quality’ means the degree to which 
health services for individuals and populations in-
crease the likelihood of desired health outcomes and 
are consistent with current professional knowledge, 
based upon the following criteria: 
‘‘(A) EFFECTIVENESS.—Health care serv-
ices should be provided based upon scientific 
knowledge of all who could benefit. 
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‘‘(B) 
EFFICIENCY.—Waste, 
including 
waste of equipment, supplies, ideas, and ener-
gies, should be avoided. 
‘‘(C) EQUITY.—The provision of health 
care should not vary in quality because of per-
sonal characteristics of the individuals involved. 
‘‘(D) 
PATIENT-CENTEREDNESS.—Health 
care should be responsive to, and respectful of, 
individual patient preferences. 
‘‘(E) SAFETY.—Injuries to patients from 
the health care that is supposed to help them 
should be avoided. 
‘‘(F) TIMELINESS.—Waiting times and 
harmful delays in providing health care should 
be reduced. 
‘‘(2) HEALTH CARE QUALITY MEASURE.—The 
term ‘health care quality measure’ means a national 
consensus standard for measuring the performance 
and improvement of population health or of institu-
tional providers of services, physicians, and other cli-
nicians in the delivery of health care services, con-
sistent with the health care quality criteria described 
in paragraph (1). 
‘‘(3) MULTI-STAKEHOLDER GROUP.—The term 
‘multi-stakeholder group’ means, with respect to a 
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health care quality measure, a voluntary collabo-
rative of public and private organizations rep-
resenting persons interested in, or affected by, the 
use of such health care quality measure, including— 
‘‘(A) health care providers and practi-
tioners, including providers and practitioners 
primarily serving children and those with long- 
term health care needs; 
‘‘(B) health care quality entities; 
‘‘(C) health plans; 
‘‘(D) patient advocates and consumer 
groups; 
‘‘(E) employers; 
‘‘(F) public and private purchasers of 
health care items and services; 
‘‘(G) labor organizations; 
‘‘(H) relevant departments or agencies of 
the United States; 
‘‘(I) 
biopharmaceutical 
companies 
and 
manufacturers of medical devices; and 
‘‘(J) licensing, credentialing, and accred-
iting bodies. 
‘‘(4) the term ‘health care quality measure’ 
means a national consensus standard for measuring 
the performance and improvement of population 
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‘‘(K) biopharmaceutical companies and 
manufacturers of medical devices; and 
‘‘(L) licensing, credentialing, and accred-
iting bodies. 
‘‘SEC. 941. RESEARCH PRIORITIES. 
‘‘The Director, in consultation with the heads of 
agencies within the Department of Health and Human 
Services shall ensure that the health care quality improve-
ment priorities identified by the Director of the Office of 
National Health Care Quality Improvement, established 
under section 4 of the National Health Care Quality Act, 
are taken into consideration in all applicable research con-
ducted under the Department of Health and Human Serv-
ices, including the National Institutes of Health and the 
demonstration projects. 
‘‘SEC. 942. QUALITY MEASURES. 
‘‘(a) APPLICATION OF QUALITY MEASURES TO PRO-
GRAMS UNDER
THE DEPARTMENT
OF HEALTH
AND 
HUMAN SERVICES.— 
‘‘(1) IN GENERAL.—The Director, in consulta-
tion with the Administrator of the Centers for Medi-
care & Medicaid Services, the Director of the Cen-
ters for Disease Control and Prevention, the Direc-
tor of the National Institutes of Health, and a con-
sensus-based entity (as such term is used in section 
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1890 of the Social Security Act), shall define uni-
form health care quality measures, which shall apply 
to Federal health programs under the Department 
of Health and Human Services, including the fol-
lowing Federal programs, in order of priority: 
‘‘(A) The Medicare program under title 
XVIII of the Social Security Act, the rural 
health and pharmacy programs of the Health 
Resources and Services Administration, and the 
health programs of the Administration on 
Aging. 
‘‘(B) The Medicaid program under title 
XIX of the Social Security Act, the Children’s 
Health Insurance program under title XXI of 
such Act, the health programs of the Adminis-
tration for Children and Families, and the ma-
ternal and child health programs of the Health 
Resources and Services Administration. 
