		II

		109th CONGRESS

		2d Session

		S. 2387

		IN THE SENATE OF THE UNITED STATES

			March 8, 2006

			Mr. Allard (for himself

			 and Mr. Salazar) introduced the following

			 bill; which was read twice and referred to the

			 Committee on Veterans'

			 Affairs

		A BILL

		To direct the Secretary of Veterans Affairs

		  to establish a national cemetery for veterans in the Pikes Peak Region of

		  Colorado.

		1.Establishment of national

			 cemetery in the Pikes Peak region

			(a)Defined

			 termIn this Act, the term Pikes Peak region means

			 the geographic area consisting of the following counties in Colorado:

				(1)Teller.

				(2)El Paso.

				(3)Fremont.

				(4)Pueblo.

				(b)In

			 generalThe Secretary of

			 Veterans Affairs shall establish, in accordance with chapter 24 of title 38,

			 United States Code, a national cemetery in the Pikes Peaks region to serve the

			 needs of veterans and their families.

			(c)Consultation in

			 selection of siteBefore

			 selecting the site for the national cemetery to be established under subsection

			 (b), the Secretary shall consult with—

				(1)appropriate officials of the State of

			 Colorado and local officials in the Pikes Peaks region; and

				(2)appropriate officials of the United States,

			 including the Administrator of General Services, with respect to land belonging

			 to the United States in that area that would be suitable to establish the

			 national cemetery under subsection (b).

				(d)Authority to

			 accept donation of parcel of land

				(1)In

			 generalThe Secretary may

			 accept on behalf of the United States the gift of an appropriate parcel of real

			 property. The Secretary shall have administrative jurisdiction over such parcel

			 of real property, and shall use such parcel to establish the national cemetery

			 under subsection (b).

				(2)Income tax

			 treatment of giftFor

			 purposes of Federal income, estate, and gift taxes, the real property accepted

			 under paragraph (1) shall be considered a gift to the United States.

				(e)ReportAs soon as practicable after the date of

			 the enactment of this Act, the Secretary shall submit to Congress a report on

			 the establishment of the national cemetery under subsection (b). The report

			 shall set forth a schedule for the establishment of the national cemetery and

			 an estimate of the costs associated with the establishment of the national

			 cemetery.


110 HRES 433 IH: Supporting the goals and ideals of National

U.S. House of Representatives
2007-05-23
text/xml
EN
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		IV
		110th CONGRESS
		1st Session
		H. RES. 433
		IN THE HOUSE OF REPRESENTATIVES

			May 23, 2007
			Mrs. Capps (for
			 herself and Mrs. Cubin) submitted the
			 following resolution; which was referred to the
			 Committee on Energy and
			 Commerce

		RESOLUTION
		Supporting the goals and ideals of National
		  Peripheral Arterial Disease Awareness Month.

		Whereas peripheral arterial disease is a vascular disease
			 that occurs when narrowed arteries reduce the blood flow to the limbs;
		Whereas peripheral arterial disease is a significant
			 vascular disease that can be as serious as a heart attack or stroke;
		Whereas peripheral arterial disease affects approximately
			 8,000,000 to 12,000,000 Americans;
		Whereas patients with peripheral arterial disease are at
			 increased risk of heart attack and stroke and are 6 times more likely to die
			 within 10 years than are patients without peripheral arterial disease;
		Whereas the survival rate for individuals with peripheral
			 arterial disease is worse than the outcome for many common cancers;
		Whereas peripheral arterial disease is a leading cause of
			 lower limb amputation in the United States;
		Whereas many patients with peripheral arterial disease
			 have walking impairment that leads to a diminished quality of life and
			 functional capacity;
		Whereas a majority of patients with peripheral arterial
			 disease are asymptomatic and less than half of individuals with peripheral
			 arterial disease are aware of their diagnoses;
		Whereas African American ethnicity is a strong and
			 independent risk factor for peripheral arterial disease, and yet this fact is
			 not well known to those at risk;
		Whereas effective treatments are available for people with
			 peripheral arterial disease to reduce heart attacks, strokes, and amputations
			 and to improve quality of life;
		Whereas many patients with peripheral arterial disease are
			 still untreated with proven therapies;
		Whereas there is a need for comprehensive educational
			 efforts designed to increase awareness of peripheral arterial disease among
			 medical professionals and the greater public in order to promote early
			 detection and proper treatment of this disease to improve quality of life,
			 prevent heart attacks and strokes, and save lives and limbs; and
		Whereas September 1 through September 30, 2007, would be
			 an appropriate month to observe National Peripheral Arterial Disease Awareness
			 Month: Now, therefore, be it

		That the House of
			 Representatives—
			(1)supports the goals
			 and ideals of National Peripheral Arterial Disease Awareness Month;
			(2)supports efforts
			 to educate people about peripheral arterial disease;
			(3)acknowledges the
			 critical importance of peripheral arterial disease awareness to improve
			 national cardiovascular health;
			(4)supports raising
			 awareness of the consequences of undiagnosed and untreated peripheral arterial
			 disease and the need to seek appropriate care as a serious public health issue;
			 and
			(5)calls upon the
			 people of the United States to observe the month with appropriate programs and
			 activities.


114 S1076 IS: Smartphone Theft Prevention Act of 2015
U.S. Senate
2015-04-23
text/xml
EN
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II114th CONGRESS1st SessionS. 1076IN THE SENATE OF THE UNITED STATESApril 23, 2015Ms. Klobuchar (for herself, Ms. Mikulski, Ms. Hirono, and Mr. Blumenthal) introduced the following bill; which was read twice and referred to the Committee on Commerce, Science, and TransportationA BILLTo require mobile service providers and smartphone manufacturers to give consumers the ability to
			 remotely delete data from smartphones and render smartphones inoperable.

 1.Short titleThis Act may be cited as the Smartphone Theft Prevention Act of 2015.
 2.FindingsCongress finds that— (1)mobile device theft costs consumers billions of dollars each year, according to the Federal Communications Commission;
 (2)1 in 3 robberies include the theft of a mobile device; (3)carriers, manufacturers, law enforcement, the Federal Communications Commission, and State governments have worked to address the growing trend of mobile device theft, but more remains to be done;
 (4)consumers deserve to have the most secure technology available to protect them and their information;
 (5)technological protections continue to develop, evolve, and improve in ways that are good for the economy and the consumers of the United States, and for public safety in the United States;
 (6)the wireless industry should work with law enforcement to educate consumers about the security tools that are available to them and how to keep their data, their devices, and themselves safe;
 (7)because engineering and security needs change rapidly, the mobile device industry, law enforcement, and consumer advocates are best suited to proactively develop solutions to protect consumers, drive innovation, and deter theft; and
 (8)major cities such as San Francisco, New York, and London have seen recent decreases in smartphone theft since carriers and manufacturers began rolling out sophisticated new technological functions to protect consumers from theft.
			3.Function for stolen smartphones
 (a)In generalPart I of title III of the Communications Act of 1934 (47 U.S.C. 301 et seq.) is amended by adding at the end the following:

