,i #aae? ,,congress #b;d ,session ,h4 ,r4 #dihg ,,9 ,,! ,,h\se ,,( ,,repres5tatives ,febru>y #h1 #bjah,mr4 ,burgess 7= himself1 ,mr4 ,g5e ,gre5 ( ,texas1 ,mr4 ,roskam1 & ,mr4 ,lev97 introduc$ ! foll[+ bill2 :i* 0 ref]r$ to ! ,committee on ,en]gy & ,comm]ce1 & 9 addition to ! ,committee on ,ways & ,means1 = a p]iod to be subsequ5tly det]m9$ by ! ,speak]1 9 ea* case = consid]ation ( su* provisions z fall )9 ! jurisdiction ( ! committee conc]n$ ,a ,,bill ,to am5d title ,,xviii ( ! ,social ,security ,act to provide = te*nical am5dm5ts to ! ,m]it-bas$ ,inc5tive ,paym5t ,sy/em "u ,m$ic>e4 #a4 ,te*nical am5dm5ts to ,public ,law #aad-aj 7a7 ,,mips transition ,section #ahdh ( ! ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#d7 is am5d$-- 7#a7 9 subsection 7q7-- 7,a7 9 p>agraph 7#a7-- 7i7 9 subp>agraph 7,b71 by /rik+ items & s]vices & ins]t+ cov]$ pr(essional s]vices 7z def9$ 9 subsection 7k77#c77;,a772 & 7ii7 9 subp>agraph 7,c77iv7-- 7,i7 by am5d+ subclause 7,i7 to read z foll[s3 7,i7 ,! m9imum numb] 7z det]m9$ by ! ,secret>y7 (-- 7aa7 = p]=mance p]iods beg9n+ be=e ,janu>y #a1 #bjah1 individuals enroll$ "u ?is "p :o are treat$ by ! eligible pr(essional = ! p]=mance p]iod involv$2 & 7bb7 = p]=mance p]iods beg9n+ on or aft] ,janu>y #a1 #bjah1 individuals enroll$ "u ?is "p :o are furni%$ cov]$ pr(essional s]vices 7z def9$ 9 subsection 7k77#c77;,a77 by ! eligible pr(essional = ! p]=mance p]iod involv$4 2 7,,ii7 9 subclause 7,,ii71 by /rik+ items & s]vices & ins]t+ cov]$ pr(essional s]vices 7z def9$ 9 subsection 7k77#c77;,a772 & 7,,iii7 by am5d+ subclause 7,,iii7 to read z foll[s3 7,,iii7 ,! m9imum am\nt 7z det]m9$ by ! ,secret>y7 (-- 7aa7 = p]=mance p]iods beg9n+ be=e ,janu>y #a1 #bjah1 all[$ *>ges bill$ by su* pr(essional "u ?is "p = su* p]=mance p]iod2 & 7bb7 = p]=mance p]iods beg9n+ on or aft] ,janu>y #a1 #bjah1 all[$ *>ges = cov]$ pr(essional s]vices 7z def9$ 9 subsection 7k77#c77;,a77 bill$ by su* pr(essional = su* p]=mance p]iod4 2 7,b7 9 p>agraph 7#e77;,d7-- 7i7 9 clause 7i77,i71 by ins]t+ subject to clause 7iii71 aft] clauses 7i7 & 7ii7 ( p>agraph 7#b77;,a712 & 7ii7 by add+ at ! end ! foll[+ new clause3 7iii7 ,transition ye>s ,= ea* ( ! second1 ?ird1 f\r?1 & fif? ye>s = :i* ! ,,mips applies to paym5ts1 ! p]=mance score = ! p]=mance category describ$ 9 p>agraph 7#b77;,a77ii7 %all n take into acc\nt ! improvem5t ( ! pr(essional involv$4 2 7,c7 9 p>agraph 7#e77;,e7-- 7i7 9 clause 7i77,i77bb7-- 7,i7 9 ! head+ by /rik+ ,fir/ #b ye>s & ins]t+ ,fir/ #e ye>s2 & 7,,ii7 by /rik+ ! fir/ & second ye>s & ins]t+ ea* ( ! fir/ ?r\gh fif? ye>s2 & 7ii7 9 clause 7i77,,ii77bb7-- 7,i7 9 ! head+1 by /rik+ #b ye>s & ins]t+ #e ye>s2 & 7,,ii7 by /rik+ ! second s5t5ce & ins]t+ ! foll[+ new s5t5ces3 ,= ea* ( ! second1 ?ird1 f\r?1 & fif? ye>s = :i* ! ,,mips applies to paym5ts1 n less ?an #aj p]c5t & n m ?an #cj p]c5t ( su* score %all be bas$ on p]=mance ) respect to ! category describ$ 9 clause 7ii7 ( p>agraph 7#b77;,a74 ,no?