Consultation. Public "(b) IDENTIFICATION OF QUALITY MEASURES.— "(1) IDENTIFICATION.-The Secretary, in consultation with the Director of the Agency for Healthcare Research and Quality and the Administrator of the Centers for Medicare & Medicaid Services, shall identify, not less often than triennially, gaps where no quality measures exist and existing quality measures that need improvement, updating, or expansion, consistent with the national strategy under section 399HH, to the extent available, for use in Federal health programs. In identifying such gaps and existing quality measures that need improvement, the Secretary shall take into consideration "(A) the gaps identified by the entity with a contract under section 1890(a) of the Social Security Act and other stakeholders; "(B) quality measures identified by the pediatric quality measures program under section 1139A of the Social Security Act; and "(C) quality measures identified through the Medicaid Quality Measurement Program under section 1139B of the Social Security Act. "(2) PUBLICATION.-The Secretary shall make available to the public on an Internet website a report on any gaps identified under paragraph (1) and the process used to make such identification. "(c) GRANTS OR CONTRACTS FOR QUALITY MEASURE DEVELOP MENT. “(1) IN GENERAL.-The Secretary shall award grants, contracts, or intergovernmental agreements to eligible entities for purposes of developing, improving, updating, or expanding quality measures identified under subsection (b). "(2) PRIORITIZATION IN THE DEVELOPMENT OF QUALITY MEASURES. In awarding grants, contracts, or agreements under this subsection, the Secretary shall give priority to the development of quality measures that allow the assessment of— "(A) health outcomes and functional status of patients; "(B) the management and coordination of health care across episodes of care and care transitions for patients across the continuum of providers, health care settings, and health plans; "(C) the experience, quality, and use of information provided to and used by patients, caregivers, and authorized representatives to inform decisionmaking about treatment options, including the use of shared decisionmaking tools and preference sensitive care (as defined in section 936); "(D) the meaningful use of health information technology; "(E) the safety, effectiveness, patient-centeredness, appropriateness, and timeliness of care; "(F) the efficiency of care; "(G) the equity of health services and health disparities across health disparity populations (as defined in section 485E) and geographic areas; "(H) patient experience and satisfaction; "(I) the use of innovative strategies and methodologies identified under section 933; and “(J) other areas determined appropriate by the Sec "(3) ELIGIBLE ENTITIES.-To be eligible for a grant or contract under this subsection, an entity shall— "(A) have demonstrated expertise and capacity in the development and evaluation of quality measures; "(B) have adopted procedures to include in the quality measure development process "(i) the views of those providers or payers whose performance will be assessed by the measure; and "(ii) the views of other parties who also will use the quality measures (such as patients, consumers, and health care purchasers); "(C) collaborate with the entity with a contract under section 1890(a) of the Social Security Act and other stakeholders, as practicable, and the Secretary so that quality measures developed by the eligible entity will meet the requirements to be considered for endorsement by the entity with a contract under such section 1890(a); "(D) have transparent policies regarding governance and conflicts of interest; and "(E) submit an application to the Secretary at such time and in such manner, as the Secretary may require. “(4) USE OF FUNDS.-An entity that receives a grant, con- Requirements. tract, or agreement under this subsection shall use such award to develop quality measures that meet the following require ments: "(A) Such measures support measures required to be reported under the Social Security Act, where applicable, and in support of gaps and existing quality measures that need improvement, as described in subsection (b)(1)(A). "(B) Such measures support measures developed under section 1139A of the Social Security Act and the Medicaid Quality Measurement Program under section 1139B of such Act, where applicable. "(C) To the extent practicable, data on such quality measures is able to be collected using health information technologies. "(D) Each quality measure is free of charge to users of such measure. "(E) Each quality measure is publicly available on an Internet website. "(d) OTHER ACTIVITIES BY THE SECRETARY.