In this task, you are given text for US Congressional and California state bills, your task is to generate a summary for this bill.

Input: Consider Input: SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Social Security and Medicare 
Protection Act''.

SEC. 2. FINDINGS AND PURPOSE.

    (a) Findings.--The Congress finds that--
            (1) fiscal pressures will mount as an aging population 
        increases the Government's obligations to provide retirement 
        income and health services;
            (2) Social Security and Medicare surpluses should be 
        reserved for strengthening and preserving the Social Security 
        trust funds; and
            (3) preserving Social Security and Medicare surpluses would 
        restore confidence in the long-term financial integrity of 
        Social Security and Medicare.
    (b) Purpose.--It is the purpose of this Act to prevent the Social 
Security and Medicare hospital insurance trust funds from being used 
for any purpose other than providing retirement and health security.

SEC. 3. PROTECTION OF SOCIAL SECURITY AND MEDICARE SURPLUSES.

    (a) Protection of Social Security and Medicare Surpluses.--Title 
III of the Congressional Budget Act of 1974 is amended by adding at the 
end the following new section:

   ``protection for social security and hospital insurance surpluses

    ``Sec. 316.  (a) Protection for Social Security and Hospital 
Insurance Surpluses.--
            ``(1) Concurrent resolutions on the budget.--
                    ``(A) In general.--It shall not be in order in the 
                House of Representatives or the Senate to consider any 
                concurrent resolution on the budget, or an amendment 
                thereto or conference report thereon, that would set 
                forth a surplus for any fiscal year that is less than 
                the surplus of the Federal Hospital Insurance Trust 
                Fund for that fiscal year.
                    ``(B) Exception.--(i) Subparagraph (A) shall not 
                apply to the extent that a violation of such 
                subparagraph would result from an assumption in the 
                resolution, amendment, or conference report, as 
                applicable, of an increase in outlays or a decrease in 
                revenue relative to the baseline underlying that 
                resolution for social security reform legislation or 
                medicare reform legislation for any such fiscal year.
                    ``(ii) If a concurrent resolution on the budget, or 
                an amendment thereto or conference report thereon, 
                would be in violation of subparagraph (A) because of an 
                assumption of an increase in outlays or a decrease in 
                revenue relative to the baseline underlying that 
                resolution for social security reform legislation or 
                medicare reform legislation for any such fiscal year, 
                then that resolution shall include a statement 
                identifying any such increase in outlays or decrease in 
                revenue.
            ``(2) Spending and tax legislation.--
                    ``(A) In general.--It shall not be in order in the 
                House of Representatives or the Senate to consider any 
                bill, joint resolution, amendment, motion, or 
                conference report if--
                            ``(i) the enactment of that bill or 
                        resolution, as reported;
                            ``(ii) the adoption and enactment of that 
                        amendment; or
                            ``(iii) the enactment of that bill or 
                        resolution in the form recommended in that 
                        conference report,
                would cause the surplus for any fiscal year covered by 
                the most recently agreed to concurrent resolution on 
                the budget to be less than the surplus of the Federal 
                Hospital Insurance Trust Fund for that fiscal year.
                    ``(B) Exception.--Subparagraph (A) shall not apply 
                to social security reform legislation or medicare 
                reform legislation.
    ``(b) Enforcement.--
            ``(1) Budgetary levels with respect to concurrent 
        resolutions on the budget.--For purposes of enforcing any point 
        of order under subsection (a)(1), the surplus for any fiscal 
        year shall be--
                    ``(A) the levels set forth in the later of the 
                concurrent resolution on the budget, as reported, or in 
                the conference report on the concurrent resolution on 
                the budget; and
                    ``(B) adjusted to the maximum extent allowable 
                under all procedures that allow budgetary aggregates to 
                be adjusted for legislation that would cause a decrease 
                in the surplus for any fiscal year covered by the 
                concurrent resolution on the budget (other than 
                procedures described in paragraph (2)(A)(ii)).
