Hospital Quality Report Card Act of 2006 - Amends title XVIII (Medicare) of the Social Security Act to direct the Secretary of Health and Human Services, acting through the Administrator of the Centers for Medicare & Medicaid Services, to establish a Hospital Quality Report Card Initiative under the Medicare program to report on health care quality in subsection (d) hospitals.
Directs the Administrator to establish the Hospital Quality Advisory Committee to advise on the submission, collection, and reporting of quality measures data.
[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 2359 Introduced in Senate (IS)]
109th CONGRESS
2d Session
S. 2359
To amend title XVIII of the Social Security Act to establish a Hospital
Quality Report Card Initiative under the Medicare program to assess and
report on health care quality in hospitals.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
March 2, 2006
Mr. Obama introduced the following bill; which was read twice and
referred to the Committee on Finance
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to establish a Hospital
Quality Report Card Initiative under the Medicare program to assess and
report on health care quality in hospitals.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Hospital Quality Report Card Act of
2006''.
SEC. 2. PURPOSE.
The purpose of this Act is to expand hospital quality reporting by
establishing the Hospital Quality Report Card Initiative under the
Medicare program to ensure that hospital quality measures data are
readily available and accessible in order to--
(1) assist patients and consumers in making decisions about
where to get health care;
(2) assist purchasers and insurers in making decisions that
determine where employees, subscribers, members, or
participants are able to go for their health care;
(3) assist health care providers in identifying
opportunities for quality improvement and cost containment; and
(4) enhance the understanding of policy makers and public
officials of health care issues, raise public awareness of
hospital quality issues, and to help constituents of such
policy makers and officials identify quality health care
options.
SEC. 3. HOSPITAL QUALITY REPORT CARD INITIATIVE.
(a) In General.--Title XVIII of the Social Security Act (42 U.S.C.
1395 et seq.) is amended by adding at the end the following new
section:
``SEC. 1898. HOSPITAL QUALITY REPORT CARD INITIATIVE.
``(a) In General.--Not later than 18 months after the date of the
enactment of the Hospital Quality Report Card Act of 2006, the
Secretary, acting through the Administrator of the Centers for Medicare
& Medicaid Services (in this section referred to as the
`Administrator') and in consultation with the Director of the Agency
for Healthcare Research and Quality, shall, directly or through
contracts with States, establish and implement a Hospital Quality
Report Card Initiative (in this section referred to as the
`Initiative') to report on health care quality in subsection (d)
hospitals.
``(b) Subsection (d) Hospital.--For purposes of this section, the
term `subsection (d) hospital' has the meaning given such term in
section 1886(d)(1)(B).
``(c) Requirements of Initiative.--
``(1) Quality measurement reports for hospitals.--
``(A) Quality measures.--Not less than 2 times each
year, the Secretary shall publish reports on hospital
quality. Such reports shall include quality measures
data submitted under section 1886(b)(3)(B)(viii), and
other data as feasible, that allow for an assessment of
health care--
``(i) effectiveness;
``(ii) safety;
``(iii) timeliness;
``(iv) efficiency;
``(v) patient-centeredness; and
``(vi) equity.
``(B) Report card features.--In collecting and
reporting data as provided for under subparagraph (A),
the Secretary shall include hospital information, as
possible, relating to--
``(i) staffing levels of nurses and other
health professionals, as appropriate;
``(ii) rates of nosocomial infections;
``(iii) the volume of various procedures
performed;
``(iv) the availability of interpreter
services on-site;
``(v) the accreditation of hospitals, as
well as sanctions and other violations found by
accreditation or State licensing boards;
``(vi) the quality of care for various
patient populations, including pediatric
populations and racial and ethnic minority
populations;
``(vii) the availability of emergency
rooms, intensive care units, obstetrical units,
and burn units;
``(viii) the quality of care in various
hospital settings, including inpatient,
outpatient, emergency, maternity, and intensive
care unit settings;
``(ix) the use of health information
technology, telemedicine, and electronic
medical records;
``(x) ongoing patient safety initiatives;
and
``(xi) other measures determined
appropriate by the Secretary.
``(C) Tailoring of hospital quality reports.--The
Director of the Agency for Healthcare Research and
Quality may modify and publish hospital reports to
include quality measures for diseases and health
conditions of particular relevance to certain regions,
States, or local areas.
``(D) Risk adjustment.--
``(i) In general.--In reporting data as
provided for under subparagraph (A), the
Secretary may risk adjust quality measures to
account for differences relating to--
``(I) the characteristics of the
reporting hospital, such as licensed
bed size, geography, teaching hospital
status, and profit status; and
``(II) patient characteristics,
such as health status, severity of
illness, insurance status, and
socioeconomic status.
``(ii) Availability of unadjusted data.--If
the Secretary reports data under subparagraph
(A) using risk-adjusted quality measures, the
Secretary shall establish procedures for making
the unadjusted data available to the public in
a manner determined appropriate by the
Secretary.
``(E) Costs.--The Secretary shall--
``(i) compile data relating to the average
hospital cost for ICD-9 conditions for which
quality measures data are collected; and
``(ii) report such information in a manner
that allows cost comparisons between or among
subsection (d) hospitals.
``(F) Verification.--Under the Initiative, the
Secretary may verify data reported under this paragraph
to ensure accuracy and validity.
``(G) Disclosure.--The Secretary shall disclose the
entire methodology for the reporting of data under this
paragraph to all relevant organizations and all
subsection (d) hospitals that are the subject of any
such information that is to be made available to the
public prior to the public disclosure of such
information.