					343.Function for stolen smartphones
						(a)Definitions
 (1)In generalIn this section—
 (A)the term account holder, with respect to a smartphone— (i)means the person who holds the account through which commercial mobile service or commercial mobile data service is provided on the smartphone; and
 (ii)includes a person authorized by the person described in clause (i) to take actions with respect to the smartphone;
 (B)the term commercial mobile data service has the meaning given the term in section 6001 of the Middle Class Tax Relief and Job Creation Act of 2012 (47 U.S.C. 1401);
 (C)the term commercial mobile service has the meaning given the term in section 332; and
 (D)the term smartphone means a cellular radio telephone or other mobile voice communications handset device— (i)on which commercial mobile service or commercial mobile data service is provided; and
 (ii)that— (I)utilizes a mobile operating system;
 (II)possesses advanced data capabilities, including software applications, Internet access, digital voice services, email, and text messaging;
 (III)has wireless network connectivity; and (IV)is capable of operating on a long-term evolution network.
 (2)FCC authority to modify definition of smartphoneThe Commission may modify the definition of the term smartphone under paragraph (1) if the Commission determines that circumstances require such a modification. (b)Requirements (1)Function (A)In generalA provider of commercial mobile service or commercial mobile data service on a smartphone, in coordination with the manufacturer of, and the provider of the operating system for, the smartphone, shall—
 (i)make available on the smartphone a function described in subparagraph (B); and (ii)ensure that—
 (I)during the initial device setup process, the smartphone prompts the account holder to enable the function described in subparagraph (B); and
 (II)only the account holder is able to opt out of enabling the function described in subparagraph (B). (B)Function detailsA function described in this subparagraph, with respect to a smartphone, is a function that—
 (i)may only be used by the account holder; and (ii)includes the capability to remotely—
 (I)delete or render inaccessible from the smartphone all information relating to the account holder that has been placed on the smartphone;
 (II)render the smartphone inoperable on the network of any provider of commercial mobile service or commercial mobile data service globally;
 (III)prevent the smartphone from being reactivated or reprogrammed without a passcode or similar authorization after the smartphone has been—
 (aa)rendered inoperable as described in subclause (II); or
 (bb)subject to an unauthorized factory reset; and (IV)restore personal information from the smartphone onto a compatible or interoperable device.
 (2)Device standardsA person may not manufacture in the United States, or import into the United States for sale or resale to the public, a smartphone unless the smartphone is configured in such a manner that the provider of commercial mobile service or commercial mobile data service on the smartphone is able to comply with the requirements under paragraph (1).
							(3)Exemptions for functionally equivalent technology
 (A)Mobile service providersThe Commission may exempt a provider of commercial mobile service or commercial mobile data service on a smartphone, and the manufacturer of, and provider of the operating system for, the smartphone, from the requirement under paragraph (1) with respect to that smartphone if the service provider, in coordination with the manufacturer and operating system provider, makes available on the smartphone technology that accomplishes the functional equivalent of the function, initial prompt, and ability to opt out required under paragraph (1)(A).
 (B)Manufacturers and importersThe Commission may exempt a person from the requirement under paragraph (2)(A), with respect to a smartphone that the person manufactures in the United States or imports into the United States for sale or resale to the public, if the smartphone is configured in such a manner that the provider of commercial mobile service or commercial mobile data service on the smartphone may make available on the smartphone technology that accomplishes the functional equivalent of the function, initial prompt, and ability to opt out required under paragraph (1)(A).
 (c)No feeA provider of commercial mobile service or commercial mobile data service on a smartphone may not charge the account holder any fee for making the function, initial prompt, and ability to opt out required under subsection (b)(1)(A), or any equivalent technology described in subsection (b)(3)(A), available to the account holder.
						(d)Forfeiture penalty
 (1)In generalAny person that is determined by the Commission, in accordance with paragraphs (3) and (4) of section 503(b), to have violated subsection (b) or (c) of this section, including a manufacturer or operating system provider that violates the requirement to coordinate with a service provider under subsection (b)(1)(A), shall be liable to the United States for a forfeiture penalty, in an amount to be determined by the Commission.
 (2)Other penaltiesA forfeiture penalty under this subsection shall be in addition to any other penalty provided for in this Act.
 (e)Common national frameworkThe Commission shall establish a common national framework for smartphone anti-theft measures that takes into consideration the interest of all stakeholders for the purpose of promoting national uniformity of the function, initial prompt, and ability to opt out required under subsection (b)(1)(A), or functionally equivalent technology described in subsection (b)(3)(A), to protect consumers from the theft of smartphones.
						(f)Tablets
 (1)Commission determinationNot later than 180 days after the date of enactment of the Smartphone Theft Prevention Act of 2015, the Commission shall determine whether this section should apply with respect to tablets on which commercial mobile service or commercial mobile data service is provided.
 (2)RegulationsIf the Commission determines that this section should apply with respect to tablets described in paragraph (1), the Commission shall promulgate regulations to implement that determination.
 (g)Rule of constructionNothing in this section shall be construed to prohibit a manufacturer of smartphones, or a provider of commercial mobile service or commercial mobile data service, from taking actions not described in this section to protect consumers from the theft of smartphones.
 (h)Relationship to State lawNothing in this section shall be construed to preempt any provision of State law that provides protections to users of smartphones (or tablets, if applicable) that are at least as strong as the protections provided under this section..
			(b)Applicability of  function requirement
 (1)DefinitionIn this subsection, the term smartphone has the meaning given the term in section 343 of the Communications Act of 1934, as added by subsection (a).
 (2)ApplicabilityExcept as provided in paragraph (3), section 343 of the Communications Act of 1934, as added by subsection (a), shall apply with respect to any smartphone that, on or after January 1, 2016, is—
 (A)manufactured in the United States; or (B)imported into the United States for sale to the public.
 (3)Compliance ExtensionsThe Federal Communications Commission may exempt a person that is subject to any requirement under section 343(b) of the Communications Act of 1934, as added by subsection (a), from that requirement for a temporary period after the date described in paragraph (2) of this subsection, upon a showing by the person that the person requires more time to be able to comply with the requirement.


115 HR 1889 IH: Udall-Eisenhower Arctic Wilderness Act
U.S. House of Representatives
2017-04-04
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

I115th CONGRESS1st SessionH. R. 1889IN THE HOUSE OF REPRESENTATIVESApril 4, 2017Mr. Huffman (for himself, Mr. Fitzpatrick, Mr. LoBiondo, and Mr. Gallego) introduced the following bill; which was referred to the Committee on Natural ResourcesA BILLTo preserve the Arctic coastal plain of the Arctic National Wildlife Refuge, Alaska, as wilderness
			 in recognition of its extraordinary natural ecosystems and for the
			 permanent good of present and future generations of Americans.