            ``(2) Current levels with respect to spending and tax 
        legislation.--
                    ``(A) In general.--For purposes of enforcing 
                subsection (a)(2), the current levels of the surplus 
                for any fiscal year shall be--
                            ``(i) calculated using the following 
                        assumptions--
                                    ``(I) direct spending and revenue 
                                levels at the baseline levels 
                                underlying the most recently agreed to 
                                concurrent resolution on the budget; 
                                and
                                    ``(II) for the budget year, 
                                discretionary spending levels at 
                                current law levels and, for outyears, 
                                discretionary spending levels at the 
                                baseline levels underlying the most 
                                recently agreed to concurrent 
                                resolution on the budget; and
                            ``(ii) adjusted for changes in the surplus 
                        levels set forth in the most recently agreed to 
                        concurrent resolution on the budget pursuant to 
                        procedures in such resolution that authorize 
                        adjustments in budgetary aggregates for updated 
                        economic and technical assumptions in the mid-
                        session report of the Director of the 
                        Congressional Budget Office.
                Such revisions shall be included in the first current 
                level report on the congressional budget submitted for 
                publication in the Congressional Record after the 
                release of such mid-session report.
                    ``(B) Budgetary treatment.--Outlays (or receipts) 
                for any fiscal year resulting from social security or 
                medicare reform legislation in excess of the amount of 
                outlays (or less than the amount of receipts) for that 
                fiscal year set forth in the most recently agreed to 
                concurrent resolution on the budget or the section 
                302(a) allocation for such legislation, as applicable, 
                shall not be taken into account for purposes of 
                enforcing any point of order under subsection (a)(2).
            ``(3) Disclosure of hi surplus.--For purposes of enforcing 
        any point of order under subsection (a), the surplus of the 
        Federal Hospital Insurance Trust Fund for a fiscal year shall 
        be the levels set forth in the later of the report accompanying 
        the concurrent resolution on the budget (or, in the absence of 
        such a report, placed in the Congressional Record prior to the 
        consideration of such resolution) or in the joint explanatory 
        statement of managers accompanying such resolution.
    ``(c) Additional Content of Reports Accompanying Budget Resolutions 
and of Joint Explanatory Statements.--The report accompanying any 
concurrent resolution on the budget and the joint explanatory statement 
accompanying the conference report on each such resolution shall 
include the levels of the surplus in the budget for each fiscal year 
set forth in such resolution and of the surplus or deficit in the 
Federal Hospital Insurance Trust Fund, calculated using the assumptions 
set forth in subsection (b)(2)(A).
    ``(d) Definitions.--As used in this section:
            ``(1) The term `medicare reform legislation' means a bill 
        or a joint resolution to save Medicare that includes a 
        provision stating the following: `For purposes of section 
        316(a) of the Congressional Budget Act of 1974, this Act 
        constitutes medicare reform legislation.'.
            ``(2) The term `social security reform legislation' means a 
        bill or a joint resolution to save social security that 
        includes a provision stating the following: `For purposes of 
        section 316(a) of the Congressional Budget Act of 1974, this 
        Act constitutes social security reform legislation.'.
    ``(e) Waiver and Appeal.--Subsection (a) may be waived or suspended 
in the Senate only by an affirmative vote of three-fifths of the 
Members, duly chosen and sworn. An affirmative vote of three-fifths of 
the Members of the Senate, duly chosen and sworn, shall be required in 
the Senate to sustain an appeal of the ruling of the Chair on a point 
of order raised under this section.
    ``(f) Effective Date.--This section shall cease to have any force 
or effect upon the enactment of social security reform legislation and 
medicare reform legislation.''.
    (b) Conforming Amendment.--The item relating to section 316 in the 
table of contents set forth in section 1(b) of the Congressional Budget 
and Impoundment Control Act of 1974 is amended to read as follows:

``Sec. 316. Protection for Social Security and hospital insurance 
                            surpluses.''.

SEC. 4. PRESIDENT'S BUDGET.