‘‘(C) The Indian Health Service. 
‘‘(D) The Substance Abuse and Mental 
Health Services Administration. 
‘‘(E) Programs of the Health Resources 
and Services Administration other than those 
described in subparagraph (B). 
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‘‘(F) Centers of the Food and Drug Ad-
ministration. 
‘‘(2) 
PRIORITIZATION.—The 
Director 
shall 
apply the health care quality measures under this 
section to the Federal programs in the order of pri-
ority described in paragraph (1). 
‘‘(3) CONSIDERATIONS
REGARDING
QUALITY 
MEASURE APPLICATION.—Before applying the health 
care quality measures described in paragraph (1), 
the Director shall consider— 
‘‘(A) the potential of such measures to im-
prove patient outcomes; 
‘‘(B) the ease of integration as a factor in 
health care provider reimbursement; 
‘‘(C) the applicability of such measures 
across health care settings; 
‘‘(D) the unique quality improvement 
needs of vulnerable populations, including chil-
dren, the elderly, individuals with disabilities, 
individuals near the end of life, and racial and 
ethnic minorities; 
‘‘(E) the burden of disease, including the 
prevalence, incidence, and cost of disease to the 
United States; and 
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‘‘(F) payment distortions that encourage 
certain practice norms which may not lead to 
greater patient health outcomes. 
‘‘(4) UPDATING OF THE APPLICATION OF QUAL-
ITY MEASURES.—The Director, in consultation with 
the Administrator of the Centers for Medicare & 
Medicaid Services, the Director of the Centers for 
Disease Control and Prevention, the Director of the 
National Institutes of Health, and a consensus-based 
entity (as such term is used in section 1890 of the 
Social Security Act), shall develop a process for up-
dating the health care quality measures defined 
under paragraph (1) as new research and evidence 
become available. 
‘‘(b) QUALITY MEASURE REPORTING TO FEDERAL 
HEALTH PROGRAMS.—The Director, in cooperation with 
the Administrator of the Centers for Medicare & Medicaid 
Services, the National Coordinator for Health Information 
Technology, the Administrator of the Health Resources 
and Services Administration, the Director of the Centers 
for Disease Control and Prevention, and the Commis-
sioner of Food and Drugs, shall create a streamlined proc-
ess for health care providers to report quality measures 
to the heads of relevant agencies and departments for the 
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purpose of quality improvement in the Federal health pro-
grams described in subsection (a)(1). 
‘‘(c) DEVELOPMENT OF ADDITIONAL QUALITY IM-
PROVEMENT STRATEGIES.—The Director, in consultation 
with the Administrator of the Centers for Medicare & 
Medicaid Services, the Director of the Centers for Disease 
Control and Prevention, the Director of the National Insti-
tutes of Health, and multi-stakeholder groups, shall de-
velop quality improvement strategies to address activities 
other than health care quality measurement that lead to 
improved patient outcomes, such as alternative care mod-
els, licensing, professional certification, medical education, 
alternative staffing models, and public reporting. 
‘‘SEC. 943. PUBLIC EDUCATION CAMPAIGNS. 
‘‘(a) IN GENERAL.—The Director shall conduct a 
public education campaign, designed to educate health 
care providers and consumers of health care about health 
care quality improvement. 
‘‘(b) CONSUMER EDUCATION CAMPAIGNS.— 
‘‘(1) IN GENERAL.—The Director, in coordina-
tion with the Administrator of the Centers for Medi-
care & Medicaid Services and the Director of the 
Centers for Disease Control and Prevention, shall 
create a consumer education campaign to develop ac-
curate and reliable information about health care 
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quality. In compiling the information for the con-
sumer education campaign, the Secretary may use 
mechanisms and sources of information that are 
available through other Federal agencies. 
‘‘(2) REQUIREMENTS.—The consumer edu-
cation campaign shall include information regard-
ing— 
‘‘(A) the importance of quality in health 
care decisions; 
‘‘(B) the ways in which health care experts 
define and identify quality in health care; 
‘‘(C) the variance of quality among health 
insurance plans, health care facilities, health 
care organizations, and health care providers; 
and 
‘‘(D) the role of consumers in improving 
the quality of health care. 
