Appendix 2. Affordable Care Act Sec. 2701. Adult Quality Measures

Identifying Health Care Quality Measures for Medicaid-Eligible Adults

Subtitle I—Improving the Quality of Medicaid for Patients and Providers

SEC. 2701. ADULT HEALTH QUALITY MEASURES.

    Title XI of the Social Security Act (42 U.S.C. 1301 et seq.), as amended by section 401 of the Children's Health Insurance Program  Reauthorization Act of 2009 (Public Law 111-3), is amended by inserting after section 1139A the following new section:

"SEC. 1139B. ADULT HEALTH QUALITY MEASURES.

    "(a) Development of Core Set of Health Care Quality Measures for Adults Eligible for Benefits Under Medicaid.—The  Secretary shall identify and publish a recommended core set of adult health quality measures for Medicaid eligible adults in the same manner as the Secretary identifies and publishes a core set of child health quality measures under section  1139A, including with respect to identifying and publishing existing 
adult health quality measures that are in use under public and privately 
sponsored health care coverage arrangements, or that are part of 
reporting systems that measure both the presence and duration of health 
insurance coverage over time, that may be applicable to Medicaid 
eligible adults.

    "(b) Deadlines.—
            "(1) Recommended measures.—Not 
        later than January 1, 2011, the Secretary shall identify and 
        publish for comment a recommended core set of adult health 
        quality measures for Medicaid eligible adults.
            "(2) Dissemination.—Not later than 
        January 1, 2012, the Secretary shall publish an initial core set 
        of adult health quality measures that are applicable to Medicaid 
        eligible adults.
            "(3) Standardized reporting.—Not later than January 1, 
        2013, the Secretary, in consultation with States, shall develop 
        a standardized format for reporting information based on the 
        initial core set of adult health quality measures and create 
        procedures to encourage States to use such measures to 
        voluntarily report information regarding the quality of health 
        care for Medicaid eligible adults.
            "(4) Reports to congress.—Not later than January 1, 2014, 
        and every 3 years thereafter, the Secretary shall include in the 
        report to Congress required under section 1139A(a)(6) 
        information similar to the information required under that 
        section with respect to the measures established under this 
        section.
            "(5) Establishment of medicaid quality measurement program.—
                    "(A) In general.—Not later than 12 months after 
                the release of the recommended core set of adult health 
                quality measures under paragraph (1), the Secretary 
                shall establish a Medicaid Quality Measurement Program 
                in the same manner as the Secretary establishes the 
                pediatric quality measures program under section 
                1139A(b). The aggregate amount awarded by the Secretary 
                for grants and contracts for the development, testing, 
                and validation of emerging and innovative evidence-based
                measures under such program shall equal the aggregate amount
                awarded by the Secretary for grants under section 1139A(b)(4)(A)
                    "(B) Revising, strengthening, and improving initial 
                core measures.—Beginning not later than 24 months after
                the establishment of the Medicaid Quality Measurement Program,
                and annually thereafter, the Secretary shall publish recommended 
                changes to the initial core set of adult health quality 
                measures that shall reflect the results of the testing, 
                validation, and consensus process for the development of 
                adult health quality measures.

    "(c) Construction.—Nothing in this section shall be construed as 
supporting the restriction of coverage, under title XIX or XXI or 
otherwise, to only those services that are evidence-based, or in anyway 
limiting available services.
    "(d) Annual State Reports Regarding State-Specific Quality of Care 
Measures Applied Under Medicaid.—
            "(1) Annual state reports.—Each State with a State plan or 
        waiver approved under title XIX shall annually report 
        (separately or as part of the annual report required under 
        section 1139A(c)), to the Secretary on the—
                    "(A) State-specific adult health quality measures 
                applied by the State under the such plan, including 
                measures described in subsection (a)(5); and
                    "(B) State-specific information on the quality of 
                health care furnished to Medicaid eligible adults under 
                such plan, including information collected through 
                external quality reviews of managed care organizations 
                under section 1932 and benchmark plans under section 
                1937.
            "(2) Publication.—Not later than September 30, 2014, and annually 
        thereafter, the Secretary shall collect, analyze, and make 
        publicly available the information reported by States under 
        paragraph (1).

    "(e) Appropriation.—Out of any funds in the Treasury not otherwise 
appropriated, there is appropriated for each of fiscal years 2010 
through 2014, $60,000,000 for the purpose of carrying out this section. 
Funds appropriated under this subsection shall remain available until 
expended.".
Current as of December 2010
Internet Citation: Appendix 2. Affordable Care Act Sec. 2701. Adult Quality Measures: Identifying Health Care Quality Measures for Medicaid-Eligible Adults. December 2010. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/events/nac/reports/nacqm11/appendix2.html