``(H) Public input.--The Secretary shall provide an
opportunity for public review and comment with respect
to the quality measures to be reported for subsection
(d) hospitals under this section for at least 60 days
prior to the finalization by the Secretary of the
quality measures to be used for such hospitals.
``(I) Availability of reports and findings.--
``(i) Electronic availability.--The
Secretary shall ensure that reports are made
available under this section in an electronic
format, in an understandable manner with
respect to various populations (including those
with low functional health literacy), and in a
manner that allows health care quality
comparisons to be made between local hospitals.
``(ii) Findings.--The Secretary shall
establish procedures for making report findings
available to the public, upon request, in a
non-electronic format, such as through the
toll-free telephone number 1-800-MEDICARE.
``(J) Identification of methodology.--The analytic
methodologies and limitations on data sources utilized
by the Secretary to develop and disseminate the
comparative data under this section shall be identified
and acknowledged as part of the dissemination of such
data, and include the appropriate and inappropriate
uses of such data.
``(K) Adverse selection of patients.--On at least
an annual basis, the Secretary shall compare quality
measures data submitted by each subsection (d) hospital
under section 1886(b)(3)(B)(viii) with data submitted
in the prior year or years by the same hospital in
order to identify and report actions that would lead to
false or artificial improvements in the hospital's
quality measurements, including--
``(i) adverse selection against patients
with severe illness or other factors that
predispose patients to poor health outcomes;
and
``(ii) provision of health care that does
not meet established recommendations or
accepted standards for care.
``(2) Data safeguards.--
``(A) Unauthorized use and disclosure.--The
Secretary shall develop and implement effective
safeguards to protect against the unauthorized use or
disclosure of hospital data that is reported under this
section.
``(B) Inaccurate information.--The Secretary shall
develop and implement effective safeguards to protect
against the dissemination of inconsistent, incomplete,
invalid, inaccurate, or subjective hospital data.
``(C) Identifiable data.--The Secretary shall
ensure that identifiable patient data shall not be
released to the public.
``(d) Grants and Technical Assistance.--The Secretary may award
grants to national or State organizations, partnerships, or other
entities that may assist with hospital quality improvement.
``(e) Hospital Quality Advisory Committee.--
``(1) Establishment.--The Administrator, in consultation
with the Director of the Agency for Healthcare Research and
Quality, shall establish the Hospital Quality Advisory
Committee (in this subsection referred to as the `Advisory
Committee') to provide advice to the Administrator on the
submission, collection, and reporting of quality measures data.
The Administrator shall serve as the chairperson of the
Advisory Committee.
``(2) Membership.--The Advisory Committee shall include
representatives of the following (except with respect to
subparagraphs (A) through (D), to be appointed by the
Administrator):
``(A) The Agency for Healthcare Research and
Quality.
``(B) The Health Resources and Services
Administration.
``(C) The Department of Veterans Affairs.
``(D) The Centers for Disease Control and
Prevention.
``(E) National membership organizations that focus
on health care quality improvement.
``(F) Public and private hospitals.
``(G) Physicians, nurses, and other health
professionals.
``(H) Patients and patient advocates.
``(I) Health insurance purchasers and other payers.
``(J) Health researchers, policymakers, and other
experts in the field of health care quality.
``(K) Health care accreditation entities.
``(L) Other agencies and groups as determined
appropriate by the Administrator.
``(3) Duties.--The Advisory Committee shall review and
provide guidance and recommendations to the Administrator on--
``(A) the establishment of the Initiative;
``(B) integration and coordination of Federal
quality measures data submission requirements, to avoid
needless duplication and inefficiency;
``(C) legal and regulatory barriers that may hinder
quality measures data collection and reporting; and
``(D) necessary technical and financial assistance
to encourage quality measures data collection and
reporting;
``(4) Staff and resources.--The Administrator shall provide
the Advisory Committee with appropriate staff and resources for
the functioning of the Advisory Committee.
``(5) Duration.--The Advisory Committee shall terminate at
the discretion of the Administrator, but in no event later than
5 years after the date of enactment of this section.
``(f) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section such sums as may be necessary
for each of fiscal years 2007 through 2016.''.
(b) Conforming Amendment.--Section 1886(b)(3)(B)(viii) of the
Social Security Act (42 U.S.C. 1395ww(b)(3)(B)(viii)), as added by
section 5001 of the Deficit Reduction Act of 2005, is amended to read
as follows:
``(VII) The Secretary shall use the data
submitted under this clause for the Hospital
Quality Report Card Initiative under section
1898.''.
SEC. 4. EVALUATION OF THE HOSPITAL QUALITY REPORT CARD INITIATIVE.
(a) In General.--The Director of the Agency for Healthcare Research
and Quality, directly or through contract, shall evaluate and
periodically report to Congress on the effectiveness of the Hospital
Quality Report Card Initiative established under section 1898 of the
Social Security Act, as added by section 3, including the effectiveness
of the Initiative in meeting the purpose described in section 2. The
Director shall make such reports available to the public.
(b) Research.--The Director of the Agency for Healthcare Research
and Quality, in consultation with the Administrator of the Centers for
Medicare & Medicaid Services, shall use the outcomes from the
evaluation conducted pursuant to subsection (a) to increase the
usefulness of the Hospital Quality Report Card Initiative, particularly
for patients, as necessary.
<all>
Introduced in Senate
Sponsor introductory remarks on measure. (CR S1651)
Read twice and referred to the Committee on Finance.
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