(2) SELECTION OF MEMBERS.—Each member 
of the Council shall be a member of a health profes-
sion. Five members of the Council shall be physi-
cians. Individuals shall be appointed to the Council 
on the basis of national reputations for clinical and 
academic excellence. To the greatest extent feasible, 
the membership of the Council shall represent the 
various geographic regions of the United States and 
shall reflect the racial, ethnic, and gender composi-
tion of the population of the United States. 
(3) TERMS
OF
MEMBERS.—Individuals ap-
pointed to the Council shall serve for a term of 5 
years, except that the terms of 4 of the individuals 
initially appointed shall be, as designated by the 
President at the time of their appointment, for 1, 2, 
3, and 4 years. 
(d) VACANCIES.— 
(1) IN GENERAL.—The President shall fill any 
vacancy in the membership of the Council in the 
same manner as the original appointment. The va-
cancy shall not affect the power of the remaining 
members to execute the duties of the Council. 
(2) VACANCY
APPOINTMENTS.—Any member 
appointed to fill a vacancy shall serve for the re-
mainder of the term for which the predecessor of the 
member was appointed. 
(3) REAPPOINTMENT.—The President may re-
appoint a member of the Council for a second term 
in the same manner as the original appointment. A 
member who has served for 2 consecutive 5-year 
terms shall not be eligible for reappointment until 2 
years after the member has ceased to serve. 
(e) CHAIR.—The President shall designate 1 of the 
members of the Council to serve at the will of the Presi-
dent as Chair of the Council. 
(f) COMPENSATION.—Members of the Council who 
are not employees of the Federal Government shall be en-
titled to compensation at a level equivalent to level II of 
the Executive Schedule, in accordance with section 5313 
of title 5, United States Code. 
SEC. 502. DEVELOPMENT OF CERTAIN METHODOLOGIES, 
GUIDELINES, AND STANDARDS. 
(a) PROFILING OF PATTERNS OF PRACTICE; IDENTI-
FICATION OF OUTLIERS.—The Council shall adopt meth-
odologies for profiling the patterns of practice of health 
care professionals and for identifying outliers (as defined 
in subsection (e)). 
(b) CENTERS OF EXCELLENCE.—The Council shall 
develop guidelines for certain medical procedures des-
ignated by the Board to be performed only at tertiary care 
centers which can meet standards for frequency of proce-
dure performance and intensity of support mechanisms 
that are consistent with the high probability of desired pa-
tient outcome. Reimbursement under this Act for such a 
designated procedure may only be provided if the proce-
dure was performed at a center that meets such stand-
ards. 
(c) REMEDIAL ACTIONS.—The Council shall develop 
standards for education and sanctions with respect to 
outliers so as to assure the quality of health care services 
provided under this Act. The Council shall develop criteria 
for referral of providers to the State licensing board if edu-
cation proves ineffective in correcting provider practice be-
havior. 
(d) DISSEMINATION.—The Council shall disseminate 
to the State— 
(1) the methodologies adopted under subsection 
(a); 
(2) the guidelines developed under subsection 
(b); and 
(3) the standards developed under subsection 
(c); 
for use by the States under section 503.
(e) OUTLIER DEFINED.—In this title, the term 
‘‘outlier’’ means a health care provider whose pattern of 
practice, relative to applicable practice guidelines, suggests 
deficiencies in the quality of health care services being pro-
vided. 
SEC. 503. STATE QUALITY REVIEW PROGRAMS. 
(a) REQUIREMENT.—In order to meet the require-
ment of section 404(b)(1)(H), each State health security 
program shall establish 1 or more qualified entities to con-
duct quality reviews of persons providing covered services 
under the program, in accordance with standards estab-
lished under subsection (b)(1) (except as provided in sub-
section (b)(2)) and subsection (d). 
(b) FEDERAL STANDARDS.— 
(1) IN GENERAL.—The Council shall establish 
standards with respect to— 
(A) the adoption of practice guidelines 
(whether developed by the Federal Government 
or other entities); 
(B) the identification of outliers (con-
sistent with methodologies adopted under sec-
tion 502(a)); 
(C) the development of remedial programs 
and monitoring for outliers; and