 1.Short titleThis Act may be cited as the Udall-Eisenhower Arctic Wilderness Act. 2.Findings and statement of policy (a)FindingsThe Congress finds the following:
 (1)Americans cherish the continued existence of expansive, unspoiled wilderness ecosystems and wildlife found on their public lands, and feel a strong moral responsibility to protect this wilderness heritage as an enduring resource to bequeath undisturbed to future generations of Americans.
 (2)It is widely believed by ecologists, wildlife scientists, public land specialists, and other experts that the wilderness ecosystem centered around and dependent upon the Arctic coastal plain of the Arctic National Wildlife Refuge, Alaska, represents the very epitome of a primeval wilderness ecosystem and constitutes the greatest wilderness area and diversity of wildlife habitats of its kind in the United States.
 (3)President Dwight D. Eisenhower initiated protection of the wilderness values of the Arctic coastal plain in 1960 when he set aside 8,900,000 acres establishing the Arctic National Wildlife Range expressly for the purpose of preserving unique wildlife, wilderness and recreational values.
 (4)In 1980, when the Congress acted to strengthen the protective management of the Eisenhower-designated area with the enactment of the Alaska National Interest Lands Conservation Act (Public Law 96–487), Representative Morris K. Udall led the effort to more than double the size of the Arctic National Wildlife Refuge and extend statutory wilderness protection to most of the original area.
 (5)Before the enactment of the Alaska National Interest Lands Conservation Act, the House of Representatives twice passed legislation that would have protected the entire Eisenhower-designated area as wilderness, including the Arctic coastal plain.
 (6)A majority of Americans have supported and continue to support preserving and protecting the Arctic National Wildlife Refuge, including the Arctic coastal plain, from any industrial development and consider oil and gas exploration and development in particular to be incompatible with the purposes for which this incomparable wilderness ecosystem has been set aside.
 (7)When the Arctic National Wildlife Refuge was established in 1980 by paragraph (2) of section 303 of the Alaska National Interest Lands Conservation Act (Public Law 96–487; 94 Stat. 2390; 16 U.S.C. 668dd note), subparagraph (B)(iii) of such paragraph specifically stated that one of the purposes for which the Arctic National Wildlife Refuge is established and managed would be to provide the opportunity for continued subsistence uses by local residents, and, therefore, the lands designated as wilderness within the Refuge, including the area designated by this Act, are and will continue to be managed consistent with such subparagraph.
 (8)Canada has taken action to preserve those portions of the wilderness ecosystem of the Arctic that exist on its side of the international border and provides strong legal protection for the habitat of the Porcupine River caribou herd that migrates annually through both countries to calve on the Arctic coastal plain.
 (9)The extension of full wilderness protection for the Arctic coastal plain within the Arctic National Wildlife Refuge will still leave most of the North Slope of Alaska available for the development of energy resources, which will allow Alaska to continue to contribute significantly to meeting the energy needs of the United States without despoiling the unique Arctic coastal plain of the Arctic National Wildlife Refuge.
 (b)Statement of PolicyThe Congress hereby declares that it is the policy of the United States— (1)to honor the decades of bipartisan efforts that have increasingly protected the great wilderness ecosystem of the Arctic coastal plain;
 (2)to sustain this natural treasure for the current generation of Americans; and (3)to do everything possible to protect and preserve this magnificent natural ecosystem so that it may be bequeathed in its unspoiled natural condition to future generations of Americans.
				3.Designation of additional wilderness, Arctic National Wildlife Refuge, Alaska
 (a)DesignationA portion of the Arctic National Wildlife Refuge in Alaska comprising approximately 1,559,538 acres, as generally depicted on the map entitled Arctic National Wildlife Refuge, Coastal Plain Proposed Wilderness, dated October 20, 2015, labeled with Map ID 03–0172, and available for inspection in the offices of the Secretary of the Interior, is designated as a component of the National Wilderness Preservation System under the Wilderness Act (16 U.S.C. 1131 et seq.).
 (b)AdministrationThe Secretary of the Interior shall administer the area designated as wilderness by subsection (a) in accordance with the Wilderness Act as part of the wilderness area already in existence within the Arctic National Wildlife Refuge as of the date of the enactment of this Act.


110 HR 7067 IH: Quality FIRST (From Incentives,

U.S. House of Representatives
2008-09-25
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

		I
		110th CONGRESS
		2d Session
		H. R. 7067
		IN THE HOUSE OF REPRESENTATIVES

			September 25, 2008
			Mr. Altmire
			 introduced the following bill; which was referred to the
			 Committee on Ways and
			 Means

		A BILL
		To amend title XVIII of the Social Security Act to expand
		  the development of quality measures for inpatient hospital services, to
		  implement a performance-based payment methodology for the provision of such
		  services under the Medicare Program, and for other purposes.

		1.Short titleThis Act may be cited as the
			 Quality FIRST (From Incentives,
			 Reporting, Standards, and Technology) Act of 2008.
		2.Expansion of
			 reporting and development of quality measures for inpatient hospital services;
			 implementation of performance-based payment under the prospective payment
			 system for such services
			(a)In
			 generalTitle XVIII of the Social Security Act (42 U.S.C. 1395 et
			 seq.) is amended by inserting after section 1886 the following new
			 section:

