,i  #aafth ,,congress  #ast ,session    
,h4 ,r4 #cdjf  ,,in ,,the ,,house ,,of  
,,representatives  ,june #ba1 #bjai,mr4 
,neal 7for himself and ,mr4 ,brady7     
introduced the following bill2 which was
 referred to the ,committee on ,ways and
 ,means1 and in addition to the         
,committee on ,energy and ,commerce1 for
 a period to be subsequently determined 
by the ,speaker1 in each case for       
consideration of such provisions as fall
 within the jurisdiction of the         
committee concerned  ,a ,,bill  ,to     
amend title ,,xviii of the ,social      
,security ,act to improve measurements  
under the skilled nursing facility      
value-based purchasing program under the
 ,medicare program1 and for other       
purposes4  #a4 ,improving measurements  
under the skilled nursing facility      
value-based purchasing program under the
 ,medicare program  7a7 ,in general     
,section #ahhh7;h7 of the ,social       
,security ,act 7#db ,u4,s4,c4           
#acieyy7h77 is amended-- 7#a7 in        

paragraph 7#a71 by adding at the end the
 following new subparagraph3  7,c7      
,exclusions ,with respect to payments   
for services furnished on or after      
,october #a1 #bjba1 this subsection     
shall not apply to a facility for which 
there are not a minimum number 7as      
determined by the ,secretary7 of--  7i7 
cases for the measures that apply to the
 facility for the performance period for
 the applicable fiscal year2 or  7ii7   
measures that apply to the facility for 
the performance period for the          
applicable fiscal year4  2  7#b7 in     
paragraph 7#b77;,a7--  7,a7 by striking 
,the ,secretary shall apply and         
inserting ,the ,secretary-- 7i7 shall   
apply  2  7,b7 by striking the period at
 the end and inserting 2 and2 and  7,c7 
by adding at the end the following3     
7ii7 may1 with respect to payments for  
services furnished on or after ,october 
#a1 #bjbb1 apply additional measures    
determined appropriate by the           
,secretary1 which may include measures  

of functional status1 patient safety1   
care coordination1 or patient           
experience4  ,subject to the succeeding 
sentence1 in the case that the          
,secretary applies additional measures  
under clause 7ii71 the ,secretary shall 
consider and apply1 as appropriate1     
quality measures specified under section
 #ahii;,b7c77#a74 ,in no case may the   
,secretary apply more than #aj measures 
under this subparagraph4 2  7#c7 in     
subparagraph 7,a7 of each of paragraphs 
7#c7 and 7#d71 by striking measure and  
inserting measures2 and  7#d7 by adding 
at the end the following new paragraph3 
7#ab7 ,validation  7,a7 ,in general ,the
 ,secretary shall apply to the measures 
applied under this subsection and the   
data submitted under subsection 7e77#f7 
a process to validate such measures and 
data1 as appropriate1 which may be      
similar to the process specified in     
section #ahhf7;b77#c77;,b77viii77,,xi7  
for validating inpatient hospital       
measures4  7,b7 ,funding ,for purposes  

of carrying out this paragraph1 the     
,secretary shall provide for the        
transfer1 from the ,federal ,hospital   
,insurance ,trust ,fund established     
under section #ahag1 of #e1jjj1jjj to   
the ,centers for ,medicare  ,medicaid   
,services ,program ,management ,account 
for each of fiscal years #bjbb through  
#bjbd4  4  7b7 ,report by ,med,p,a,c    
,not later than ,march #ae1 #bjba1 the  
,medicare ,payment ,advisory ,commission
 shall submit to ,congress a report on  
establishing a prototype value-based    
payment program under a unified         
prospective payment system for          
post-acute care services under the      
,medicare program under title ,,xviii of
 the ,social ,security ,act 7#db        
,u4,s4,c4 #acie et seq474 ,such report--
  7#a7 shall-- 7,a7 consider design     
elements such as--  7i7 measures that   
are important to the ,medicare program  
and to beneficiaries under such program2
  7ii7 methodologies for scoring        
provider performance and effects on     

payment2 and  7iii7 other elements      
determined appropriate by the           
,commission2 and  7,b7 analyze the      
effects of implementing such prototype  
program2 and  7#b7 may-- 7,a7 discuss   
the possible effects1 with respect to   
the ,medicare program1 on program       
spending1 post-acute care providers1    
patient outcomes1 and other effects     
determined appropriate by the           
,commission2 and  7,b7 include          
recommendations with respect to such    
prototype program1 as determined        
appropriate by the ,commission1 to      
,congress and the ,secretary of ,health 
and ,human ,services4