Quality reform task force

Section 1848(q)(2) of the Social Security Act (42 U.S.C. 1395w–4(q)(2)) is amended by adding at the end the following new subparagraph: (E) Quality Reform Task Force (i) In general Not later than 6 months after the date of the enactment of this subparagraph, the Secretary shall establish a Quality Reform Task Force (in this subparagraph referred to as the Task Force) for purposes of issuing recommendations with respect to the use of quality, resource use, and care efficiency measures under this subsection. (ii) Membership (I) In general Members of the Task Force shall be appointed by the Secretary and shall include— (aa) representatives of the Department of Health and Human Services; (bb) representatives of eligible professional organizations (as defined in subparagraph (D)(ii)(II)); and (cc) other experts determined appropriate by the Secretary. (II) Appropriate representation In making appointments under subclause (I), the Secretary shall ensure that— (aa) each medical specialty or subspecialty as determined appropriate by the Secretary in which a MIPS eligible professional may practice is adequately represented on the Task Force through a relevant organization described in subclause (I)(bb) if a measure relating to such specialty or subspecialty is under consideration; (bb) a majority of the Task Force is comprised of designated health care practitioners (as defined in section 1866H(f)) or representatives of designated health care professional-led professional organizations described in subclause (I)(bb); (cc) not more than 3 members of the Task Force are representatives of group health plans, health insurance issuers, or Medicare Advantage organizations; and (dd) at least 1 designated health care practitioner who is not part of an excluded practice (as defined in section 1866H(f)) who practices in a medical specialty or subspecialty is included on the Task Force when the Task Force is considering measures relating to such specialty or subspecialty. (III) Maximum number of members The number of members of the Task Force may not exceed 25. (iii) Duties (I) In general The Task Force shall, with respect to each performance period beginning on or after January 1, 2032— (aa) issue recommendations on quality, resource use, and care efficiency measures for use under this subsection; and (bb) update any recommendations previously issued by the Task Force as determined appropriate by the Task Force. (II) Requirements The Task Force— (aa) shall ensure that any measure recommended under subclause (I) conforms with applicable clinical guidelines developed by a professional organization representing the medical specialty or subspecialty to be subject to such measure and is designed to promote quality of care, improve resource use, or reduce costs; (bb) may only recommend a quality measure to the extent that data for such measure can be submitted through certified EHR technology, administrative or billing claims, or a qualified clinical data registry; (cc) shall take into account the circumstances of practitioners in specialty types that furnish services that do not typically involve face-to-face interaction with patients (or that typically involve such interaction only at the direction of another practitioner ordering such services); (dd) shall, in reviewing measures and making recommendations, take into account— (AA) how the measure relates to an episode of care or a continuum of health care, as applicable, involved; (BB) the context of the respective performance category of such measure and how the measure may serve to complement or align with measures applicable in other performance categories under this subsection; (CC) measures developed by qualified clinical data registries; and (DD) consult with such registries as necessary in the development and evaluation of measures; and (ee) ensure that the role of qualified clinical data registries in the development, maintenance, and refinement of measures is preserved or strengthened. (iv) Secretarial response to recommendations (I) In general Not later than 120 days after the Task Force issues recommendations with respect to measures for a performance period, the Secretary shall transmit to the Task Force and to the Committee on Ways and Means and the Committee on Energy and Commerce of the House of Representatives and the Committee on Finance of the Senate a formal written response that, with respect to each such recommendation, affirmatively states one of the following: (aa) The Secretary will implement the recommendation as issued. (bb) The Secretary will implement the recommendation with specified modifications, accompanied by a written explanation of the modifications and the clinical, administrative, or program integrity basis for each such modification. (cc) The Secretary will implement the recommendation in part, accompanied by a written explanation of which elements will be implemented and the basis for declining the remainder. (dd) The Secretary declines to implement the recommendation, accompanied by a detailed written explanation of the clinical, administrative, or program integrity basis for the decision. (II) Inclusion of measures (aa) In general The Secretary shall include a measure receiving a recommendation from the Task Force for a performance period in the final measures list published under subparagraph (D)(i) for such performance period unless the Secretary, not later than 90 days after receiving the recommendation, publishes in the Federal Register a written determination explaining the specific clinical, administrative, or program integrity basis for excluding the measure. (bb) Further requirements for certain recommendations Notwithstanding item (aa), with respect to any measure recommended by the Task Force for a performance period with the support of not fewer than 75 percent of the members of the Task Force, the Secretary may not exclude such measure from the final measures list published under subparagraph (D)(i) for such performance period unless the Secretary— (AA) consults with the task force regarding such proposed exclusion; and (BB) includes in the written determination under subclause (I) a response to the Task Force's position and a specific finding that the basis for exclusion outweighs the clinical judgment of the Task Force. (III) Annual report Not later than March 1 of each year beginning with the first calendar year after the Task Force issues its initial recommendations, the Secretary shall submit to the Committee on Ways and Means and the Committee on Energy and Commerce of the House of Representatives and the Committee on Finance of the Senate, and shall make publicly available on the website of the Centers for Medicare & Medicaid Services, a report that includes, for each recommendation issued by the Task Force during the preceding calendar year— (aa) the text of the recommendation and the vote of the Task Force; (bb) the Secretary’s response under subclause (I); (cc) the outcome with respect to the final measures list published under subparagraph (D)(i), including whether the recommended measure was included, included with modifications, or excluded; and (dd) if the measure was excluded or modified, the written justification provided under subclause (I)..