    (a) Protection of Social Security and Medicare Surpluses.--If the 
budget of the Government submitted by the President under section 
1105(a) of title 31, United States Code, recommends a surplus for any 
fiscal year that is less than the surplus of the Federal Hospital 
Insurance Trust Fund for that fiscal year, then it shall include a 
detailed proposal for social security reform legislation or medicare 
reform legislation.
    (b) Effective Date.--Subsection (a) shall cease to have any force 
or effect upon the enactment of social security reform legislation and 
medicare reform legislation as defined by section 316(d) of the 
Congressional Budget Act of 1974.

Output: Social Security and Medicare Protection Act - Amends the Congressional Budget Act of 1974 to make it out of order in the House of Representatives or the Senate to consider any concurrent resolution on the budget (or related measure) that would set forth a surplus for any fiscal year less than the surplus of the Federal Hospital Insurance Trust Fund for that fiscal year.

Creates an exception to such point of order if a violation of it would result from an assumption in the measure of an increase in outlays or a decrease in revenue relative to the baseline underlying the measure for Social Security or Medicare reform legislation for any such year.

Makes it out of order in the House of Representatives or the Senate to consider any (spending or tax) measure if its enactment would cause the surplus for any fiscal year covered by the most recently agreed to budget resolution to be less than the surplus of the Federal Hospital Insurance Trust Fund for that fiscal year. Creates an exception to such point of order similar to the other one.

Declares that, if the President's budget recommends an on-budget surplus for any fiscal year less than the surplus of the Federal Hospital Insurance Trust Fund for that fiscal year, then it shall include a detailed proposal for Social Security or Medicare reform legislation.


Input: Consider Input: SECTION 1. SHORT TITLE.

    This Act may be cited as the ``SSI Reform Act of 1993''.

SEC. 2. INCREASE IN INCOME AND RESOURCE ELIGIBILITY STANDARDS AND 
              BENEFITS; ELIMINATION OF CERTAIN RESOURCE EXCLUSIONS.

    (a) Increase in Income and Resource Eligibility Standards.--
            (1) In general.--Section 1611 of the Social Security Act 
        (42 U.S.C. 1382) is amended--
                    (A) in subsection (a)--
                            (i) in paragraph (1)(A)--
                                    (I) by striking ``$1,752'' and 
                                inserting ``the adjusted poverty 
                                line''; and
                                    (II) by striking ``1974'' and 
                                inserting ``1994'';
                            (ii) in paragraph (2)(A)--
                                    (I) by striking ``$2,628'' and 
                                inserting ``150 percent of the adjusted 
                                poverty line''; and
                                    (II) by striking ``1974'' and 
                                inserting ``1994''; and
                            (iii) in paragraph (3)--
                                    (I) in subparagraph (A), by 
                                striking ``and to $3,000 on January 1, 
                                1989'' and inserting ``to $3,000 on 
                                January 1, 1989, and to $10,500 on 
                                January 1, 1994''; and
                                    (II) in subparagraph (B), by 
                                striking ``and to $3,000 on January 1, 
                                1989'' and inserting ``to $3,000 on 
                                January 1, 1989, and to $7,000 on 
                                January 1, 1994''; and
                    (B) in subsection (b)--
                            (i) in paragraph (1)--
                                    (I) by striking ``$1,752'' and 
                                inserting ``the adjusted poverty 
                                line''; and
                                    (II) by striking ``1974'' and 
                                inserting ``1994''; and
                            (ii) in paragraph (2)--
                                    (I) by striking ``$2,628'' and 
                                inserting ``150 percent of the adjusted 
                                poverty line''; and
                                    (II) by striking ``1974'' and 
                                inserting ``1994''.
            (2) Adjusted poverty line.--Subsection (a) of such section 
        (42 U.S.C. 1382(a)) is amended by adding at the end the 
        following:
    ``(4)(A) For purposes of this subsection and subsection (b), the 
term `adjusted poverty line' means, with respect to a family--
            ``(i) 80 percent of the poverty line for calendar year 
        1994;
            ``(ii) 90 percent of the poverty line for calendar year 
        1995;
            ``(iii) 100 percent of the poverty line for calendar year 
        1996;
            ``(iv) 110 percent of the poverty line for calendar year 
        1997; and
            ``(v) 120 percent of the poverty line for calendar year 
        1998 and each calendar year thereafter.
    ``(B) As used in subparagraph (A), the term `poverty line' means, 
with respect to a family, the official poverty line (as defined by the 
Office of Management and Budget, and revised annually in accordance 
with section 673(2) of the Omnibus Budget Reconciliation Act of 1981) 
applicable to a family of the size involved.''.
            (3) No reduction in benefits.--The amendments made by this 
        subsection shall not apply to any individual or couple whose 
        supplemental security income benefits under title XVI of the 
        Social Security Act would be reduced by reason of such 
        application.
    (b) Elimination of Certain Resource Exclusions.--Section 1613 of 
such Act (42 U.S.C. 1382b) is amended--
            (1) in the 1st sentence of subsection (a)--
                    (A) in paragraph (2)--
                            (i) by striking ``(A)''; and
                            (ii) by striking subparagraph (B);
                    (B) in paragraph (4), by adding ``and'' at the end;
                    (C) by striking all that follows paragraph (6);
                    (D) in paragraph (6), by striking the semicolon and 
                inserting a period; and
                    (E) by striking paragraph (5) and redesignating 
                paragraph (6) as paragraph (5); and
            (2) by striking subsection (d).