‘‘(3) PUBLICATION.—The Director shall make 
the information described in paragraph (1) available 
to the public through the Internet. 
‘‘(4) GRANT
PROGRAM.—The Director shall 
award grants to States and private nonprofit organi-
zations to assist with the creation and dissemination 
of the information described in paragraph (1). 
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‘‘(c) QUALITY RESOURCE CENTER
FOR HEALTH 
CARE PROVIDERS.— 
‘‘(1) IN GENERAL.—The Director, in coordina-
tion with the Administrator of the Centers for Medi-
care & Medicaid Services, shall create a National 
Quality Resource Center (referred to in this sub-
section as the ‘NQRC’) for health care providers to 
assist with the understanding and implementation of 
quality improvement initiatives for health care pro-
viders. 
‘‘(2) DUTIES.—The national resource center de-
veloped under paragraph (1) shall— 
‘‘(A) inform providers about quality im-
provement techniques and the value of such 
techniques to improving quality; 
‘‘(B) accelerate the transfer of lessons 
learned from other initiatives in the public and 
private sectors, including those initiatives re-
ceiving Federal financial support; 
‘‘(C) provide a forum for exchange of 
knowledge and experience among health care 
providers; 
‘‘(D) provide technical assistance to health 
care providers for implementing quality im-
provement efforts; and 
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‘‘(E) provide a forum for feedback from 
health care providers concerning the effect of 
the efforts under subparagraphs (A) through 
(D). 
‘‘(3) NATIONAL QUALITY SUPPORT EXTENSION 
GRANT PROGRAM.— 
‘‘(A) IN GENERAL.—The Director, in co-
ordination with the NQRC, shall award Na-
tional Quality Support Extension grants (re-
ferred to in this paragraph as ‘NQSE grants’ 
or the ‘NQSE grant program’), on a competi-
tive basis, to eligible entities for the purpose of 
supporting and facilitating local health care 
quality improvement efforts throughout the 
United States. 
‘‘(B) PURPOSES.—The purposes of the 
NQSE grant program are— 
‘‘(i) to assist qualified eligible entities 
in carrying out projects related to health 
care quality improvement activities among 
the provider community to help test and 
acclimate to new, innovative quality im-
provement activities; 
‘‘(ii) 
to 
facilitate 
communication 
among local health care quality groups re-
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garding the best practices in the area of 
quality improvement and prevention in the 
clinical setting; and 
‘‘(iii) to enable, empower, support, 
and assist local health care quality im-
provement efforts, particularly those that 
facilitate 
collaboration 
between 
inde-
pendent providers. 
‘‘(C) ELIGIBLE ENTITIES.—An entity de-
siring a grant under this paragraph shall— 
‘‘(i) be a public or private nonprofit 
entity engaged in health care quality im-
provement; 
‘‘(ii) submit to the Director a program 
design that describes the purpose of the 
plan for which the entity seeks a grant and 
the community leadership that will support 
the entity in carrying out such plan; and 
‘‘(iii) submit to the Director an appli-
cation at such time, in such manner, and 
containing such information as the Direc-
tor may require. 
‘‘(4) 
IMPLEMENTATION
ASSISTANCE.—The 
Health Information Technology regional extension 
centers under section 3012(c) shall operate as exten-
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sion centers for the NQRC, for the purposes of im-
plementation assistance. 
‘‘(5) TECHNICAL
ASSISTANCE
FOR
HEALTH 
CARE PROVIDERS WORKING WITH VULNERABLE POP-
ULATIONS.—In carrying out this subsection, the Di-
rector shall give particular attention to the technical 
assistance that health care providers who serve vul-
nerable populations need. 
‘‘SEC. 944. FUNDING. 