-The Secretary may use amounts available under this section to update and test, where applicable, quality measures endorsed by the entity with a contract under section 1890(a) of the Social Security Act or adopted by the Secretary. "(e) COORDINATION OF GRANTS.-The Secretary shall ensure that grants or contracts awarded under this section are coordinated with grants and contracts awarded under sections 1139A(5) and 1139B(4)(A) of the Social Security Act.". (b) SOCIAL SECURITY ACT.-Section 1890A of the Social Security Act, as added by section 3014(b), is amended by adding at the end the following new subsection: "(e) DEVELOPMENT OF QUALITY MEASURES.-The Administrator of the Center for Medicare & Medicaid Services shall through contracts develop quality measures (as determined appropriate by the Administrator) for use under this Act. In developing such measures, the Administrator shall consult with the Director of the Agency for Healthcare Research and Quality.". (c) FUNDING.-There are authorized to be appropriated to the Secretary of Health and Human Services to carry out this section, $75,000,000 for each of fiscal years 2010 through 2014. Of the amounts appropriated under the preceding sentence in a fiscal year, not less than 50 percent of such amounts shall be used pursuant to subsection (e) of section 1890A of the Social Security Act, as added by subsection (b), with respect to programs under such Act. Amounts appropriated under this subsection for a fiscal year shall remain available until expended. SEC. 3014. QUALITY MEASUREMENT. (a) NEW DUTIES FOR CONSENSUS-BASED ENTITY.— (1) MULTI-STAKEHOLDER GROUP INPUT.-Section 1890(b) of the Social Security Act (42 U.S.C. 1395aaa(b)), as amended by section 3003, is amended by adding at the end the following new paragraphs: "(7) CONVENING MULTI-STAKEHOLDER GROUPS.— "(A) IN GENERAL.-The entity shall convene multistakeholder groups to provide input on "(i) the selection of quality measures described in subparagraph (B), from among "(I) such measures that have been endorsed by the entity; and "(II) such measures that have not been considered for endorsement by such entity but are used or proposed to be used by the Secretary for the collection or reporting of quality measures; and "(ii) national priorities (as identified under section 399HH of the Public Health Service Act) for improvement in population health and in the delivery of health care services for consideration under the national strategy established under section 399HH of the Public Health Service Act. "(B) QUALITY MEASURES.— “(i) IN GENERAL.-Subject to clause (ii), the quality measures described in this subparagraph are quality measures "(I) for use pursuant to sections 1814(i)(5)(D), 1833(i)(7), 1833(t)(17), 1848(k)(2)(C), 1866(k)(3), 1881(h)(2)(A)(iii), 1886(b)(3)(B)(viii), 1886(j)(7)(D), 1886(m)(5)(D), 1886(o)(2), and 1895(b)(3)(B)(v); "(II) for use in reporting performance information to the public; and "(III) for use in health care programs other than for use under this Act. "(ii) EXCLUSION.-Data sets (such as the outcome and assessment information set for home health services and the minimum data set for skilled nursing facility services) that are used for purposes of classification systems used in establishing payment rates under this title shall not be quality measures described in this subparagraph. "(C) REQUIREMENT FOR TRANSPARENCY IN PROCESS. “(i) IN GENERAL.-In convening multi-stakeholder groups under subparagraph (A) with respect to the selection of quality measures, the entity shall provide for an open and transparent process for the activities conducted pursuant to such convening. GROUPS.-The "(ii) SELECTION OF ORGANIZATIONS PARTICIPATING IN MULTI-STAKEHOLDER process described in clause (i) shall ensure that the selection of representatives comprising such groups provides for public nominations for, and the opportunity for public comment on, such selection. "(D) MULTI-STAKEHOLDER GROUP DEFINED.-In this paragraph, the term 'multi-stakeholder group' means, with respect to a quality measure, a voluntary collaborative of organizations representing a broad group of stakeholders interested in or affected by the use of such quality measure. "(8) TRANSMISSION OF MULTI-STAKEHOLDER INPUT.-Not Deadline. later than February 1 of each year (beginning with 2012), the entity shall transmit to the Secretary the input of multistakeholder groups provided under paragraph (7).". (2) ANNUAL REPORT.