SEC. 3. IN-KIND SUPPORT AND MAINTENANCE DISREGARDED IN DETERMINING 
              INCOME.

    Section 1612(a)(2) of the Social Security Act (42 U.S.C. 
1382a(a)(2)) is amended--
            (1) by inserting ``(other than support or maintenance 
        furnished in kind)'' after ``all other income'';
            (2) in subparagraph (A)--
                    (A) by striking ``or kind'';
                    (B) by striking clause (i) and redesignating 
                clauses (ii) and (iii) as clauses (i) and (ii), 
                respectively; and
                    (C) in clause (ii) (as so redesignated), by 
                striking ``and the provisions of clause (i) shall not 
                be applicable''.

SEC. 4. WORK INCENTIVE.

    Section 1612(b)(4) of the Social Security Act (42 U.S.C. 
1382a(b)(4)) is amended--
            (1) by striking ``$780'' each place such term appears and 
        inserting ``$2,400''; and
            (2) by striking ``one-half'' each place such term appears 
        and inserting ``\2/3\''.

SEC. 5. PHASED-IN EXPANSION OF ELIGIBILITY BY REASON OF AGE.

    (a) Age 64 for Calendar Year 1994.--
            (1) In general.--Section 1614(a)(1)(A) of the Social 
        Security Act (42 U.S.C. 1382c(a)(1)(A)) is amended by striking 
        ``65'' and inserting ``64''.
            (2) Conforming amendments.--
                    (A) Section 1615(a)(1) of such Act (42 U.S.C. 
                1382d(a)(1)) is amended by striking ``65'' and 
                inserting ``64''.
                    (B) Section 1612(b)(4) of such Act (42 U.S.C. 
                1382a(b)) is amended by striking ``65'' each place such 
                term appears and inserting ``64''.
            (3) Effective date.--The amendments made by this subsection 
        shall take effect on January 1, 1994.
    (b) Age 63 for Calendar Year 1995.--
            (1) In general.--Section 1614(a)(1)(A) of such Act (42 
        U.S.C. 1382c(a)(1)(A)), as amended by subsection (a)(1) of this 
        section, is amended by striking ``64'' and inserting ``63''.
            (2) Conforming amendments.--
                    (A) Section 1615(a)(1) of such Act (42 U.S.C. 
                1382d(a)(1)), as amended by subsection (a)(2)(A) of 
                this section, is amended by striking ``64'' and 
                inserting ``63''.
                    (B) Section 1612(b)(4) of such Act (42 U.S.C. 
                1382a(b)), as amended by subsection (a)(2)(B) of this 
                section, is amended by striking ``64'' each place such 
                term appears and inserting ``63''.
            (3) Effective date.--The amendments made by this subsection 
        shall take effect on January 1, 1995.
    (c) Age 62 Thereafter.--
            (1) In general.--Section 1614(a)(1)(A) of such Act (42 
        U.S.C. 1382c(a)(1)(A)), as amended by paragraph (2)(A) of this 
        subsection, is amended by striking ``63'' and inserting ``62''.
            (2) Conforming amendments.--
                    (A) Section 1615(a)(1) of such Act (42 U.S.C. 