					1886A.Performance-based payment system for inpatient hospital
		  services(a)Expansion of reporting
				and development of quality measures
							(1)Requirement to
				report data on quality measuresFor purposes of section
				1886(b)(3)(B)(i) for fiscal year 2010 and each subsequent fiscal year, in the
				case of a hospital that does not submit, to the Secretary in accordance with
				this section, data required to be submitted on specified quality measures (as
				defined in paragraph (4)(A)) with respect to such fiscal year, the applicable
				percentage increase under section 1886(b)(3)(B)(i) for such fiscal year shall
				be reduced by 2.0 percentage points.
							(2)Application of
				reduction only to fiscal year involvedAny reduction under
				paragraph (1) shall apply only with respect to the fiscal year involved. The
				Secretary shall not take into account such reduction in computing the
				applicable percentage increase under section 1886(b)(3)(B)(i) for a subsequent
				fiscal year.
							(3)Data
				submissionEach hospital
				shall submit to the Secretary the required data on specified quality measures
				under this section in the form and manner provided under subsection (h).
							(4)DefinitionsIn
				this section:
								(A)The term
				specified quality measures means quality measures—
									(i)specified under
				clause (vii)(II) of section 1886(b)(3)(B);
									(ii)selected under
				clause (viii) of such section; and
									(iii)selected under
				subsection (b).
									(B)The term
				hospital means a subsection (d) hospital (as defined in section
				1886(d)(1)(B)).
								(b)Addition of new
				quality measures
							(1)In
				generalIn addition to the specified quality measures described
				in clauses (i) and (ii) of subsection (a)(4)(A), the Secretary shall select
				under this subsection such quality measures as the Secretary determines to be
				appropriate for the measurement of the quality of care furnished by hospitals
				in inpatient settings.
							(2)Expansion and
				refinement of performance measuresEffective for payments
				beginning with fiscal year 2009, in selecting additional quality measures under
				paragraph (1), the Secretary shall expand and revise the baseline set of
				performance measures adopted under section 1886(b)(3)(B)(viii)(IV). Subject to
				the succeeding provisions of this subsection, the Secretary shall add such
				additional measures that reflect consensus among affected parties and, to the
				extent feasible and practicable, shall include measures set forth by one or
				more national consensus-building organizations (as defined in paragraph
				(4)(B)).
							(3)Requirement for
				evidence-based measures
								(A)In
				generalWith respect to fiscal year 2009 and each subsequent
				fiscal year, the Secretary may not add any quality measure under this
				subsection unless that quality measure—
									(i)is
				evidence-based and statistically valid;
									(ii)subject to
				paragraph (7)(C), is endorsed by the National Quality Forum or such other
				similar consensus-building organization as the Secretary may designate;
									(iii)is recommended for use by the Hospital
				Quality Alliance; and
									(iv)has been
				sufficiently tested to ensure the measure is accurate and efficacious and to
				determine the resources required of a hospital to collect and report data on
				the measure.
									(B)Prohibition on
				use of quality measure for public reporting or performance-based payment unless
				endorsed and recommendedA quality measure proposed to be added
				under this subsection may not be made available to the public under subsection
				(e) or otherwise, or used in the performance-based payment program under
				subsection (f), before the date on which the measure has been endorsed as
				provided in subparagraph (A)(ii) and recommended as provided in subparagraph
				(A)(iii).
								(4)Requirement for
				collaboration with consensus organizations
								(A)In
				generalWith respect to fiscal year 2010 and each subsequent
				fiscal year, the Secretary shall collaborate with consensus-building
				organizations to develop new quality measures in each of the following areas of
				inpatient hospital services:
									(i)Efficiency.
									(ii)Clinical
				effectiveness.
									(iii)Patient-centeredness.
									(iv)Care
				coordination.
									(v)Patient
				safety.
									(vi)Performance in
				areas where the Secretary identifies a need for an appropriate quality
				measure.
									(B)Consensus-building
				organizationFor purposes of this subsection, the term
				consensus-building organization means an organization, such as the
				National Quality Forum, that the Secretary identifies as—
									(i)having experience
				in using a transparent process for reaching a group consensus with respect to
				measures relating to performance of hospitals providing inpatient hospital
				services; and
									(ii)including in such
				process representatives of the Secretary, hospitals, physicians’ organizations,
				individuals entitled to benefits under part A, experts in health care quality,
				experts in measure development, organizations with experience in measure
				implementation, and individuals with experience in the delivery of health care
				in urban, rural, and frontier areas and to underserved populations and those
				who serve a disproportionate share of minority patients.
									(5)Alternative
				measures for patient outcomes and experience
								(A)In
				generalIn addition to the quality measures for clinical process
				selected by the Secretary under section 1886(b)(3)(B)(viii), the Secretary
				shall consider alternative methodologies to measure quality that reflect
				patient outcomes and patient experience of care measures. Of the alternative
				methodologies available for the consideration of the Secretary, quality
				measures under this paragraph shall be based on a set of criteria that include
				importance, feasibility, scientific acceptability, improvability, usability,
				controllability, potential for unintended consequences, and contribution to
				comprehensiveness.
								(B)Risk-adjustmentWith
				respect to quality measures for outcomes of care, the Secretary shall provide
				for an appropriate adjustment for such risk factors as age, disability status,
				gender, institutional status, and such other factors as the Secretary
				determines to be appropriate to maintain incentives for hospitals to treat
				patients with severe illnesses or conditions.
								(6)Submission of
				data on proposed new quality measures
								(A)Preliminary data
				submission periodWith respect to any proposed new quality
				measure identified by the Secretary as a possible addition to specified quality
				measures in effect, data that are required to be submitted by hospitals for
				that new quality measure shall be submitted for a preliminary period of such
				length as the Secretary may specify.
								(B)Confidentiality
				of informationAny data submitted under subparagraph (A) during
				the preliminary data submission period shall be treated as a confidential
				submission of information and may not be made available to the public.
								(C)Application to
				performance-based paymentsA new quality measure may not be
				incorporated in the performance-based payment program established under
				subsection (f) unless—
									(i)the preliminary
				data submission period under subparagraph (A) is completed;
									(ii)the Secretary
				ensures that data have been made available to the public under subsection (e)
				for such period as the Secretary determines to be appropriate to provide
				adequate notice to the parties concerned; and
									(iii)the requirements
				of paragraph (3) have been met.
									(7)Alignment of
				inpatient hospital quality measures with quality measures of other providers
				and suppliers
								(A)In
				generalThe Secretary shall ensure that the specified quality
				measures applicable to hospitals are coordinated with quality measures
				applicable to physicians under section 1848(k) and with quality measures
				applicable to other providers of services and suppliers under this
				title.
								(B)Use of quality
				measurement development organizationsIf the Secretary determines
				that there is evidence that a complementary quality measure in a particular
				circumstance would improve the quality of patient care, the Secretary shall
				enter into arrangements with quality measurement development organizations for
				the development of complementary quality measures for hospitals, physicians,
				and other providers of services and suppliers.
								(C)Condition for
				selectionFor purposes of paragraph (3), the Secretary may not
				accept the endorsement of a quality measure by the National Quality Forum or
				such other similar organization designated by the Secretary under paragraph
				(3)(A)(ii) unless the National Quality Forum or other organization has ensured
				the alignment of the quality measure for inpatient hospital services with one
				or more related quality measures for physicians’ services (if any).
								(c)Discontinued use
				of measures
							(1)Authority to
				discontinue use of measureThe Secretary may terminate the use of
				a specified quality measure under this section if the Secretary determines that
				the continued use of the measure is inappropriate or unnecessary by reason of
				one or more of the following rationale:
								(A)A change in
				science, technology, or practice patterns.
								(B)Subject to
				paragraph (2), a determination by the Secretary that hospitals have achieved
				uniformly high performance with respect to that measure (commonly referred to
				as a topped out measure).
								(C)A determination by
				the Secretary that the measure has been subsequently shown not to represent the
				best clinical practice.
								(D)Such other
				considerations as the Secretary determines to be appropriate.
								(2)Provisions
				relating to topped out measures
								(A)Continued
				reportingIn the case of a specified quality measure referred to
				in paragraph (1)(B), the Secretary shall require the submission of data from
				hospitals on such a measure notwithstanding that such measures shall not be
				used for purposes of the performance-based payment program under subsection
				(f).
								(B)Review of
				hospital performanceIn the case of a specified quality measure
				referred to in paragraph (1)(B), the Secretary shall monitor performance of
				hospitals on such measure to ensure that hospitals maintain high levels of
				performance.
								(C)Authority to
				reinstate
									(i)In
				generalSubject to clause (ii), for purposes of the
				performance-based payment program under subsection (f), the Secretary may
				reinstate the use of a specified quality measure referred to in paragraph
				(1)(B) that has been terminated under paragraph (1) if the Secretary determines
				that a significant percentage of hospitals fails to meet the performance
				threshold for that quality measure.
									(ii)NoticeThe
				authority under clause (i) shall not apply before the conclusion of a period,
				of not less than one year, of notice to the public indicating the intent of the
				Secretary to reinstate such specified quality measure.
									(3)Regular review
				of measuresThe Secretary shall periodically reassess specified
				quality measures to determine whether the continued use of such measures is
				appropriate and necessary for purposes of public reporting under subsection (e)
				and performance-based payment under subsection (f).
							(d)Development of
				composite measures
							(1)In
				generalThe Secretary shall combine individual specified quality
				measures into composite measures that assess the overall quality of care for a
				clinical condition or in a performance area.
							(2)ConsiderationsIn
				carrying out paragraph (1), the Secretary shall—
								(A)evaluate the
				adequacy of individual specified quality measures in each significant clinical
				condition or performance area, including the validity of such measures for the
				creation of a composite measure; and
								(B)determine the best
				methodology to report composite quality measures for those areas of clinical
				practice with a limited number of specified quality measures, including how to
				incorporate such composite measures in the performance-based payment program
				under subsection (f).
								(e)Public
				reporting
							(1)Continuation of
				public reporting requirementsProcedures established under
				subclause (VII) of section 1886(b)(3)(B)(viii) for making data submitted by a
				hospital under subclause (I) of such section available to the public shall, as
				modified by the succeeding provisions of this subsection, apply to data
				required to be submitted under this section on all specified quality
				measures.
							(2)General
				reporting requirementsThe Secretary shall report quality
				measures of process, structure, outcome, patient perspectives on care,
				efficiency, and costs of care that relate to services furnished in inpatient
				hospital settings on the Hospital Compare Internet website maintained by the
				Department of Health and Human Services.
							(3)Prompt
				dissemination of information on qualityThe Secretary shall
				review ways in which information on the quality of inpatient hospital services
				can be used more effectively by hospitals to increase the quality of patient
				care and to improve performance in the delivery of inpatient hospital services.
				The Secretary shall provide for the dissemination of appropriate and timely
				quality information to such hospitals in a manner that most effectively
				contributes to continuous quality improvement by the hospitals.
							(4)Dissemination on
				quality information to patients
								(A)In
				generalThe Secretary shall make available to the public
				information on the quality of inpatient hospital services provided by hospitals
				to patients in a manner that facilitates informed and balanced decision-making
				by patients and physicians.
								(B)Requirements for
				comparative informationInsofar as the Secretary makes
				information on the quality of inpatient hospital services provided by hospitals
				to patients available for purposes of comparison among hospitals, the Secretary
				shall only present such information by specific clinical condition or
				performance area and may not aggregate results across clinical conditions or
				performance areas or otherwise make available information indicating an overall
				ranking of hospitals.
								(5)Website
				improvements
								(A)Tailored
				standard reportsThe
				Secretary shall develop a series of standard Internet website reports tailored
				to respond to the differing needs of hospitals, patients, researchers,
				policymakers, and such other stakeholders as the Secretary may identify. The
				Secretary shall seek input from such stakeholders through such means as the
				Secretary determines to be most effective, including meetings and surveys, to
				determine the type of information that is useful to the various stakeholders
				and the format that best facilitates use of the reports and of the Hospital
				Compare Internet website maintained by the Department of Health and Human
				Services.
								(B)Information and
				formatThe Secretary shall
				modify the Hospital Compare Internet website maintained by the Department of
				Health and Human Services to make the use and navigation of that website
				readily available to individuals accessing it. The Secretary shall develop a
				flexible format to meet the differing needs of the various stakeholders and
				shall modify the website to permit a user to easily customize queries.
								(f)Performance-based
				payment program
							(1)EstablishmentThe
				Secretary shall establish a program under which performance-based payments are
				made each fiscal year to hospitals that provide high quality inpatient hospital
				services to individuals who are entitled to benefits under part A and who are
				inpatients of the hospital. The Secretary shall implement the program under
				this subsection so that performance-based payments are made to such hospitals
				in fiscal year 2011 and each subsequent fiscal year.
							(2)Adjustment in
				payment based on quality performance
								(A)Payment based on
				performance
									(i)Increase in
				amount of payment for operating costs of inpatient hospital
				servicesSubject to subparagraph (B), from payment amounts
				reduced by the Secretary for operational costs of inpatient hospital services
				of a hospital for specified diagnosis-related groups under section
				1886(d)(1)(F)(i) with respect to a fiscal year, the Secretary shall make a
				performance-based payment to that hospital for such costs for that fiscal year
				in the amount determined under clause (ii) and in the manner specified in
				section 1886(d)(1)(F)(iv).
									(ii)Methodology to
				determine the amount of paymentThe Secretary shall determine the
				amount of the performance-based payment based on the hospital’s performance on
				each specified clinical condition or performance area during the preceding year
				to individuals who are entitled to benefits under part A and are inpatients of
				the hospital using the payment and scoring methodologies contained in the
				Report to Congress submitted by the Centers for Medicare & Medicaid
				Services on November 21, 2007, as modified by the succeeding provisions of this
				subsection.
									(B)Requirement to
				submit dataIn order for a hospital to be eligible for a
				performance-based payment with respect to a fiscal year, the hospital must have
				complied with the requirements under subsection (a)(1) to submit data for
				specified quality measures.
								(C)Measured
				clinical conditions for performance-based payments in fiscal year 2011
									(i)Conditions
				measuredWith respect to performance-based payments made to a
				hospital under this paragraph in fiscal year 2011, the Secretary shall measure
				quality performance only for the following four specific conditions or clinical
				performance areas: acute myocardial infarction (AMI), heart failure, pneumonia,
				and Surgical Care Improvement Project (formerly referred to as Surgical
				Infection Prevention for discharges occurring before July 2006).
									(ii)Measures cited
				in november 2007 cms report to congressIn measuring quality
				performance for the conditions specified under clause (i), the Secretary shall
				use the specified quality measures identified as initial performance measures
				in the report referred to in subparagraph (A)(ii).
									(iii)HCAHPS
				measures excluded from initial performance-based payments
