‘‘(B) TARGETS.—Using such system and 
data, the Secretary shall establish the chronic 
care performance targets for purposes of the 
payments under paragraph (1). Such perform-
ance targets shall be established in consultation 
with States, associations representing individ-
uals with chronic illnesses, entities providing 
treatment to such individuals for such chronic 
illnesses, and other stakeholders, including the 
National Association of Medicaid Directors and 
the National Governors Association. 
‘‘(4) DATA TO BE USED.—The data to be used 
under paragraph (3) shall include— 
‘‘(A) data collected through methods such 
as— 
‘‘(i) the ‘Healthcare Effectiveness 
Data and Information Set’ (also known as 
‘HEDIS’) (or an appropriate successor 
performance measurement tool); 
‘‘(ii) the ‘Consumer Assessment of 
Healthcare Providers and Systems’ (also 
known as ‘CAHPS’) (or an appropriate 
successor performance measurement tool); 
and 
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‘‘(iii) the ‘Health Outcomes Survey’ 
(also known as ‘HOS’) (or an appropriate 
successor performance measurement tool); 
and 
‘‘(B) other data collected by the State. 
‘‘(5) REPORTS.— 
‘‘(A) IN GENERAL.—Each State shall col-
lect, analyze, and report to the Secretary, at a 
frequency and in a manner to be established by 
the Secretary, data described in paragraph (4) 
that permit the Secretary to monitor the State’s 
performance relative to the chronic care per-
formance targets established under paragraph 
(3). 
‘‘(B) REVIEW
AND
VERIFICATION.—The 
Secretary may review the data collected by the 
State under subparagraph (A) to verify the 
State’s analysis of such data with respect to the 
performance targets under paragraph (3). 
‘‘(6) AMOUNT OF BONUS PAYMENTS.— 
‘‘(A) IN
GENERAL.—Subject to subpara-
graphs (B) and (C), with respect to each cat-
egory of Medicaid beneficiaries, in the case of 
a State that the Secretary determines, based on 
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the chronic care performance targets set under 
paragraph (3) for such category, performs— 
‘‘(i) in the top five States in such cat-
egory, subject to subparagraph (C)(ii), the 
amount of the bonus shall be 10 percent of 
the payment amount otherwise paid to the 
State under subsection (a) for individuals 
enrolled under the plan within such cat-
egory; 
‘‘(ii) in the next five States in such 
category, subject to subparagraph (C)(ii), 
the amount of the bonus shall be 5 percent 
of the payment amount otherwise paid to 
the State under subsection (a) for individ-
uals enrolled under the plan within such 
category; 
‘‘(iii) in the next five States in such 
category, subject to clauses (i) and (iii) of 
subparagraph (C), the amount of the 
bonus shall be 3 percent of the payment 
amount otherwise paid to the State under 
subsection (a) for individuals enrolled 
under the plan within such category; 
‘‘(iv) in the next five States in such 
category, subject to clauses (i) and (iii) of 
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subparagraph (C), the amount of the 
bonus shall be 2 percent of the payment 
amount otherwise paid to the State under 
subsection (a) for individuals enrolled 
under the plan within such category; and 
‘‘(v) in the next five States in such 
category, subject to clauses (i) and (iii) of 
subparagraph (C), the amount of the 
bonus shall be 1 percent of the payment 
amount otherwise paid to the State under 
subsection (a) for individuals enrolled 
under the plan within such category. 
‘‘(B) AGGREGATE
ANNUAL
LIMIT
FOR 
EACH
CATEGORY
OF
MEDICAID
BENE-
FICIARIES.— 
‘‘(i) IN GENERAL.—In no case may 
the aggregate amount of bonuses under 
this subsection for a fiscal year for a cat-
egory of Medicaid beneficiaries exceed the 
limit specified in clause (ii) for the fiscal 
year. 
‘‘(ii) LIMIT.—The limit specified in 
this clause— 
‘‘(I) for the fiscal year 2015 is 
equal to $250,000,000; or 
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‘‘(II) for a subsequent fiscal year 
is equal to the limit specified in this 
clause for the previous fiscal year in-
creased by the per capita percentage 
increase determined under paragraph 
(1)(E) of subsection (c). 
‘‘(C) LIMITATION AND PRORATION OF BO-
NUSES BASED ON APPLICATION OF AGGREGATE 
LIMIT.— 
‘‘(i) NO BONUS FOR THIRD OR SUBSE-
QUENT TIERS UNLESS AGGREGATE LIMIT 
NOT REACHED ON FIRST TWO TIERS.—No 
bonus shall be payable under clause (iii), 
(iv), or (v) of subparagraph (A) for a cat-
egory of Medicaid beneficiaries for a fiscal 
year unless the aggregate amount of bo-
nuses under clauses (i) and (ii) of such 
subparagraph for such category and fiscal 
year is less than the limit specified in sub-
paragraph (C)(ii) for the fiscal year. 
‘‘(ii) PRORATION
FOR
FIRST
TWO 
TIERS.—If the aggregate amount of bo-
nuses under clauses (i) and (ii) of subpara-
graph (A) for a category of Medicaid bene-
ficiaries for a fiscal year exceeds the limit 
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specified in subparagraph (C)(ii) for the 
fiscal year, the amount of each such bonus 
shall be prorated in a manner so the ag-
gregate amount of such bonuses is equal to 
such limit. 
‘‘(iii) PRORATION FOR NEXT THREE 
TIERS.—If the aggregate amount of bo-
nuses under clauses (i) and (ii) of subpara-
graph (A) for a category of Medicaid bene-
ficiaries for a fiscal year is less than the 
limit specified in subparagraph (C)(ii) for 
the fiscal year, but the aggregate amount 
of bonuses under clauses (i) through (v) of 
subparagraph (A) for the category and fis-
cal year exceeds the limit specified in sub-
paragraph (C)(ii) for the fiscal year, the 
amount of each bonus in clauses (iii), (iv), 
and (v) of subparagraph (A) shall be pro-
rated in a manner so the aggregate 
amount of all the bonuses under subpara-
graph (A) is equal to such limit. 
‘‘(g) STATE OPTION FOR RECEIVING MEDICARE PAY-
MENTS FOR FULL-BENEFIT DUAL ELIGIBLE INDIVID-
UALS.— 
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