‘‘(a) TRUST FUNDS.—For purposes of funding the 
activities under this part, the Secretary shall provide for 
the transfer from the Federal Hospital Insurance Trust 
Fund under section 1817 of the Social Security Act (42 
U.S.C. 1395i) and the Federal Supplementary Insurance 
Trust Fund under section 1841 of the Social Security Act 
(42 U.S.C. 1395t), including the Medicare Prescription 
Drug Account in such Trust Fund, in such proportion as 
determined appropriate by the Secretary, of $150,000,000 
for each of fiscal years 2010 through 2014. 
‘‘(b) AMERICAN RECOVERY
AND REINVESTMENT 
FUNDS.—At the end of the recession adjustment period 
(as defined in section 5001(h)(3) of the American Recov-
ery and Reinvestment Act (Public Law 111–5; 123 Stat. 
496), the Secretary of the Treasury shall transfer any 
funds appropriated under such Act and not otherwise ex-
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pended to the Agency for purposes of carrying out this 
part. 
‘‘(c) MEDICAID
AND
MEDICARE
IMPROVEMENT 
FUNDS.—For purposes of funding the activities under this 
part for fiscal year 2014, the Secretary shall provide for 
the transfer of $100,000,000 from the Medicaid Improve-
ment Fund under section 1898 of the Social Security Act 
(42 U.S.C. 1395iii), and $100,000,000 from the Medicare 
Improvement Fund under section 1941 of such Act (42 
U.S.C 1396w–1).’’. 
(c) TECHNICAL AMENDMENT.—Section 937(b) of the 
Public Health Service Act (42 U.S.C. 299c–6(b)) is 
amended by inserting ‘‘except for part E,’’ after ‘‘this 
title’’. 
(d) DEVELOPMENT
OF QUALITY MEASURES
FOR 
FEDERAL HEALTH PROGRAMS.— 
(1) PERIOD OF CONTRACT.—Section 1890(a)(3) 
of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1395aaa(a)(3)) is amended— 
(A) by striking ‘‘4 years’’ and inserting ‘‘4 
years, in the case of the first contract entered 
into under such paragraph, and 3 years in the 
case of each subsequent contract entered into 
under such paragraph’’; and 
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(B) by inserting ‘‘for a period of 3 years’’ 
after ‘‘renewed’’. 
(2) 
PRIORITY
SETTING
PROCESS.—Section 
1890(b)(1) of the Social Security Act (42 U.S.C. 
1395aaa(b)(1)) is amended— 
(A) in the matter preceding subparagraph 
(A)— 
(i) by striking ‘‘an integrated national 
strategy and priorities for’’; and 
(ii) by inserting ‘‘in a manner con-
sistent with the national priorities for 
health care quality improvement (as de-
fined in section 4(c)(1))’’ after ‘‘settings’’; 
(B) in subparagraph (A)— 
(i) 
by 
redesignating 
clauses 
(i) 
through (iii) as clauses (ii) through (iv), 
respectively; and 
(ii) by inserting before clause (ii), as 
so redesignated, the following new clause: 
‘‘(i) that are consistent with such na-
tional priorities for health care quality im-
provement;’’. 
(3) ANNUAL REPORT TO CONGRESS.—Section 
1890(b)(5) of the Social Security Act (42 U.S.C. 
1395aaa(b)(5)) is amended— 
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(A) by redesignating clauses (i) through 
(iii) as clauses (ii) through (iv); and 
(B) by inserting before clause (ii), as so re-
designated, the following new clause: 
‘‘(i) the extent to which the priorities 
set and the quality improvement measures 
endorsed by the entity under paragraphs 
(1) and (2), respectively, are consistent 
with the national priorities for health care 
quality improvement (as so defined);’’. 
(4) FUNDING.—Section 1890(d) of the Social 
Security Act (42 U.S.C. 1395aaa(d)) is amended by 
inserting ‘‘and, for purposes of carrying out this sec-
tion under a new or renewed contract, there are au-
thorized to be appropriated such sums as are nec-
essary, taking into consideration the results of the 
study contained in the 18-month report submitted to 
Congress under section 183(b)(2) of the Medicare 
Improvements for Patients and Providers Act of 
2008 (Public Law 110–275), for each of fiscal years 
2013 through 2015’’ before the period at the end. 
SEC. 7. REPORTS TO CONGRESS. 