                1382d(a)(1)), as amended by subsections (a)(2)(A) and 
                (b)(2)(A) of this section, is amended by striking 
                ``63'' and inserting ``62''.
                    (B) Section 1612(b)(4) of such Act (42 U.S.C. 
                1382a(b)), as amended by subsections (a)(2)(B) and 
                (b)(2)(B) of this section, is amended by striking 
                ``63'' each place such term appears and inserting 
                ``62''.
            (3) Effective date.--The amendments made by this subsection 
        shall take effect on January 1, 1996.

Output: SSI Reform Act of 1993 - Amends title XVI (Supplemental Security Income) (SSI) of the Social Security Act to:  (1) increase the limit on the amount of income and resources needed to qualify for SSI; (2) increase the amount of SSI benefits payable; (3) eliminate certain resource exclusions and increase certain earned income exclusions; (4) disregard in-kind support and maintenance in determining income; and (5) phase-in an expansion of eligibility based on age.


Input: Consider Input: SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Rural Health Care 
Quality Improvement Act of 2016''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
                       TITLE I--RURAL HEALTH CARE

Sec. 101. Establishment of core set of rural health care quality 
                            measures.
Sec. 102. Revisions to Medicare rural grants.
                 TITLE II--RURAL-BASED PAYMENT REFORMS

Sec. 201. Integrating core set of rural health care quality measures 
                            into certain payment models.
Sec. 202. Center for Medicare and Medicaid Innovation testing of 
                            providing financial incentives for rural 
                            providers of services and suppliers to 
                            submit data on quality measures.
Sec. 203. Center for Medicare and Medicaid Innovation testing of value-
                            based payment models for rural providers of 
                            services and suppliers.
Sec. 204. Center for Medicare and Medicaid Innovation testing of 
                            hospital readmissions reduction program for 
                            rural hospitals.
Sec. 205. Participation by rural health clinics and Federally qualified 
                            health centers in Comprehensive Primary 
                            Care Plus model.
               TITLE III--IMPROVING RURAL REPRESENTATION

Sec. 301. Inclusion of rural representation on CMS Rural Health 
                            Council.
Sec. 302. Ensuring rural representation on the Medicare Payment 
                            Advisory Commission and the Medicaid and 
                            CHIP Payment and Access Commission.

                       TITLE I--RURAL HEALTH CARE

SEC. 101. ESTABLISHMENT OF CORE SET OF RURAL HEALTH CARE QUALITY 
              MEASURES.

    (a) In General.--Title XVIII of the Social Security Act (42 U.S.C. 
1395 et seq.) is amended by inserting after section 1890A the following 
new section:

                  ``rural health care quality measures

    ``Sec. 1890B.  (a) Establishment.--Not later than January 1, 2018, 
the Secretary shall, using the process described in section 1890(b)(7), 
establish a core set of relevant quality measures that address the 
following with respect to rural providers of services and suppliers who 
furnish items and services to individuals in rural areas:
            ``(1) Improving patient outcomes, such as mortality rates, 
        hospital acquired infections, hospital readmissions, and other 
        patient-reported outcomes.
            ``(2) Improving care coordination, transitions, and 
        medicine reconciliation.
            ``(3) Reducing costs.
            ``(4) Improving patient safety.
            ``(5) Use of preventive care services, including 
        immunizations and screening tests.
            ``(6) Improving care for individuals with chronic disease, 
        including cardiovascular disease, diabetes, behavioral health, 
        and other chronic conditions.
            ``(7) Other purposes specified by the Secretary.
    ``(b) Aligning Measures With Existing Quality Reporting 
Requirements.--In establishing the core set of quality measures under 
subsection (a), the Secretary shall reduce reporting burdens for small 
rural providers of services and suppliers (as determined by the 
Secretary) by, to the extent practicable, ensuring that such quality 
measures are consistent with measures applicable under other quality 
and value-based payment reporting requirements under this title, as 
determined by the Secretary, including the Merit-Based Incentive 
Payment System under section 1848(q) and incentive payments for the 
meaningful use of certified EHR technology under section 
1886(b)(3)(B)(ix).
    ``(c) Implementation.--The provisions of paragraphs (4) and (5) of 
section 1890A(a) shall apply to the establishment of the core set of 
quality measures under subsection (a) in the same manner as such 
provisions apply to the selection of quality and efficiency measures 
described in section 1890(b)(7)(B).
    ``(d) Annual Updating.--The Secretary shall, using the process 
described in section 1890A, review and update the core set of quality 
measures established under subsection (a) in accordance with section 
1890A(c) to ensure such quality measures remain reliable, 
scientifically valid, and appropriate for quality measurement 
purposes.''.
    (b) Conforming Amendment.--Section 1890(b)(5)(A)(iv) of the Social 
Security Act (42 U.S.C. 1395aaa(b)(5)(A)(iv)) is amended by inserting 
``and (beginning with 2019) rural health care quality measures under 
section 1890B'' after ``Public Health Service Act''.

SEC. 102. REVISIONS TO MEDICARE RURAL GRANTS.

    (a) Reauthorization.--Section 1820(j) of the Social Security Act 
(42 U.S.C. 1395i-4(j)) is amended--
            (1) by striking ``Appropriations.--There'' and inserting 
        the following: ``Appropriations.--
            ``(1) HI trust fund.--There''; and
            (2) by adding at the end the following new paragraph:
            ``(2) General revenues.--There are authorized to be 
        appropriated, from amounts in the Treasury not otherwise 
        appropriated, for making grants to all States under subsection 
        (g), $50,000,000 in each of fiscal years 2017 through 2021, to 
        remain available until expended.''.
    (b) Medicare Rural Emergency Medical Services Grants.--Section 
1820(g)(2)(A) of the Social Security Act (42 U.S.C. 1395i-4(g)(2)(A)) 
is amended by inserting the following before the period at the end: ``, 
which may include plans to support emergency medical transportation 
services, particularly in rural communities that have lost their rural 
hospital''.
    (c) Grants To Provide Technical Assistance for Quality Improvement 
Reporting by Critical Access Hospitals.--Section 1820(g) of the Social 
Security Act (42 U.S.C. 1395i-4(g)) is amended by adding at the end the 
following new paragraph:
            ``(8) Technical assistance for quality improvement 
        reporting by critical access hospitals.--
                    ``(A) Grants.--The Secretary may award grants to 
                critical access hospitals that have submitted 
                applications in accordance with subparagraph (B) for--
                            ``(i) assisting such hospitals in 
                        establishing or expanding a quality improvement 
                        reporting program; and
                            ``(ii) supporting the provision of 
                        technical assistance for quality improvement 
                        reporting.
                    ``(B) Application.--A critical access hospital 
                seeking a grant under this paragraph shall submit an 
                application to the Secretary on or before such date and 
                in such form and manner as the Secretary specifies.
                    ``(C) Reporting requirement in order to continue to 
                receive grants after second year.--The Secretary may 
                not award a grant under this paragraph to a critical 
                access hospital for more than 2 years unless the 
                hospital agrees to submit, for each year after that 
                second year, such relevant quality data specified by 
                the Secretary, including data on rural health care 
                quality measures established under section 1890B, as 
                appropriate.
                    ``(D) Availability to public.--The Secretary shall 
                establish procedures for making data submitted under 
                subparagraph (C) available to the public.
                    ``(E) Opportunity to review.--The procedures 
                established under subparagraph (D) shall ensure that a 
                critical access hospital has the opportunity to review 
                the data that are to be made public with respect to the 
                hospital prior to such data being made public.
                    ``(F) Measures.--The Secretary shall report quality 
                measures of process, structure, outcome, patients' 
                perspective on care, efficiency, and costs of care that 
                relate to services furnished in such hospitals on the 
                Internet website of the Centers for Medicare & Medicaid 
                Services.''.

