,i  #aaf? ,,congress  #a/ ,session  ,h4 
,r4 #cdjf  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,june #ba1 #bjai,mr4  
,neal 7= himself & ,mr4 ,brady7         
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,ways & ,means1 & 9    
addition to ! ,committee on ,en]gy &    
,comm]ce1 = 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 improve       
measurem5ts "u ! skill$ nurs+ facility  
value-bas$ pur*as+ program "u ! ,m$ic>e 
program1 & = o!r purposes4  #a4 ,improv+
 measurem5ts "u ! skill$ nurs+ facility 
value-bas$ pur*as+ program "u ! ,m$ic>e 
program  7a7 ,9 g5]al ,section #ahhh7;h7
 ( ! ,social ,security ,act 7#db        
,u4,s4,c4 #acieyy7h77 is am5d$-- 7#a7 9 
p>agraph 7#a71 by add+ at ! end ! foll[+
 new subp>agraph3  7,c7 ,exclusions ,)  
respect to paym5ts = s]vices furni%$ on 
or aft] ,octob] #a1 #bjba1 ?is          

subsection %all n apply to a facility = 
:i* !re are n a m9imum numb] 7z det]m9$ 
by ! ,secret>y7 (--  7i7 cases = !      
measures t apply to ! facility = !      
p]=mance p]iod = ! applicable fiscal    
ye>2 or  7ii7 measures t apply to !     
facility = ! p]=mance p]iod = !         
applicable fiscal ye>4  2  7#b7 9       
p>agraph 7#b77;,a7--  7,a7 by /rik+ ,!  
,secret>y %all apply & ins]t+ ,!        
,secret>y-- 7i7 %all apply  2  7,b7 by  
/rik+ ! p]iod at ! end & ins]t+ 2 &2 &  
7,c7 by add+ at ! end ! foll[+3  7ii7   
may1 ) respect to paym5ts = s]vices     
furni%$ on or aft] ,octob] #a1 #bjbb1   
apply additional measures det]m9$       
appropriate by ! ,secret>y1 :i* may     
include measures ( functional /atus1    
pati5t safety1 c>e coord9ation1 or      
pati5t exp]i5ce4  ,subject to ! succe$+ 
s5t5ce1 9 ! case t ! ,secret>y applies  
additional measures "u clause 7ii71 !   
,secret>y %all consid] & apply1 z       
appropriate1 quality measures specifi$  
"u section #ahii;,b7c77#a74 ,9 no case  

may ! ,secret>y apply m ?an #aj measures
 "u ?is subp>agraph4 2  7#c7 9          
subp>agraph 7,a7 ( ea* ( p>agraphs 7#c7 
& 7#d71 by /rik+ measure & ins]t+       
measures2 &  7#d7 by add+ at ! end !    
foll[+ new p>agraph3  7#ab7 ,validation 
7,a7 ,9 g5]al ,! ,secret>y %all apply to
 ! measures appli$ "u ?is subsection & !
 data submitt$ "u subsection 7e77#f7 a  
process to validate su* measures & data1
 z appropriate1 :i* may be simil> to !  
process specifi$ 9 section              
#ahhf7;b77#c77;,b77viii77,,xi7 =        
validat+ inpati5t hospital measures4    
7,b7 ,fund+ ,= purposes ( c>ry+ out ?is 
p>agraph1 ! ,secret>y %all provide = !  
transf]1 f ! ,f$]al ,hospital ,insurance
 ,tru/ ,fund e/abli%$ "u section #ahag1 
( #e1jjj1jjj to ! ,c5t]s = ,m$ic>e      
,m$icaid ,s]vices ,program ,managem5t   
,acc\nt = ea* ( fiscal ye>s #bjbb ?r\gh 
#bjbd4  4  7b7 ,report by ,med,p,a,c ,n 
lat] ?an ,m>* #ae1 #bjba1 ! ,m$ic>e     
,paym5t ,advisory ,commission %all      
submit to ,congress a report on e/abli%+

 a prototype value-bas$ paym5t program  
"u a unifi$ prospective paym5t sy/em =  
po/-acute c>e s]vices "u ! ,m$ic>e      
program "u title ,,xviii ( ! ,social    
,security ,act 7#db ,u4,s4,c4 #acie et  
seq474 ,su* report--  7#a7 %all-- 7,a7  
consid] design elem5ts su* z--  7i7     
measures t are important to ! ,m$ic>e   
program & to b5efici>ies "u su* program2
  7ii7 me?odologies = scor+ provid]     
p]=mance & effects on paym5t2 &  7iii7  
o!r elem5ts det]m9$ appropriate by !    
,commission2 &  7,b7 analyze ! effects (
 implem5t+ su* prototype program2 &     
7#b7 may-- 7,a7 discuss ! possible      
effects1 ) respect to ! ,m$ic>e program1
 on program sp5d+1 po/-acute c>e        
provid]s1 pati5t outcomes1 & o!r effects
 det]m9$ appropriate by ! ,commission2 &
  7,b7 include recomm5dations ) respect 
to su* prototype program1 z det]m9$     
appropriate by ! ,commission1 to        
,congress & ! ,secret>y ( ,heal? &      
,human ,s]vices4