(a) EVALUATION OF THE CONSUMER EDUCATION 
CAMPAIGN.—Not later than 18 months after the establish-
ment of the quality resource center under section 943(c) 
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of the Public Health Service Act (as added by section 6), 
the Comptroller General of the United States shall submit 
to Congress a report describing— 
(1) the effectiveness of the quality resource cen-
ter for health care providers under such section 
943(c); and 
(2) the effectiveness of the consumer education 
program under section 943(b) of such Act (as added 
by section 6). 
(b) QUALITY
DISSEMINATION
STRATEGIES.—Not 
later than 18 months after the date of enactment of this 
Act, the Secretary of Health and Human Services, acting 
through the Director of the Agency for Healthcare Re-
search and Quality, shall submit a report to Congress that 
includes— 
(1) a description of the efforts made to trans-
late clinical information regarding health care qual-
ity improvement into reasonable clinical practice; 
(2) the processes through which the Secretary 
disseminated the information described in paragraph 
(1); and 
(3) recommendations for the most effective 
methods for translating and disseminating informa-
tion concerning health care quality, and required 
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statutory changes to implement the recommended 
methods. 
(c) IOM REPORT TO CONGRESS REGARDING THE 
VALUE OF QUALITY MEASURE REPORTING.— 
(1) IN GENERAL.—The Secretary of Health and 
Human Services shall enter into a contract with the 
Director of the Institute of Medicine requiring that, 
not later than 18 months after the date of enact-
ment of this Act, the Director submit to Congress a 
report regarding the value of quality measure report-
ing in improving patient health outcomes. 
(2) CONSIDERATIONS.—In preparing the report 
described in paragraph (1), the Director of the Insti-
tutes of Medicine shall consider— 
(A) specific instances in the history of ex-
isting public health care programs within the 
Federal Government in which quality measure 
reporting has been shown, through peer-re-
viewed studies or literature, to result in im-
proved patient health outcomes; and 
(B) instances in which quality measure re-
porting has been shown to improve existing 
health disparities among vulnerable populations, 
including children, underserved populations, 
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rural populations, individuals with disabilities, 
the elderly, and racial and ethnic minorities. 
(3) AUTHORIZATION
OF
APPROPRIATIONS.— 
There are authorized to be appropriated such sums 
as may be necessary to carry out this subsection. 
(d) GAO STUDY AND REPORTS.—Section 183(b)(1) 
of the Medicare Improvements for Patients and Providers 
Act of 2008 (Public Law 110–275; 122 Stat. 2586) is 
amended— 
(1) in subparagraph (A), by striking ‘‘and’’ 
after the semicolon; 
(2) in subparagraph (B), by striking the period 
at the end and inserting a semicolon; and 
(3) by inserting after subparagraph (B) the fol-
lowing: 
‘‘(C) any negative effect on patients, par-
ticularly on patients in underserved or vulner-
able populations; and 
‘‘(D) any negative effect on health care 
providers, particularly health care providers in 
rural and underserved areas.’’. 
SEC. 8. DATA COLLECTION. 
(a) IN GENERAL.—Not later than January 1, 2011, 
and at least every 5 years thereafter, the Comptroller Gen-
eral of the United States (referred to in this section as 
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the ‘‘Comptroller General’’) shall conduct evaluations of 
the implementation of the data collection processes for 
quality measures used by the Federal health programs ad-
ministered through the Department of Health and Human 
Services. 
(b) CONSIDERATIONS.—In conducting the evalua-
tions under subsection (a), the Comptroller General shall 
consider— 
(1) whether the system for the collection of 
data for quality measures provides for validation of 
data in a manner that is relevant, fair, and scientif-
ically credible; 
(2) whether data collection efforts under the 
system— 
(A) use the most efficient and cost-effec-
tive means in a manner that minimizes admin-
istrative burden on persons required to collect 
data; 
(B) adequately protects the privacy the 
personal health information of patients; and 
(C) provides data security; 
(3) whether standards under the system provide 
for an opportunity for health care providers and in-
stitutional providers of services to review and correct 
any inaccuracies with regard to the findings; and 
VerDate Nov 24 2008 
22:45 May 06, 2009
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