S.Amdt. 2898

SA 2898. Mr. LIEBERMAN (for himself and Ms. Collins) submitted an
amendment intended to be proposed to amendment SA 2786 proposed by Mr.
Reid (for himself, Mr. Baucus, Mr. Dodd, and Mr. Harkin) to the bill
H.R. 3590, to amend the Internal Revenue Code of 1986 to modify the
first-time homebuyers credit in the case of members of the Armed Forces
and certain other Federal employees, and for other purposes; which was
ordered to lie on the table; as follows:

On page 1134, between lines 3 and 4, insert the following:

Subtitle G--Additional Health Care Quality and Efficiency Improvements

SEC. 3601. REPORT ON DEMONSTRATION AND PILOT PROGRAMS.

(a) Report.--Not later than 12 months after the date of
enactment of this Act, and every 3 years thereafter, the
Secretary of Health and Human Services shall submit to the
appropriate committees of Congress a report that describes
all pilot programs and demonstration projects that the
Secretary has authority to carry out (regardless of whether
such programs or projects are actually implemented), as
authorized by law, during the period for which the report is
submitted.
(b) Requirements.--A report under subsection (a) shall--
(1) list all pilot programs or demonstration projects
involved and indicate whether each program or project is--
(A) not yet being implemented;
(B) currently being implemented; or
(C) complete and awaiting further determinations; and
(2) with respect to programs or projects described in
subparagraphs (A) or (B) of paragraph (1), include the
recommendations of the Secretary as to whether such programs
or projects are necessary.
(c) Actions Based on Recommendations.--Based on the
recommendations of the Secretary under subsection (b)(2)--
(1) if the Secretary determines that a program or project
is necessary, the Secretary shall submit to Congress a
strategic plan for the implementation of the program or
project and may transfer such program or project into the
jurisdiction of the Innovation Center of the Centers for
Medicare & Medicaid Services; or
(2) if the Secretary determines that a program or project
is unnecessary, the Secretary may terminate the program.
(d) Action by Congress.--Congress may continue in effect
any program or project terminated by the Secretary under
subsection (c)(2) through the enactment of a Concurrent
Resolution expressing the sense of Congress to continue the
program or project involved.

SEC. 3602. AVAILABILITY OF DATA ON DENIAL OF CLAIMS.

Section 2715(b)(3) of the Public Health Service Act, as
added by section 1001, is amended--
(1) in subparagraph (H), by striking ``and'' at the end;
(2) by redesignating subparagraph (I) as subparagraph (J):
and
(3) by inserting after subparagraph (H) the following new
subparagraph:
``(I) a statement relating to claims procedures including
the percentage of claims that are annually denied by the plan
or coverage and the percentage of such denials that are
overturned on appeal; and''.

SEC. 3603. ACCELERATION AND INCREASE OF THE PAYMENT
ADJUSTMENT FOR CONDITIONS ACQUIRED IN
HOSPITALS.

Section 1886(p) of the Social Security Act (42 U.S.C.
1395(p)), as added by section 3008(a), is amended--
(1) in paragraph (1)--
(A) by striking ``2015'' and inserting ``2013''; and
(B) by striking ``99 percent'' and inserting ``98
percent''; and
(2) in paragraph (5), by striking ``2015'' and inserting
``2013''.

SEC. 3604. IMPROVEMENTS TO NATIONAL PILOT PROGRAM ON PAYMENT
BUNDLING.

Section 1866D of the Social Security Act, as added by
section 3023, is amended--
(1) in subsection (a)(3), by striking ``January 1, 2013''
and inserting ``January 1, 2012''; and
(2) by amending subsection (g) to read as follows:
``(g) Authority to Expand Implementation.--
``(1) In general.--Taking into account the evaluation under
subparagraph (e), the Secretary may, through rulemaking,
expand (including implementation on a nationwide basis) the
duration and the scope of the pilot program, to the extent
determined appropriate by the Secretary, if--
``(A) the Secretary determines that such expansion is
expected to--
``(i) reduce spending under this title without reducing the
quality of care; or
``(ii) improve the quality of care and reduce spending; and
``(B) the Chief Actuary of the Centers for Medicare &
Medicaid Services certifies that such expansion would reduce
program spending under this title.
``(2) Implementation plan.--In the case where the Secretary
does not exercise the authority under paragraph (1) by
January 1, 2015, not later than such date, the Secretary
shall submit a plan for the implementation of an expansion of
the pilot program if the Secretary determines that such
expansion will result in improving or not reducing the
quality of patient care and reducing spending under this
title.''.

