U.S Code last checked for updates: Nov 22, 2024
§ 1395aaa–1.
Quality and efficiency measurement
(a)
Multi-stakeholder group input into selection of quality and efficiency measures
The Secretary shall establish a pre-rulemaking process under which the following steps occur with respect to the selection of quality and efficiency measures described in section 1395aaa(b)(7)(B) of this title:
(1)
Input
(2)
Public availability of measures considered for selection
(3)
Transmission of multi-stakeholder input
(4)
Consideration of multi-stakeholder input
(5)
Rationale for use of quality and efficiency measures
(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 and efficiency impact of the use of endorsed measures described in section 1395aaa(b)(7)(B) of this title; 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 and efficiency 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 and efficiency measures through the national strategy developed under section 280j of this title.
(2)
Existing methods
(c)
Review of quality and efficiency 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 and efficiency measures described in section 1395aaa(b)(7)(B) of this title; 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
(B)
take into consideration current innovative methodologies and strategies for quality and efficiency improvement practices in the delivery of health care services that represent best practices for such quality and efficiency improvement and measures endorsed by the entity with a contract under section 1395aaa of this title since the previous review by the Secretary.
(d)
Rule of construction
(e)
Development of quality and efficiency measures
(f)
Hospital acquired conditions
(g)
Technical expert panel review of opioid and opioid use disorder quality measures
(1)
In general
(2)
Review and assessment
Not later than 1 year after the date the technical expert panel described in paragraph (1) is established (and periodically thereafter as the Secretary determines appropriate), the technical expert panel shall—
(A)
review quality measures that relate to opioids and opioid use disorders, including existing measures and those under development;
(B)
identify gaps in areas of quality measurement that relate to opioids and opioid use disorders, and identify measure development priorities for such measure gaps; and
(C)
make recommendations to the Secretary on quality measures with respect to opioids and opioid use disorders for purposes of improving care, prevention, diagnosis, health outcomes, and treatment, including recommendations for revisions of such measures, need for development of new measures, and recommendations for including such measures in the Merit-Based Incentive Payment System under section 1395w–4(q) of this title, the alternative payment models under section 1395l(z)(3)(C) of this title, the shared savings program under section 1395jjj of this title, the quality reporting requirements for inpatient hospitals under section 1395ww(b)(3)(B)(viii) of this title, and the hospital value-based purchasing program under section 1395ww(o) of this title.
(3)
Consideration of measures by Secretary
The Secretary shall consider—
(A)
using opioid and opioid use disorder measures (including measures used under the Merit-Based Incentive Payment System under section 1395w–4(q) of this title, measures recommended under paragraph (2)(C), and other such measures identified by the Secretary) in alternative payment models under section 1395l(z)(3)(C) of this title and in the shared savings program under section 1395jjj of this title; and
(B)
using opioid measures described in subparagraph (A), as applicable, in the quality reporting requirements for inpatient hospitals under section 1395ww(b)(3)(B)(viii) of this title, and in the hospital value-based purchasing program under section 1395ww(o) of this title.
(4)
Prioritization of measure development
(5)
Prioritization of measure endorsement
The Secretary—
(A)
during the period beginning on October 24, 2018, and ending on December 31, 2023, shall prioritize the endorsement of measures relating to opioids and opioid use disorders by the entity with a contract under subsection (a) of section 1395aaa of this title in connection with endorsement of measures described in subsection (b)(2) of such section; and
(B)
on and after January 1, 2024, may prioritize the endorsement of such measures by such entity.
(Aug. 14, 1935, ch. 531, title XVIII, § 1890A, as added and amended Pub. L. 111–148, title III, §§ 3013(b), 3014(b), title X, §§ 10303(b), 10304, Mar. 23, 2010, 124 Stat. 383, 385, 938; Pub. L. 115–271, title VI, § 6093, Oct. 24, 2018, 132 Stat. 4001.)
cite as: 42 USC 1395aaa-1