                 TITLE II--RURAL-BASED PAYMENT REFORMS

SEC. 201. INTEGRATING CORE SET OF RURAL HEALTH CARE QUALITY MEASURES 
              INTO CERTAIN PAYMENT MODELS.

    Section 1890B of the Social Security Act, as added by section 101, 
is amended by adding at the end the following new subsection:
    ``(e) Inclusion Under Alternative Payment Models and Value-Based 
Demonstration Projects.--Effective beginning with calendar year or 
fiscal year 2021, as applicable, the Secretary shall ensure that rural 
health care quality measures established under this section are 
included in quality reporting under alternative payment models and 
value-based payment demonstration projects under this title, as 
appropriate, including the shared savings program under section 1899 
and the Merit-Based Incentive Payment System under section 1848(q).''.

SEC. 202. CENTER FOR MEDICARE AND MEDICAID INNOVATION TESTING OF 
              PROVIDING FINANCIAL INCENTIVES FOR RURAL PROVIDERS OF 
              SERVICES AND SUPPLIERS TO SUBMIT DATA ON QUALITY 
              MEASURES.

    Section 1115A of the Social Security Act (42 U.S.C. 1315a) is 
amended--
            (1) in subsection (b)(2)(A), by adding at the end the 
        following new sentence: ``The models selected under this 
        subparagraph shall include the model described in subsection 
        (h).''; and
            (2) by adding at the end the following new subsection:
    ``(h) Providing Financial Incentives for Rural Providers of 
Services and Suppliers To Submit Data on Quality Measures.--The 
Secretary shall test a model providing financial incentives to 
providers of services and suppliers located in rural areas to submit 
data on applicable quality measures under title XVIII, including rural 
health care quality measures established under section 1890B.''.

SEC. 203. CENTER FOR MEDICARE AND MEDICAID INNOVATION TESTING OF VALUE-
              BASED PAYMENT MODELS FOR RURAL PROVIDERS OF SERVICES AND 
              SUPPLIERS.

    Section 1115A of the Social Security Act (42 U.S.C. 1315a), as 
amended by section 202, is amended--
            (1) in subsection (b)(2)(A), by striking ``model described 
        in subsection (h)'' and inserting ``models described in 
        subsections (h) and (i)''; and
            (2) by adding at the end the following new subsection:
    ``(i) Value-Based Payment Models for Rural Providers of Services 
and Suppliers.--The Secretary shall test value-based payment models, 
including value-based purchasing, for items and services furnished by 
providers of services and suppliers located in rural areas under title 
XVIII, including critical access hospitals.''.

SEC. 204. CENTER FOR MEDICARE AND MEDICAID INNOVATION TESTING OF 
              HOSPITAL READMISSIONS REDUCTION PROGRAM FOR RURAL 
              HOSPITALS.

    Section 1115A of the Social Security Act (42 U.S.C. 1315a), as 
amended by sections 202 and 203, is amended--
            (1) in subsection (b)(2)(A), by striking ``and (i)'' and 
        inserting ``, (i), and (j)''; and
            (2) by adding at the end the following new subsection:
    ``(j) Hospital Readmissions Reduction Program for Rural 
Hospitals.--The Secretary shall test a hospital readmissions reduction 
program under title XVIII for hospitals located in rural areas that are 
not otherwise subject to the program under section 1886(q).''.

