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1 ‘‘(2) AVAILABILITY OF MEASURES.—The Sec-
2 retary shall make quality measures developed under
3 this section available to the public.
4 ‘‘(3) TESTING OF PROPOSED MEASURES.—The

5 Secretary may use amounts made available under

6 subsection (f) to fund the testing of proposed quality
7 measures by qualified entities. Testing funded under
8 this paragraph shall include testing of the feasibility
9 and usability of proposed measures.
10 ‘‘(4) UPDATING OF ENDORSED MEASURES.—

11 The Secretary may use amounts made available

12 under subsection (f) to fund the updating (and test-
13 ing, if applicable) by consensus-based entities of
14 quality measures that have been previously endorsed
15 by such an entity as new evidence is developed, in
16 a manner consistent with section 1890(b)(3).
17 ‘‘(d) QUALIFIED ENTITIES.—Before entering into
18 agreements with a qualified entity, the Secretary shall en-
19 sure that the entity is a public, nonprofit or academic in-
20 stitution with technical expertise in the area of health
21 quality measurement.
22 ‘‘(e) APPLICATION FOR GRANT.—A grant may be
23 made under this section only if an application for the
24 grant is submitted to the Secretary and the application
25 is in such form, is made in such manner, and contains

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1 such agreements, assurances, and information as the Sec-
2 retary determines to be necessary to carry out this section.
3 ‘‘(f) FUNDING.—
4 ‘‘(1) IN GENERAL.—The Secretary shall provide
5 for the transfer, from the Federal Hospital Insur-
6 ance Trust Fund under section 1817 and the Fed-
7 eral Supplementary Medical Insurance Trust Fund
8 under section 1841 (in such proportion as the Sec-
9 retary determines appropriate), of $25,000,000, to
10 the Secretary for purposes of carrying out this sec-
11 tion for each of the fiscal years 2010 through 2014.
12 ‘‘(2) AUTHORIZATION OF APPROPRIATIONS.—

13 For purposes of carrying out the provisions of this

14 section, in addition to funds otherwise available, out
15 of any funds in the Treasury not otherwise appro-
16 priated, there are appropriated to the Secretary of
17 Health and Human Services $25,000,000 for each
18 of the fiscal years 2010 through 2014.
19 ‘‘SEC. 1193. GAO EVALUATION OF DATA COLLECTION PROC-

20 ESS FOR QUALITY MEASUREMENT.

21 ‘‘(a) GAO EVALUATIONS.—The Comptroller General

22 of the United States shall conduct periodic evaluations of
23 the implementation of the data collection processes for
24 quality measures used by the Secretary.

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1 ‘‘(b) CONSIDERATIONS.—In carrying out the evalua-
2 tion under subsection (a), the Comptroller General shall
3 determine—
4 ‘‘(1) whether the system for the collection of
5 data for quality measures provides for validation of
6 data as relevant and scientifically credible;
7 ‘‘(2) whether data collection efforts under the
8 system use the most efficient and cost-effective
9 means in a manner that minimizes administrative
10 burden on persons required to collect data and that
11 adequately protects the privacy of patients’ personal
12 health information and provides data security;
13 ‘‘(3) whether standards under the system pro-
14 vide for an appropriate opportunity for physicians
15 and other clinicians and institutional providers of
16 services to review and correct findings; and
17 ‘‘(4) the extent to which quality measures are
18 consistent with section 1192(c)(1) or result in direct
19 or indirect costs to users of such measures.
20 ‘‘(c) REPORT.—The Comptroller General shall sub-
21 mit reports to Congress and to the Secretary containing
22 a description of the findings and conclusions of the results
23 of each such evaluation.’’.

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1 SEC. 1443. MULTI-STAKEHOLDER PRE-RULEMAKING INPUT

2 INTO SELECTION OF QUALITY MEASURES.

3 Section 1808 of the Social Security Act (42 U.S.C.

4 1395b–9) is amended by adding at the end the following
5 new subsection:
6 ‘‘(d) MULTI-STAKEHOLDER PRE-RULEMAKING
7 INPUT INTO SELECTION OF QUALITY MEASURES.—
8 ‘‘(1) LIST OF MEASURES.—Not later than De-
9 cember 1 before each year (beginning with 2011),
10 the Secretary shall make public a list of measures
11 being considered for selection for quality measure-
12 ment by the Secretary in rulemaking with respect to
13 payment systems under this title beginning in the
14 payment year beginning in such year and for pay-
15 ment systems beginning in the calendar year fol-
16 lowing such year, as the case may be.
17 ‘‘(2) CONSULTATION ON SELECTION OF EN-

18 DORSED QUALITY MEASURES.—A consensus-based

19 entity that has entered into a contract under section
20 1890 shall, as part of such contract, convene multi-
21 stakeholder groups to provide recommendations on
22 the selection of individual or composite quality meas-
23 ures, for use in reporting performance information
24 to the public or for use in public health care pro-
25 grams.