										(I)In
				generalIn measuring quality
				performance under clause (i), except as provided in subclause (II), the
				Secretary may not include specified quality measures with respect to the
				Hospital Consumer Assessment of Healthcare Providers and Systems Survey
				(HCAHPS).
										(II)Use in
				subsequent yearsSubject to subparagraph (D)(ii), the Secretary
				shall collect data on measures relating to assessment of care by consumers and
				make refinements to such measures for use in measuring performance for fiscal
				years after fiscal year 2011 for performance-based payments under this
				paragraph.
										(iv)30-day
				mortality measures excluded from initial performance-based payments
										(I)In
				generalIn measuring quality performance under clause (i), except
				as provided in subclause (II), the Secretary may not include specified quality
				measures with respect to mortality.
										(II)Use in
				subsequent yearsSubject to subparagraph (D)(ii), the Secretary
				may include specified quality measures with respect to 30-day mortality rates
				for use in measuring performance for fiscal years after fiscal year 2011 for
				performance-based payments under this paragraph insofar as the Secretary
				establishes a mechanism for hospitals to receive timely information from the
				Secretary to enable hospitals to evaluate performance on such measures.
										(D)Measured clinical
				conditions and performance areas for fiscal years after fiscal year
				2011
									(i)In
				generalSubject to clause (ii), with respect to performance-based
				payments made to a hospital under this paragraph during a fiscal year after
				fiscal year 2011, the Secretary may expand the specified quality measures used
				in measuring performance under subparagraph (C) for performance-based payments
				under this paragraph for fiscal year 2011.
									(ii)Requirement for
				notice and comment rulemakingThe Secretary may only exercise the
				authority under clause (i) by regulation, after notice of the proposed
				regulation in the Federal Register and a period of not less than 60 days for
				public comment thereon.
									(E)Advance
				publication of full-incentive benchmarksThe Secretary shall
				provide for the publication of full-incentive quality benchmarks (determined
				under paragraph (4)(C)) sufficiently in advance of a fiscal year so that
				hospitals may make such changes as are required to meet full-incentive quality
				benchmarks applicable during the fiscal year involved, and in no case shall the
				publication of the full-incentive quality benchmark be later than two years
				before the start of the fiscal year involved.
								(3)Determination of
				hospital performance
								(A)Methodology for
				scoresThe Secretary shall evaluate the performance of each
				hospital for the purpose of determining performance-based payments under
				paragraph (2). Subject to subparagraph (B), the Secretary shall determine a set
				of performance scores for each such hospital based on the performance scoring
				methodology described in the report referred to in paragraph (2)(A)(ii).
								(B)Calculation of
				separate scores by clinical condition or performance areaThe
				Secretary shall calculate composite performance scores separately for each
				specified clinical condition or performance area. The Secretary may not
				calculate a single overall performance score for each hospital.
								(C)Consideration of
				results and improvementIn calculating performance scores for
				each specified quality measure for each specified clinical condition or
				performance area, the Secretary shall determine a score for both the
				performance level attained by the hospital and the degree of improvement of the
				performance of the hospital. The final score for each such measure shall be
				equal to the greater of such attainment or such degree of improvement on the
				measure.
								(D)Equal weight for
				individual measuresIn calculating a composite performance score
				for each specified clinical condition or performance area, the Secretary shall
				weight equally the individual specified quality measures involved in assessing
				performance for such clinical condition or area.
								(E)Requirement for
				notice and comment rulemakingThe Secretary shall describe in
				detail the methodology to be used to calculate performance scores under this
				subparagraph by regulation, after notice of the proposed regulation in the
				Federal Register and a period of not less than 60 days for public comment
				thereon.
								(4)Calculation of
				performance-based payment amount
								(A)Methodology
									(i)Report
				proposalSubject to the succeeding provisions of this subsection,
				the Secretary shall calculate the amount of performance-based payment under
				paragraph (2) for a hospital by converting performance scores of a hospital to
				a payment amount for that hospital using the methodology contained in the
				report referred to in paragraph (2)(A)(ii).
									(ii)Requirement for
				notice and comment rulemakingThe Secretary shall describe in
				detail the methodology to be used to calculate the amount of performance-based
				payment under paragraph (2) by regulation, after notice of the proposed
				regulation in the Federal Register and a period of not less than 60 days for
				public comment thereon.
									(B)Minimum
				threshold
									(i)In
				generalThe Secretary shall establish a performance threshold for
				a fiscal year of zero for all specified clinical conditions or performance
				areas.
									(ii)Performance
				thresholdNo amount of performance-based payment under paragraph
				(2) for a fiscal year may be made to a hospital unless the performance score of
				that hospital with respect a specified clinical condition or performance area
				during the preceding fiscal year exceeds the performance threshold established
				under clause (i).
									(C)Full-incentive
				quality benchmark
									(i)In
				generalThe Secretary shall determine for each fiscal year a
				performance level for each clinical condition or performance area under a
				quality benchmark which, if met by a hospital, would qualify the hospital to
				receive 100 percent of the performance-based payment amount available under
				paragraph (2) for the associated diagnosis-related groups.
									(ii)Determination
				of levels
										(I)Initial
				levelThe performance level referred to in clause (i) shall be
				initially set at a level that the Secretary determines that all hospitals can
				reasonably achieve.
										(II)Modification of
				levelsThe Secretary may revise the performance level set under
				subclause (I) to a higher level from time to time as hospital performance
				improves.
										(iii)Considerations
				in setting levelsIn determining such performance level, the
				Secretary shall take into account practical experience with specified quality
				measures involved, historical performance levels, improvement rates, the
				opportunity for continued improvement, and the results of the review of
				benchmarks conducted under paragraph (5).
									(5)Review and
				modification of benchmarks
								(A)In
				generalThe Secretary shall reevaluate a quality benchmark
				established under this subsection if the Secretary determines with respect to a
				fiscal year that a significant proportion of hospitals failed to meet the
				benchmark. The Secretary shall determine whether extenuating circumstances,
				such as measure definition changes, prevented hospitals from meeting the
				benchmark.
								(B)Modification for
				performance-based paymentsThe Secretary may make modifications
				to a benchmark described in subparagraph (A), as applied to measure hospital
				performance in a fiscal year, and reassess such hospital performance in that
				fiscal year using such modified benchmark for purposes of calculating the
				amount of performance-based-payment under paragraph (2).
								(6)Budget
				neutrality for payments
								(A)Requirement for
				budget neutralityThe
				aggregate amount available for performance-based payments to hospitals under
				paragraph (2) with respect to a fiscal year may not exceed the aggregate amount
				of reductions described in subsection (g)(1) for the fiscal year and such
				performance-based payments shall be designed in a manner so that the aggregate
				of such payments for a fiscal year is equal to the aggregate amount of such
				reductions for the fiscal year.
								(B)Method and
				timingPerformance-based payments to hospitals under this
				subsection shall be made from the Federal Hospital Insurance Trust Fund under
				section 1817. Performance-based payments shall be made to a hospital under this
				subsection with respect to a fiscal year based on quality performance for the
				12-month period ending June 30th of the prior fiscal year.
								(7)Performance-based
				bonus payment for highest performing hospitals
								(A)In
				generalThe Secretary shall establish a program to reward those
				hospitals with high performance scores, as determined by the Secretary, in a
				fiscal year through the making of performance-based bonus payments.
								(B)Additional
				paymentPerformance-based bonus payments made under the program
				established in subparagraph (A) in a fiscal year shall be in addition to
				performance-based payments made under paragraph (2) in that fiscal year.
								(C)Determination of
				payment amountPerformance-based bonus payments under the program
				established in subparagraph (A) shall be made in such amount as the Secretary
				determines to be appropriate.
								(D)Required
				aggregate amount of paymentsThe Secretary shall make aggregate
				payments in a fiscal year under the performance-based bonus payment program
				established in subparagraph (A) in an amount equal to the difference between
				the aggregate amount of reductions under section 1886(d)(1)(F)(i) for the
				fiscal year involved and the aggregate amount of performance-based payments
				made under paragraph (2) for such fiscal year.
								(8)Additional
				performance-based incentive payments
								(A)Independent
				actuarial estimate of savingsWith respect to each fiscal year
				beginning after fiscal year 2009, the Secretary shall enter into arrangements
				for the analysis by a qualified independent entity or organization of the
				actuarial value of cost savings under part A attributable to the improvement in
				the delivery of inpatient hospital services by hospitals by reason of this
				section.
								(B)Performance-based
				incentive payment fund
									(i)In
				generalAmounts identified as savings under subparagraph (A) for
				a fiscal year shall be available to the Secretary to make performance-based
				payments in addition to those available under paragraphs (2) and (7) as
				incentives to hospitals to continue to improve the quality of inpatient
				hospital services provided to patients.
									(ii)Incentive
				paymentsAdditional payments under clause (i) shall be made in
				such form, manner, and periodicity as the Secretary may specify, and may
				include payments to physicians furnishing physicians’ services as part of
				inpatient hospital services based on the results of performance measures on
				quality of care furnished and volume of patients treated.
									(9)Alternative
				performance measure
								(A)In
				generalThe Secretary shall evaluate the appropriateness of
				applying an alternative method for the measurement of the quality of care
				provided by hospitals to individuals who are entitled to benefits under part A
				and who are inpatients of the hospitals.
								(B)MethodologyThe
				alternative method under subparagraph (A) shall measure the extent to which
				such individuals are reliably being provided evidence-based care by hospitals,
				expressed as the percentage of occasions on which a hospital provides the
				individual with all of the appropriate actions identified under quality
				measures during a fiscal year.
								(C)Public
				availabilityThe Secretary shall measure the performance of
				hospitals using the alternative method under subparagraph (A), and shall make
				the results of such performance measurement available to the public.
								(D)Use for
				evaluation of future measuresThe Secretary shall evaluate the
				appropriateness of using the alternative measure under subparagraph (A) for the
				purpose of making performance-based payments under this subsection.
								(g)Financing
							(1)Reduction in drg
				payment amountThe Secretary shall make performance-based
				payments under paragraphs (2) and (7) of subsection (f) from amounts credited
				to the Federal Hospital Insurance Trust Fund under section 1817 in the fiscal
				year by reason of the application of the reduction under section
				1886(d)(1)(F)(i).
							(2)No effect on
				adjustments for outlier, ime, dsh, or capital-related costsThe
				adjustments under paragraphs (5)(A), (5)(B), and (5)(F) of section 1886(d), and
				payments for capital-related costs under section 1886(g), shall be computed
				without regard to the adjustments made by reason of section
				1886(d)(1)(F).
							(h)Provisions
				relating to data submission
							(1)In
				generalSubject to the succeeding provisions of this subsection,
				each hospital shall submit data on measures selected under this section to the
				Secretary in a form and manner, and at a time, specified by the Secretary for
				purposes of subsection (a).
							(2)Data submission
				and resubmission
								(A)Period for
				submission and validationThe Secretary shall provide a 135-day
				period after the close of a calendar quarter for hospitals to submit data
				required under subsection (a) for such quarter.
								(B)Resubmission
				period
									(i)In
				generalSubject to clause (ii), insofar as an additional period
				of time is required after the end of the 135-day period referred to in
				subparagraph (A) to correct errors with respect to the data submitted by
				hospitals, the Secretary shall provide for an additional 30-day period,
				beginning on the day after the date of the end of such 135-day period, for the
				correction of such errors and resubmission of the revised data.
									(ii)ExceptionThe
				Secretary may not provide for an additional 30-day period under clause (i) if
				the data submitted by the hospital have been used to determine an amount
				performance-based payments under subsection (f) for that hospital.
									(C)Report on
				shorter timeframeThe Secretary shall submit to Congress a report
				on the feasibility and advisability of reducing the length of the 135-day
				period under subparagraph (A) to 60 days for the submission and validation of
				data.
								(3)Validation of
				data
								(A)Implementation
				of processThe Secretary shall implement a process for the
				validation of data submitted by hospitals under subsection (a). Such process
				shall provide for the selection of hospitals with respect to data submitted by
				such hospitals on both a random basis and on the basis of specific criteria,
				and shall include standards for the validation of data at the level of
				specified quality measures.
								(B)Validation for
				new quality measuresWith respect to proposed new quality
				measures, the Secretary shall not establish standards for the validation of
				data for the period of time that the Secretary determines hospitals require to
				gain experience with the new quality measures to properly report data with
				respect to such measure. The Secretary may use processes such as re-abstraction
				and validation as a learning tool for hospitals instead of establishing such
				standards.
								(4)Opportunity to
				review dataThe Secretary shall provide a hospital the
				opportunity to review data reported by the hospital before such data is made
				available to the public under subsection (e) or used for purposes of the
				performance-based payment program under subsection (f).
							(i)Rule of
				construction with respect to appeal rightsNothing in this section shall be construed
				as effecting the right of a subsection (d) hospital to seek reconsideration or
				judicial review under section 1869, 1878, or otherwise of a determination of
				the Secretary with respect to the provisions of this section, including the
				application of the performance-based payment program.
						(j)Reports to
				Congress
							(1)Quality
				assessmentsThe Secretary
				shall conduct assessments of the quality measurement and performance-based
				payment program under this section, which shall be used in developing the
				reports under paragraph (2).
							(2)Reports based on
				assessmentsThe Secretary
				shall submit to Congress by not later than March 31, 2012, and every 18 months
				thereafter, a report that—
								(A)identifies the
				accomplishments of the program under this section;
								(B)identifies any
				unintended consequences of such program for hospitals and patients;
								(C)provides
				recommendations for legislative and other modifications to the program;
								(D)includes evidence
				indicating changes in access to, quality of, and efficiency and outcomes in
				care related to the program;
								(E)assesses the
				program’s impact on disparities in care by race and ethnicity; and
								(F)identifies the
				impact of the program on hospitals of differing size and patient acuity levels,
				including safety net hospitals and hospitals with a substantial medical
				education commitment.
								(3)GAO
				evaluationNot later than September 30, 2012, the Comptroller
				General shall conduct an independent evaluation of the impact of the program
				under this section on hospitals and patients. Such evaluation shall include the
				items described in paragraph (2) as well as barriers to the program achieving
				its full
				potential.
							.
			(b)Conforming
			 amendments to quality reporting and payment under inpatient hospital
			 prospective payment system
				(1)Reporting of
			 quality dataSection 1886(b)(3)(B) of the Social Security Act (42
			 U.S.C. 1395ww(b)(3)(B)) is amended—
					(A)in clause (i), by
			 inserting and subject to section 1886A(a)(1), after
			 during a fiscal year,; and
					(B)in the first
			 sentence of clause (viii)(I)—
						(i)by
			 inserting after each subsequent fiscal year the following
			 before 2014; and
						(ii)by
			 inserting before the period at the end the following: (or 1.5, 1.0, and
			 0.5 percentage points in the case of fiscal years 2011, 2012, and 2013,
			 respectively).
						(2)Adjustment to
			 payments for operating costs of inpatient hospital
			 servicesSection 1886(d)(1) of such Act (42 U.S.C. 1395ww(d)(1))
			 is amended by adding at the end the following new subparagraph:

