42 U.S. Code § 299b–31 - Quality measure development
prev | next
(a) Quality measure
In this subpart, the term “quality measure” means a standard for measuring the performance and improvement of population health or of health plans, providers of services, and other clinicians in the delivery of health care services.
(b) Identification of quality measures
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 280j of this title, 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 [42 U.S.C. 1395aaa (a)] and other stakeholders;
(B) quality measures identified by the pediatric quality measures program under section 1139A of the Social Security Act [42 U.S.C. 1320b–9a]; and
(c) Grants or contracts for quality measure development
(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—
(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 299b–36 of this title);
(G) the equity of health services and health disparities across health disparity populations (as defined in section 285t  of this title) and geographic areas;
(I) the use of innovative strategies and methodologies identified under section 299b–33 of this title; and
(3) Eligible entities
To be eligible for a grant or contract under this subsection, an entity shall—
(B) have adopted procedures to include in the quality measure development process—
(C) collaborate with the entity with a contract under section 1890(a) of the Social Security Act [42 U.S.C. 1395aaa (a)] 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);
(4) Use of funds
An entity that receives a grant, contract, or agreement under this subsection shall use such award to develop quality measures that meet the following requirements:
(A) Such measures support measures required to be reported under the Social Security Act [42 U.S.C. 301 et seq.], 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 [42 U.S.C. 1320b–9a] and the Medicaid Quality Measurement Program under section 1139B of such Act [42 U.S.C. 1320b–9b], where applicable.
(C) To the extent practicable, data on such quality measures is able to be collected using health information technologies.
(d) Other activities by the Secretary
(e) Coordination of grants
(f) Development of outcome measures
(1) In general
The Secretary shall develop, and periodically update (not less than every 3 years), provider-level outcome measures for hospitals and physicians, as well as other providers as determined appropriate by the Secretary.
(2) Categories of measures
The measures developed under this subsection shall include, to the extent determined appropriate by the Secretary—
(A) outcome measurement for acute and chronic diseases, including, to the extent feasible, the 5 most prevalent and resource-intensive acute and chronic medical conditions; and
In developing such measures, the Secretary shall seek to—
(A) Acute and chronic diseases
Not later than 24 months after March 23, 2010,  the Secretary shall develop not less than 10 measures described in paragraph (2)(A).
(B) Primary and preventive care
Not later than 36 months after March 23, 2010,  the Secretary shall develop not less than 10 measures described in paragraph (2)(B).
 See References in Text note below.
 So in original. The subsection designation is missing.
Source(July 1, 1944, ch. 373, title IX, § 931, as added and amended Pub. L. 111–148, title III, § 3013(a)(4), title X, § 10303(a),Mar. 23, 2010, 124 Stat. 381, 937.)
References in Text
Section 285t of this title, referred to in subsec. (c)(2)(G), was in the original “section 485E”, meaning section 485E of act July 1, 1944, which was renumbered section 464z–3 by Pub. L. 111–148, title X, § 10334(c)(1)(D)(i),Mar. 23, 2010, 124 Stat. 973, and is classified to section 285t of this title. The act of July 1, 1944, no longer contains a section 485E.
The Social Security Act, referred to in subsec. (c)(4)(A), is act Aug. 14, 1935, ch. 531, 49 Stat. 620, which is classified generally to chapter 7 (§ 301 et seq.) of this title. For complete classification of this Act to the Code, see section 1305 of this title and Tables.
March 23, 2010, referred to in subsec. (f)(4)(A), (B), was in the original “the date of enactment of this Act” which was translated as meaning the date of the enactment of Pub. L. 111–148which added and amended this section, to reflect the probable intent of Congress.
A prior section 931 of act July 1, 1944, was renumbered 941 and is classified to section 299c of this title.
2010—Subsec. (f). Pub. L. 111–148, § 10303(a), added subsec. (f).
LII has no control over and does not endorse any external Internet site that contains links to or references LII.