SEC. 205. PARTICIPATION BY RURAL HEALTH CLINICS AND FEDERALLY QUALIFIED 
              HEALTH CENTERS IN COMPREHENSIVE PRIMARY CARE PLUS MODEL.

    Notwithstanding any other provision of law, the Secretary of Health 
and Human Services shall permit a rural health clinic (as defined in 
section 1861(aa)(2) of the Social Security Act (42 U.S.C. 
1395x(aa)(2))) or a Federally qualified health center (as defined in 
section 1861(aa)(4) of such Act (42 U.S.C. 1395x(aa)(4))) to 
participate in the Comprehensive Primary Care Plus model tested under 
section 1115A of such Act (42 U.S.C. 1315a).

               TITLE III--IMPROVING RURAL REPRESENTATION

SEC. 301. INCLUSION OF RURAL REPRESENTATION ON CMS RURAL HEALTH 
              COUNCIL.

    (a) In General.--To the extent the Administrator of the Centers for 
Medicare & Medicaid Services (in this section referred to as the 
``Administrator'') establishes a CMS Rural Health Council, the 
Administrator shall ensure that such Council includes external 
stakeholders who have objective rural health expertise, such as 
representatives of rural health research centers, quality improvement 
organizations, and State offices of rural health, who shall serve in an 
ex officio capacity as nonvoting members.
    (b) Collaboration With Health Care Payment Learning and Action 
Network.--The Council described in subsection (a) shall, to the extent 
practicable, work in collaboration with the Health Care Payment 
Learning and Action Network within the Department of Health and Human 
Services.

SEC. 302. ENSURING RURAL REPRESENTATION ON THE MEDICARE PAYMENT 
              ADVISORY COMMISSION AND THE MEDICAID AND CHIP PAYMENT AND 
              ACCESS COMMISSION.

    (a) Medicare Payment Advisory Commission.--
            (1) In general.--Section 1805(c)(2)(A) of the Social 
        Security Act (42 U.S.C. 1395b-6(c)(2)(A)) is amended by 
        inserting the following before the period at the end: ``, 
        including at least two members who represent a rural area''.
            (2) Applicable to future appointments.--Any appointment to 
        the Medicare Payment Advisory Commission made by the 
        Comptroller General of the United States after the date of 
        enactment of this Act shall be made in a manner that complies 
        with the requirements of section 1805(c)(2)(A) of the Social 
        Security Act, as amended by paragraph (1).
    (b) Medicaid and CHIP Payment and Access Commission.--
            (1) In general.--Section 1900(c)(2)(A) of the Social 
        Security Act (42 U.S.C. 1396(c)(2)(A)) is amended by inserting 
        the following before the period at the end: ``, including at 
        least two members who represent a rural area''.
            (2) Applicable to future appointments.--Any appointment to 
        the Medicaid and CHIP Payment and Access Commission made by the 
        Comptroller General of the United States after the date of 
        enactment of this Act shall be made in a manner that complies 
        with the requirements of section 1900(c)(2)(A) of the Social 
        Security Act, as amended by paragraph (1).


Output: Rural Health Care Quality Improvement Act of 2016 This bill amends titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act to:  establish certain health care quality measures with respect to rural providers; include&nbsp;such measures&nbsp;within specified Medicare payment models;&nbsp; revise certain requirements related to specified Medicare grants for rural emergency medical services and critical access hospitals;  require the Center for Medicare and Medicaid Innovation to test a hospital readmissions reduction program for rural hospitals, a model for incentivizing rural providers&nbsp;to submit&nbsp;data on applicable quality measures, and value-based payment models for services furnished by rural providers; and require the Centers for Medicare &amp; Medicaid Services to allow rural health clinics and federally qualified health centers to participate in the Comprehensive Primary Care Plus test model.