						(F)Adjustment for
				performance-based payment program
							(i)Targeted
				reductions
								(I)In
				generalSubject to subclause (II), in the case of a subsection
				(d) hospital that complies with the data submission requirements under section
				1886A(a)(1) for a fiscal year, beginning with fiscal year 2011, the Secretary
				shall reduce the amount of the payment with respect to the operating costs of
				inpatient hospital services determined under subparagraph (A) for specified
				diagnosis-related groups (as defined in clause (ii)) for that fiscal year by
				the performance-based payment offset percent (as defined in clause
				(iii)).
								(II)ExceptionThere
				shall be no reduction under subclause (I) by reason of clause (ii)(II) before
				fiscal year 2012.
								(ii)Specified
				diagnosis-related groups defined
								(I)Diagnosis-related
				groups evaluated under composite performance measuresFor
				purposes of clause (i) and subject to subclause (II), the term specified
				diagnosis-related groups means only those diagnosis-related groups that
				are evaluated through specified quality measures (as defined in section
				1886A(a)(4)(A))—
									(aa)that are used for
				a fiscal year to measure the performance of a subsection (d) hospital under
				section 1886A(f) for purposes of performance-based payments to that hospital
				under paragraph (2) or (7) of such section;
									(bb)that have been recommended by the Hospital
				Quality Alliance; and
									(cc)data from which are made publicly available
				through the use of the Hospital Compare Internet website maintained by the
				Department of Health and Human Services (or such similar website of the
				Department) as meets the requirements of section 1886A(e).
									(II)Across the board
				application for hcahpsWith respect only to specified quality
				measures relating to the Hospital Consumer Assessment of Healthcare Providers
				and Systems Survey (HCAHPS) and for which a diagnosis-related group is eligible
				to report, such term includes a group. Nothing in this subclause shall be
				construed as applying a reduction under this subparagraph to hospitals that are
				not subsection (d) hospitals.
								(iii)Performance-based
				payment offset percent
								(I)In
				generalFor purposes of clause (i) and subject to subclauses (II)
				and (III), the term performance-based payment offset percent means
				the percent determined by the Secretary for a fiscal year that results in
				aggregate reductions in payments under clause (i) in that fiscal year in an
				amount equal to the aggregate amount of performance-based payments that the
				Secretary elects to make under section 1886A(f)(2) for that fiscal year.
								(II)Individual
				maximum offsetsSubject to subclause (III), in no case may the
				percent determined under subclause (I) for a fiscal year exceed—
									(aa)with respect to
				specified quality measures described in clause (ii)(I), 2.0 percent; and
									(bb)with respect to
				specified quality measures described in clause (ii)(II), 0.25 percent.
									(III)Aggregate
				maximum offsetIn no case may the percent determined under
				subclause (I) for a fiscal year exceed—
									(aa)0.50 percent for
				fiscal year 2011;
									(bb)1.0
				percent for fiscal year 2012;
									(cc)1.5
				percent for fiscal year 2013; and
									(dd)2.0
				percent for fiscal year 2014 and succeeding years.
									(iv)Increase in pps
				payment amount for performance-based paymentIn the case of a
				subsection (d) hospital that received a performance-based payment under
				paragraph (2) or (7), or both, of section 1886A(f) for a fiscal year for a
				specified diagnosis-related group, the amount of the payment with respect to
				the operating costs of inpatient hospital services determined under
				subparagraph (A) for such specified diagnosis-related group shall be increased
				by the amount of such performance-based payment or payments for that fiscal
				year.
							.
				3.Consultation for
			 appropriate application of performance-based payments to small
			 hospitals
			(a)ConsultationThe
			 Secretary of Health and Human Services shall consult with representatives of
			 small hospitals, including critical access hospitals under section 1820 of the
			 Social Security Act (42 U.S.C. 1395i–4), to determine appropriate and effective
			 methods for such hospitals to participate in programs for performance-based
			 payments for inpatient hospital services (or inpatient critical access hospital
			 services) furnished to individuals who are entitled to benefits under part A of
			 title XVIII of the Social Security Act (42 U.S.C. 1395c et seq.) and who are
			 inpatients of the hospitals.
			(b)ConsiderationThe
			 Secretary shall consider innovative methods of measuring and rewarding quality
			 inpatient hospital services furnished by small hospitals, including critical
			 access hospitals, which may be difficult to quantify due to the low volume of
			 services provided by such hospitals for which quality measures have been
			 developed.
			(c)Report to
			 congressNot later than two years after the date of enactment of
			 this Act, the Secretary shall submit to Congress a report on the consultation
			 required under this section. The report shall include recommendations of the
			 Secretary with respect to the appropriate application of performance-based
			 payment and payment incentive programs to small hospitals, including critical
			 access hospitals, for the provision of quality inpatient hospital
			 services.
			4.Priority of
			 assistance from quality improvement organizations and other quality
			 organizations for hospitals with results below performance-based payment
			 benchmarks
			(a)Priority of
			 assistance to low-performing hospitalsSection 1154(a) of the Social Security Act
			 (42 U.S.C. 1320c–3(a)) is amended by adding at the end the following new
			 paragraph:

					(18)(A)The organization shall
				give priority in the provision of quality improvement assistance to subsection
				(d) hospitals that fail to meet quality benchmarks established under section
				1886A(f).
						(B)In this paragraph, the term
				quality improvement assistance includes the following:
							(i)Education on quality improvement
				initiatives, strategies, and techniques.
							(ii)Instruction on how to collect,
				submit, aggregate, and interpret data on measures used for quality improvement,
				public reporting, and payment under section 1886A.
							(iii)Technical assistance to support
				quality improvement.
							(iv)Technical assistance and
				instruction in the conduct of root-cause analyses.
							(v)Facilitating adoption of procedures
				that encourage timely candid feedback from patients and their families
				concerning perceived problems.
							(vi)Guidance on redesigning clinical
				processes, including the adoption and effective use of health information
				technology, to improve the coordination, effectiveness, and safety of
				care.
							.
			(b)Evaluation of
			 quality improvement organizationsSection 1153(c)(2) of such Act
			 (42 U.S.C. 1320c–2(c)(2)) is amended by inserting before the semicolon at the
			 end the following: , including the effectiveness of the organization in
			 improving the ability of a hospital referred to in section 1154(a)(18)(A) to
			 meet quality benchmarks established under section 1886A(f).
			(c)Assistance from
			 alternative quality organizationsSection 1886A of the Social
			 Security Act, as inserted by section 2(a), is amended—
				(1)by redesignating
			 subsection (j) as subsection (k); and
				(2)by
			 inserting after subsection (i) the following new subsection (j):