+ 9 ! previ\s s5t5ce %all be con/ru$1 ) respect to a p]=mance p]iod = a ye> describ$ 9 ! previ\s s5t5ce1 z prev5t+ ! ,secret>y f bas+ #cj p]c5t ( su* score = su* ye> ) respect to ! category describ$ 9 su* clause 7ii71 if ! ,secret>y det]m9es1 bas$ on in=mation po/$ "u subsection 7r77#b77;,i7 t suffici5t res\rce use measures are ready = adoption = use "u ! p]=mance category "u p>agraph 7#b77;,a77ii7 = su* p]=mance p]iod42 7,d7 9 p>agraph 7#f77;,d7-- 7i7 9 clause 7i71 9 ! second s5t5ce1 by /rik+ ,su* p]=mance ?re%old & ins]t+ ,subject to clauses 7iii7 & 7iv71 su* p]=mance ?re%old2 7ii7 9 clause 7ii7-- 7,i7 9 ! fir/ s5t5ce1 by ins]t+ 7beg9n+ ) #bjai & end+ ) #bjbd7 aft] = ea* ye> ( ! ,,mips2 & 7,,ii7 9 ! second s5t5ce1 by ins]t+ subject to clause 7iii71 aft] ,= ea* su* ye>12 7iii7 9 clause 7iii7-- 7,i7 9 ! head+1 by /rik+ #b & ins]t+ #e2 & 7,,ii7 9 ! fir/ s5t5ce1 by /rik+ two ye>s & ins]t+ five ye>s2 & 7iv7 by add+ at ! end ! foll[+ new clause3 7iv7 ,additional special rule = ?ird1 f\r? & fif? ye>s ( ,,mips ,= purposes ( det]m9+ ,,mips adju/m5t factors "u subp>agraph 7,a71 9 addition to ! requirem5ts specifi$ 9 clause 7iii71 ! ,secret>y %all increase ! p]=mance ?re%old ) respect to ea* ( ! ?ird1 f\r?1 & fif? ye>s to :i* ! ,,mips applies to ensure a gradual & increm5tal transition to ! p]=mance ?re%old describ$ 9 clause 7i7 7z e/imat$ by ! ,secret>y7 ) respect to ! six? ye> to :i* ! ,,mips applies4 2 7,e7 9 p>agraph 7#f77;,e7-- 7i7 by /rik+ ,9 ! case ( items & s]vices & ins]t+ ,9 ! case ( cov]$ pr(essional s]vices 7z def9$ 9 subsection 7k77#c77;,a772 & 7ii7 by /rik+ "u ?is "p ) respect to su* items & s]vices & ins]t+ "u ?is "p ) respect to su* cov]$ pr(essional s]vices2 & 7,f7 9 p>agraph 7#g71 9 ! fir/ s5t5ce1 by /rik+ items & s]vices & ins]t+ cov]$ pr(essional s]vices 7z def9$ 9 subsection 7k77#c77;,a772 7#b7 9 subsection 7r77#b71 by add+ at ! end ! foll[+ new subp>agraph3 7,i7 ,in=mation ,! ,secret>y %all1 n lat] ?an ,decemb] #ca/ ( ea* ye> 7beg9n+ ) #bjah71 po/ on ! ,int]net website ( ! ,c5t]s = ,m$ic>e ,m$icaid ,s]vices in=mation on res\rce use measures 9 use "u subsection 7q71 res\rce use measures "u developm5t & ! "t-frame = su* developm5t1 pot5tial future res\rce use measure topics1 a description ( /akehold] engagem5t1 & ! p]c5t ( exp5ditures "u "p ,a & ?is "p t are cov]$ by res\rce use measures4 2 & 7#c7 9 subsection 7s77#e77;,b71 by /rik+ section #ahcc7z77#b77;,c7 & ins]t+ section #ahcc7z77#c77;,d74 7b7 ,physician-,focus$ paym5t model te*nical advisory committee provision ( initial proposal fe$back ,section #ahfh7;c77#b77;,c7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie;ee7c77#b77;,c77 is am5d$ to read z foll[s3 7,c7 ,committee review ( models submitt$ ,! ,committee1 on a p]iodic basis-- 7i7 %all review models submitt$ "u subp>agraph 7,b72 7ii7 may provide individuals & /akehold] entities :o submitt$ su* models )-- 7,i7 initial fe$back on su* models reg>d+ ! ext5t to :i* su* models meet ! crit]ia describ$ 9 subp>agraph 7,a72 & 7,,ii7 an explanation ( ! basis = ! fe$back provid$ "u subclause 7,i72 & 7iii7 %all prep>e comm5ts & recomm5dations reg>d+ :e!r su* models meet ! crit]ia describ$ 9 subp>agraph 7,a7 & submit su* comm5ts & recomm5dations to ! ,secret>y4 4