United States. Congress

“ APPROPRIATE DISTRIBUTION- The Secretary shall ensure that the application of the methodology developed under subparagraph (A) results in an appropriate distribution of value-based incentive payments under paragraph (6) among hospitals achieving different levels of hospital performance scores, with hospitals achieving the highest hospital performance scores receiving the largest value-based incentive payments. ”

“ INFORMAL APPEALS PROCESS- The Secretary shall, by not later than January 1, 2011, establish and have in place an informal process for eligible professionals to seek a review of the determination that an eligible professional did not satisfactorily submit data on quality measures under this subsection.'. ”

“ The reporting, collection, and validation of quality data. (C) The structure of value-based payment adjustments, including the determination of thresholds or improvements in quality that would substantiate a payment adjustment, the size of such payments, and the sources of funding for the value-based bonus payments. (D) Methods for the public disclosure of information on the performance of home health agencies. ”

“ DEVELOPMENT OF EPISODE GROUPER- ` (i) IN GENERAL- The Secretary shall develop an episode grouper that combines separate but clinically related items and services into an episode of care for an individual, as appropriate. ` (ii) TIMELINE FOR DEVELOPMENT- The episode grouper described in subparagraph (A) shall be developed by not later than January 1, 2012. ”

“ Surgeries, as measured by the Surgical Care Improvement Project (formerly referred to as `Surgical Infection Prevention' for discharges occurring before July 2006) . ` (ee) Healthcare-associated infections, as measured by the prevention metrics and targets established in the HHS Action Plan to Prevent Healthcare-Associated Infections (or any successor plan) of the Department of Health and Human Services. ` (II) HCAHPS- Measures selected under subparagraph (A) shall be related to the Hospital Consumer Assessment of Healthcare Providers and Systems survey (HCAHPS) . ”

“ PUBLIC AVAILABILITY OF METHODOLOGY- The Secretary shall make available to the public-- ` (i) the methodologies established under subparagraph (C) ; ` (ii) information regarding any adjustments made to data under subparagraph (D) ; and ` (iii) aggregate reports with respect to physicians. ` (F) DEFINITION OF PHYSICIAN- In this paragraph: ` (i) IN GENERAL- The term `physician' has the meaning given that term in section 1861 (r) (1) . ` (ii) TREATMENT OF GROUPS- Such term includes, as the Secretary determines appropriate, a group of physicians. ”