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1 ‘‘(3) MULTI-STAKEHOLDER INPUT.—Not later
2 than February 1 of each year (beginning with
3 2011), the consensus-based entity described in para-
4 graph (2) shall transmit to the Secretary the rec-
5 ommendations of multi-stakeholder groups provided
6 under paragraph (2). Such recommendations shall
7 be included in the transmissions the consensus-based
8 entity makes to the Secretary under the contract
9 provided for under section 1890.
10 ‘‘(4) REQUIREMENT FOR TRANSPARENCY IN

11 PROCESS.—

12 ‘‘(A) IN GENERAL.—In convening multi-

13 stakeholder groups under paragraph (2) with
14 respect to the selection of quality measures, the
15 consensus-based entity described in such para-
16 graph shall provide for an open and transparent
17 process for the activities conducted pursuant to
18 such convening.
19 ‘‘(B) SELECTION OF ORGANIZATIONS PAR-

20 TICIPATING IN MULTI-STAKEHOLDER

21 GROUPS.—The process under paragraph (2)

22 shall ensure that the selection of representatives
23 of multi-stakeholder groups includes provision
24 for public nominations for, and the opportunity
25 for public comment on, such selection.

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1 ‘‘(5) USE OF INPUT.—The respective proposed
2 rule shall contain a summary of the recommenda-
3 tions made by the multi-stakeholder groups under
4 paragraph (2), as well as other comments received
5 regarding the proposed measures, and the extent to
6 which such proposed rule follows such recommenda-
7 tions and the rationale for not following such rec-
8 ommendations.
9 ‘‘(6) MULTI-STAKEHOLDER GROUPS.—For pur-
10 poses of this subsection, the term ‘multi-stakeholder
11 groups’ means, with respect to a quality measure, a
12 voluntary collaborative of organizations representing
13 persons interested in or affected by the use of such
14 quality measure, such as the following:
15 ‘‘(A) Hospitals and other institutional pro-
16 viders.
17 ‘‘(B) Physicians.
18 ‘‘(C) Health care quality alliances.
19 ‘‘(D) Nurses and other health care practi-
20 tioners.
21 ‘‘(E) Health plans.
22 ‘‘(F) Patient advocates and consumer
23 groups.
24 ‘‘(G) Employers.

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1 ‘‘(H) Public and private purchasers of
2 health care items and services.
3 ‘‘(I) Labor organizations.
4 ‘‘(J) Relevant departments or agencies of
5 the United States.
6 ‘‘(K) Biopharmaceutical companies and
7 manufacturers of medical devices.
8 ‘‘(L) Licensing, credentialing, and accred-
9 iting bodies.
10 ‘‘(7) FUNDING.—
11 ‘‘(A) IN GENERAL.—The Secretary shall
12 provide for the transfer, from the Federal Hos-
13 pital Insurance Trust Fund under section 1817
14 and the Federal Supplementary Medical Insur-
15 ance Trust Fund under section 1841 (in such
16 proportion as the Secretary determines appro-
17 priate), of $1,000,000, to the Secretary for pur-
18 poses of carrying out this subsection for each of
19 the fiscal years 2010 through 2014.
20 ‘‘(B) AUTHORIZATION OF APPROPRIA-

21 TIONS.—For purposes of carrying out the provi-

22 sions of this subsection, in addition to funds
23 otherwise available, out of any funds in the
24 Treasury not otherwise appropriated, there are
25 appropriated to the Secretary of Health and

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1 Human Services $1,000,000 for each of the fis-
2 cal years 2010 through 2014.’’.
3 SEC. 1444. APPLICATION OF QUALITY MEASURES.

4 (a) INPATIENT HOSPITAL SERVICES.—Section

5 1886(b)(3)(B) of such Act (42 U.S.C. 1395ww(b)(3)(B))
6 is amended by adding at the end the following new clause:
7 ‘‘(x)(I) Subject to subclause (II), for purposes of re-
8 porting data on quality measures for inpatient hospital
9 services furnished during fiscal year 2012 and each subse-
10 quent fiscal year, the quality measures specified under
11 clause (viii) shall be measures selected by the Secretary
12 from measures that have been endorsed by the entity with
13 a contract with the Secretary under section 1890(a).
14 ‘‘(II) In the case of a specified area or medical topic
15 determined appropriate by the Secretary for which a fea-
16 sible and practical quality measure has not been endorsed
17 by the entity with a contract under section 1890(a), the
18 Secretary may specify a measure that is not so endorsed
19 as long as due consideration is given to measures that
20 have been endorsed or adopted by a consensus organiza-
21 tion identified by the Secretary. The Secretary shall sub-
22 mit such a non-endorsed measure to the entity for consid-
23 eration for endorsement. If the entity considers but does
24 not endorse such a measure and if the Secretary does not
25 phase-out use of such measure, the Secretary shall include

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