Medicare Nursing Facility Pay-for-Performance Act of 2004

Bill: 108-hr-5393
Sponsor: Rep. English, Phil [R-PA-3]
Introduced: 2004-11-19 in the House
Policy area: Health
Subjects: Case mix (Medical care)
Commerce
Congress
Congressional reporting requirements
Demography
Electronic government information
Federal advisory bodies
Government Operations and Politics
Government publicity
Health care industry
Hospital rates
Long-term care
Medicaid
Medical economics
Medical personnel
Medicare
Nursing homes
Performance measurement
Profit
Quality of care
Science, Technology, Communications
Social Welfare
Web sites

Summary:
action_date: 2004-11-19
text: 
Medicare Nursing Facility Pay-for-Performance Act of 2004 - Amends title XVIII (Medicare) of the Social Security Act (SSA) to direct the Secretary of Health and Human Services, through a contract with a qualified independent party (such as the National Quality Forum), to provide for identification of: (1) between ten and 15 quality measures for the performance of skilled nursing facilities under Medicare; and (2) the data to be reported, including their collection and formatting, on a calendar quarter basis for each such quality measure. 
 
Requires the values obtained for quality measures to be appropriately risk-adjusted as applied to individual skilled nursing facilities in order to increase the likelihood that any differences in such values reflect differences in the care provided by the facilities and not differences in the characteristics of their residents. 
 
Provides for: (1) adjusting payments for skilled nursing facilities based on quality performance, including an increase of two percent for facilities in the top ten percent in quality as well as a decrease of one percent for facilities below the quality threshold; (2) limiting market basket increases to facilities that voluntarily report information; and (3) using FY 2005 payment rates as a floor for subsequent updates.
 
Establishes the Long-Term Care Financing Commission to analyse and report to Congress on the financing of long-term care.


Legislative actions:
action_date: 2004-12-07
text: Referred to the Subcommittee on Health, for a period to be subsequently determined by the Chairman.
action_date: 2004-11-22
text: Referred to the Subcommittee on Health.
action_date: 2004-11-19
text: Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
action_date: 2004-11-19
text: Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
action_date: 2004-11-19
text: Referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
action_date: 2004-11-19
text: Introduced in House
action_date: 2004-11-19
text: Introduced in House