S.Amdt. 2377

1. Inserts new text on page 298, line 25

   InsertsPrinted page

   Inserted: (5) Requirements for measures of efficiency.--"(A) In general.--Any measure of efficiency selected by the Secretary under paragraph (3)(A) shall, to the extent feasible, reflect cost reductions resulting from--"(i) improvements in quality of care, including the appropriate use of preventive and screening services and reductions in medical errors; "(ii) changes in clinical processes that eliminate practices that are clearly not beneficial, as determined by a consensus of peer-reviewed medical literature or by the relevant medical specialty societies; or "(iii) improvements in administrative processes, such as reductions in unnecessarily duplicative tests, reductions in the unnecessary use of hospital emergency departments, or the use of health information technology. "(B) Limitations on types of measures selected.--No measure of efficiency may be selected by the Secretary under paragraph (3)(A) that--"(i) is based on cost comparisons between providers that do not identify clear, scientifically justified paths to reducing costs without compromising quality of care; "(ii) is based on governmental judgments about the value of life, reduction in pain, or improvement of function; "(iii) requires physicians to limit the choice by patients and physicians of advanced medical technologies based on individual needs; or "(iv) would limit the adoption of new medical technologies. "(C) Scientifically justified.--For purposes of subparagraph (B)(i), the term 'scientifically justified' means supported by--"(i) the consensus recommendation of the relevant specialty or subspecialty society; or "(ii) a consensus of the peer-reviewed literature. "(D) Application to additional measures.--The provisions of subparagraphs (B), (C), and (D) shall apply to measures described in section 1860E-1(b)(1)(B)(iv).

   Original wording

   On page 298, after line 25, insert the following: “(5) Requirements for measures of efficiency.--“(A) In general.--Any measure of efficiency selected by the Secretary under paragraph (3)(A) shall, to the extent feasible, reflect cost reductions resulting from--“(i) improvements in quality of care, including the appropriate use of preventive and screening services and reductions in medical errors; “(ii) changes in clinical processes that eliminate practices that are clearly not beneficial, as determined by a consensus of peer-reviewed medical literature or by the relevant medical specialty societies; or “(iii) improvements in administrative processes, such as reductions in unnecessarily duplicative tests, reductions in the unnecessary use of hospital emergency departments, or the use of health information technology. “(B) Limitations on types of measures selected.--No measure of efficiency may be selected by the Secretary under paragraph (3)(A) that--“(i) is based on cost comparisons between providers that do not identify clear, scientifically justified paths to reducing costs without compromising quality of care; “(ii) is based on governmental judgments about the value of life, reduction in pain, or improvement of function; “(iii) requires physicians to limit the choice by patients and physicians of advanced medical technologies based on individual needs; or “(iv) would limit the adoption of new medical technologies. “(C) Scientifically justified.--For purposes of subparagraph (B)(i), the term ‘scientifically justified' means supported by--“(i) the consensus recommendation of the relevant specialty or subspecialty society; or “(ii) a consensus of the peer-reviewed literature. “(D) Application to additional measures.--The provisions of subparagraphs (B), (C), and (D) shall apply to measures described in section 1860E-1(b)(1)(B)(iv).

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