						(j)Assistance from
				alternative quality organizations
							(1)Private quality
				organizationsThe Secretary shall establish a program under which
				a hospital seeking to improve the quality of the provision of inpatient
				hospital services based on the results of a performance evaluation under this
				section may apply to the Secretary to receive quality improvement assistance
				from a private quality organization with expertise in supporting improvement in
				the quality of the provision of inpatient hospital services.
							(2)AccreditationBefore
				entering into arrangements with a private quality organization for the
				provision of assistance under paragraph (1), the Secretary shall ensure that
				the organization has been accredited or certified by a recognized accreditation
				or certification agency or body.
							(3)PaymentThe
				rate of payment for quality assistance services provided by a private quality
				organization under paragraph (1) shall be negotiated by the Secretary. Payment
				shall be made by the Secretary from funds made available under part B of title
				XI title for the payment of organizations with contracts with the Secretary
				under such
				part.
							.
				(d)NQF funding
			 authorizationThere are
			 authorized to be appropriated to the Secretary of Health and Human Services
			 $10,000,000 for each of 5 fiscal years to enter into arrangements with the
			 National Quality Forum for the development of quality measures that may be
			 applied under section 1886A of the Social Security Act, as inserted by section
			 2(a).


116 HRES 80 EH: Ranking certain Members of a certain standing committees of the House of Representatives.
U.S. House of Representatives
2019-01-28
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

IV
116th CONGRESS
1st Session
H. RES. 80
In the House of Representatives, U. S.,

January 28, 2019

RESOLUTION
Ranking certain Members of a certain standing committees of the House of Representatives.

That the following named Members be, and are hereby, ranked as follows on the following standing committees of the House of Representatives: Committee on Education and Labor:Mr. Walker (to rank immediately after Mr. Banks).

Committee on Homeland Security:Mr. McCaul (to rank immediately after Mr. King of New York); and Mr. Higgins of Louisiana (to rank immediately after Mr. Walker).   Karen L. Haas,Clerk.


116 HR 8915 IH: Preparing Superfund for Climate Change Act of 2020
U.S. House of Representatives
2020-12-09
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

I116th CONGRESS2d SessionH. R. 8915IN THE HOUSE OF REPRESENTATIVESDecember 9, 2020Mr. Cleaver (for himself and Ms. Bass) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Transportation and Infrastructure, 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 concernedA BILLTo amend the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 to provide for the consideration of climate change, and for other purposes.1.Short titleThis Act may be cited as the Preparing Superfund for Climate Change Act of 2020.2.Climate change mitigationSection 121 of the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (42 U.S.C. 9621) is amended—(1)in subsection (b)(1), in the fifth sentence—(A)in the matter preceding subparagraph (A), by striking account: and inserting account—;(B)in subparagraph (F), by striking and at the end;(C)in subparagraph (G), by striking the period at the end and inserting ; and; and(D)by inserting after subparagraph (G) the following:(H)the potential threat to human health and the environment associated with local natural disasters and extreme weather hazards, including any projected exacerbation or change in those disasters and hazards due to climate change.; and(2)in subsection (c), by inserting after the first sentence the following: The President shall include in the review an assessment of whether the selected remedial action remains protective after taking into account local natural disasters and extreme weather hazards, including any projected exacerbation or change in those disasters and hazards due to climate change..