-Section 1890(b)(5)(A) of the Social Security Act (42 U.S.C. 1395aaa(b)(5)(A)) is amended (A) in clause (ii), by striking “and” at the end; (B) in clause (iii), by striking the period at the end and inserting a semicolon; and (C) by adding at the end the following new clauses: "(iv) gaps in endorsed quality measures, which shall include measures that are within priority areas identified by the Secretary under the national strategy established under section 399HH of the Public Health Service Act, and where quality measures are unavailable or inadequate to identify or address such gaps; "(v) areas in which evidence is insufficient to support endorsement of quality measures in priority areas identified by the Secretary under the national strategy established under section 399HH of the Public Health Service Act and where targeted research may address such gaps; and "(vi) the matters described in clauses (i) and (ii) of paragraph (7)(A).”. (b) MULTI-STAKEHOLDER GROUP INPUT INTO SELECTION OF QUALITY MEASURES.-Title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) is amended by inserting after section 1890 the following: "QUALITY MEASUREMENT "SEC. 1890A. (a) MULTI-STAKEHOLDER GROUP INPUT INTO SELECTION OF QUALITY MEASURES.-The Secretary shall establish a pre-rulemaking process under which the following steps occur with respect to the selection of quality measures described in section 1890(b)(7)(B): “(1) INPUT.—Pursuant to section 1890(b)(7), the entity with a contract under section 1890 shall convene multi-stakeholder groups to provide input to the Secretary on the selection of quality measures described in subparagraph (B) of such paragraph. Deadlines. 42 USC 1395aaa-1. Regulations. Federal Register, publication. Public information. "(2) PUBLIC AVAILABILITY OF MEASURES CONSIDERED FOR SELECTION.-Not later than December 1 of each year (beginning with 2011), the Secretary shall make available to the public a list of quality measures described in section 1890(b)(7)(B) that the Secretary is considering under this title. "(3) TRANSMISSION OF MULTI-STAKEHOLDER INPUT.-Pursuant to section 1890(b)(8), not later than February 1 of each year (beginning with 2012), the entity shall transmit to the Secretary the input of multi-stakeholder groups described in paragraph (1). "(4) CONSIDERATION OF MULTI-STAKEHOLDER INPUT.-The Secretary shall take into consideration the input from multistakeholder groups described in paragraph (1) in selecting quality measures described in section 1890(b)(7)(B) that have been endorsed by the entity with a contract under section 1890 and measures that have not been endorsed by such entity. "(5) RATIONALE FOR USE OF QUALITY MEASURES.-The Secretary shall publish in the Federal Register the rationale for the use of of any quality measure described in section 1890(b)(7)(B) that has not been endorsed by the entity with a contract under section 1890. "(6) ASSESSMENT OF IMPACT.-Not later than March 1, 2012, and at least once every three years thereafter, the Secretary shall— "(A) conduct an assessment of the quality impact of the use of endorsed measures described in section 1890(b)(7)(B); and "(B) make such assessment available to the public. "(b) PROCESS FOR DISSEMINATION OF MEASURES USED BY THE SECRETARY. "(1) IN GENERAL.-The Secretary shall establish a process for disseminating quality measures used by the Secretary. Such process shall include the following: "(A) The incorporation of such measures, where applicable, in workforce programs, training curricula, and any other means of dissemination determined appropriate by the Secretary. "(B) The dissemination of such quality measures through the national strategy developed under section 399HH of the Public Health Service Act. "(2) EXISTING METHODS.-To the extent practicable, the Secretary shall utilize and expand existing dissemination methods in disseminating quality measures under the process established under paragraph (1). "(c) REVIEW OF QUALITY MEASURES USED BY THE SECRETARY.— "(1) IN GENERAL.-The Secretary shall— "(A) periodically (but in no case less often than once every 3 years) review quality measures described in section 1890(b)(7)(B); and "(B) with respect to each such measure, determine whether to "(i) maintain the use of such measure; or "(ii) phase out such measure. "(2) CONSIDERATIONS.-In conducting the review under paragraph (1), the Secretary shall take steps to "(A) seek to avoid duplication of measures used; and |