SEC. 3605. ENCOURAGING MEDICARE BENEFICIARIES TO CHOOSE HIGH
PERFORMING PROVIDERS.

(a) Authorization to Establish a Pilot Program to Encourage
Choice of High Performing Providers.--
(1) In general.--The Secretary of Health and Human Services
(in this section referred to as the ``Secretary'') may
establish a pilot program under which Medicare beneficiaries
are encouraged to choose high performing providers under the
Medicare program under title XVIII of the Social Security
Act.
(2) Consideration of medicare value-based purchasing
reforms.--If the Secretary establishes a pilot program under
paragraph (1), the Secretary shall, as the Secretary
determines appropriate, take into consideration information
obtained under value-based purchasing reforms implemented
under the Medicare program, including such reforms under the
provisions of and amendments made by this Act, in
establishing such pilot program.
(b) Development of Physician Compare Internet Website.--
(1) In general.--Not later than January 1, 2011, the
Secretary shall develop a Physician Compare Internet website
for use by Medicare beneficiaries to access quality and
utilization data with respect to physicians (as defined in
section 1861(r) of the Social Security Act (42 U.S.C.
1395x(r))) participating in the Medicare program.
(2) Information available.--Information shall be made
available on such Internet website on an ongoing basis as
follows:
(A) Not later than January 1, 2011 (and for each subsequent
year before 2015), the Internet website shall include
information regarding which physicians received an incentive
payment for quality reporting under section 1848(m) of the
Social Security Act (42 U.S.C. 1395w-4(m)) of the Social
Security Act for the preceding year (and, beginning with
2015, which physicians received an incentive payment
adjustment under section 1848(a)(8) of such Act, as added by
section 3002(b) for the year).
(B) On or after January 1, 2013, the Internet website may,
as determined appropriate by the Secretary, include
information on the utilization rates of physicians, as
determined for purposes of section 1848(a)(9) of such Act, as
added by section 3003.
(C) On or after January 1, 2014, the Internet website may,
as determined appropriate by the Secretary, include
information on quality measures selected by the Secretary, in
consultation with the Physician Payment Advisory Committee,
from among measures reported under the physician reporting
system under section 1848(k) of such Act (42 U.S.C. 1395w-
4(k)).
(D) On or after January 1, 2017, the Internet website shall
include results of the application of the value-based payment
modifier established under section 1848(p) of the Social
Security Act, as added by section 3007, together with the
results of any similar provisions under title XVIII of such
Act, in order for Medicare beneficiaries to see how the
quality and cost of services furnished by physicians compares
to the quality and cost of services furnished by their peers.
Such information should, if the Secretary determines
appropriate, identify physicians performing in the top 50,
60, 70, and 80th percentiles as compared to their peers.
(3) Report to congress.--Not later than January 1, 2019,
the Secretary shall submit to Congress a report on the
Physician Compare Internet website developed under this
subsection, together with recommendations for such
legislation and administrative action as the Secretary
determines appropriate.
(4) Expansion.--At any time before the date on which the
report is submitted under paragraph (3), the Secretary may
expand (including expansion to other providers of services
and suppliers under part B of title XVIII of the Social
Security Act) the information made available on such website
if the Secretary determines such expansion would improve the
quality of care and reduce spending under such title.
(c) Providing Financial Incentives to Beneficiaries Under
the Center for Medicare and Medicaid Innovation.--Section
1115A(b)(2)(B) of the Social Security Act, as added by
section 3021, is amended by adding at the end the following
new clause:

[[Page S12425]]

``(xix) Effective beginning on or after January 1, 2018,
providing financial incentives to Medicare beneficiaries who
are furnished services by high performing physicians, as
determined by the Secretary, taking into consideration
information made available on the Physician Compare Internet
website developed under section 3009(b) of the Patient
Protection and Affordable Care Act.''.
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