,,ii #aaf? ,,congress #a/ ,session ,s4 #aifj ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$ ,,/ates ,june #be1 #bjai,ms4 ,/ab5[ 7= h]self & ,ms4 ,coll9s7 introduc$ ! foll[+ bill2 :i* 0 read twice & ref]r$ to ! ,committee on ,f9ance ,a ,,bill ,to am5d title ,,xi ( ! ,social ,security ,act to improve ! quality1 heal? outcomes1 & value ( mat]nity c>e "u ! ,m$icaid & ,,*ip programs by develop+ mat]nity c>e quality measures & support+ mat]nity c>e quality collaboratives4 #a4 ,%ort title2 table ( cont5ts 7a7 ,%ort title ,?is ,act may be cit$ z ! ,quality ,c>e = ,moms & ,babies ,act4 7b7 ,table ( cont5ts ,! table ( cont5ts = ?is ,act is z foll[s3 ,sec4 #a4 ,%ort title2 table ( cont5ts4,sec4 #b4 ,quality measures = mat]nal & infant heal?4,sec4 #c4 ,quality collaboratives4,sec4 #d4 ,facilitation ( increas$ coord9ation & alignm5t betwe5 ! public & private sector ) respect to quality & effici5cy measures4 #b4 ,quality measures = mat]nal & infant heal? 7a7 ,9 g5]al ,title ,,xi ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acja et seq47 is am5d$ by ins]t+ aft] section #aaci;,b ! foll[+ new section3 #aaci;,c4 ,mat]nal & infant quality measures 7a7 ,developm5t ( core set ( heal? c>e quality measures = mat]nal & infant heal? 7#a7 ,9 g5]al ,! ,secret>y %all id5tify & publi% a recomm5d$ core set ( mat]nal & infant heal? quality measures = wom5 & *ildr5 describ$ 9 subp>agraphs 7,a7 & 7,b7 ( section #aijb7l77#a7 9 ! same mann] z ! ,secret>y id5tifies & publi%es a core set ( *ild heal? quality measures "u section #aaci;,a1 includ+ ) respect to id5tify+ & publi%+ exi/+ mat]nal & infant heal? quality measures t are 9 use "u public & privately sponsor$ heal? c>e cov]age arrangem5ts1 or t are "p ( report+ sy/ems t measure bo? ! pres5ce & duration ( heal? insurance cov]age ov] "t1 t may be applicable to ,m$icaid & ,,*ip eligible mo!rs & infants4 7#b7 ,alignm5t ) exi/+ core sets ,9 id5tify+ & publi%+ ! recomm5d$ core set ( mat]nal & infant heal? quality measures requir$ "u p>agraph 7#a71 ! ,secret>y %all ensure t1 to ! ext5t possible1 su* measures align ) & d n duplicate-- 7,a7 ! core set ( *ild heal? quality measures id5tifi$1 publi%$1 & revis$ "u section #aaci;,a2 or 7,b7 ! core set ( adult heal? quality measures id5tifi$1 publi%$1 & revis$ "u section #aaci;,b4 7#c7 ,process = mat]nal & infant quality measures program ,9 id5tify+ gaps 9 exi/+ mat]nal & infant measures & e/abli%+ priorities = ! developm5t & advancem5t ( su* measures1 ! ,secret>y %all consult )-- 7,a7 ,/ates2 7,b7 physicians1 includ+ physicians 9 ! fields ( g5]al ob/etrics1 mat]nal-fetal m$ic9e1 family m$ic9e1 neonatology1 & p$iatrics2 7,c7 nurse practition]s & nurses2 7,d7 c]tifi$ nurse-midwives & c]tifi$ midwives2 7,e7 heal? facilities & heal? sy/ems2 7,f7 national organizations repres5t+ mo!rs & infants2 7,g7 national organizations repres5t+ consum]s & pur*as]s ( heal? c>e2 7,h7 national organizations & individuals ) exp]tise 9 mat]nal & infant heal? quality measurem5t2 & 7,i7 volunt>y cons5sus /&>d-sett+ organizations & o!r organizations involv$ 9 ! advancem5t ( evid5ce-bas$ measures ( heal? c>e4 7b7 ,deadl9es 7#a7 ,recomm5d$ measures ,n lat] ?an ,janu>y #a1 #bjba1 ! ,secret>y %all id5tify & publi% = comm5t a recomm5d$ core set ( mat]nal & infant heal? quality measures t includes ! foll[+3 7,a7 ,measures ( ! process1 exp]i5ce1 effici5cy1 & outcomes ( mat]nity c>e1 includ+ po/p>tum outcomes4 7,b7 ,measures t apply to *ildbe>+ wom5 & newborns at heal?y1 l[1 & high risk1 includ+ measures ( l[-int]v5tion bir?4 7,c7 ,measures t apply to c>e dur+ pregnancy1 ! intrap>tum p]iod1 & ! po/p>tum p]iod4 7,d7 ,measures t apply to a v>iety ( sett+s & provid] types1 su* z cl9ics1 facilities1 heal? plans1 & acc\ntable c>e organizations4 7,e7 ,measures t address disp>ities1 c>e coord9ation1 & %>$ decisionmak+4 7#b7 ,dissem9ation ,n lat] ?an ,janu>y #a1 #bjbb1 ! ,secret>y %all publi% an initial core set ( mat]nal & infant heal? quality measures t are applicable to ,m$icaid & ,,*ip eligible mo!rs & infants4 7#c7 ,/&>diz$ report+ ,n lat] ?an ,janu>y #a1 #bjbc1 ! ,secret>y1 9 consultation ) ,/ates1 %all develop a /&>diz$ =mat = report+ in=mation bas$ on ! initial core set ( mat]nal & infant heal? quality measures & create proc$ures to enc\rage ,/ates to use su* measures to volunt>ily report in=mation reg>d+ ! quality ( heal? c>e = ,m$icaid & ,,*ip eligible mo!rs & infants4 7#d7 ,reports to ,congress ,n lat] ?an ,janu>y #a1 #bjbd1 & e #c ye>s !reaft]1 ! ,secret>y %all include 9 ! report to ,congress requir$ "u section #aaci;,a7a77#f7 in=mation simil> to ! in=mation requir$ "u t section ) respect to ! measures e/abli%$ "u ?is section4 7#e7 ,e/abli%m5t ( ,mat]nal & ,infant ,quality ,measurem5t ,program 7,a7 ,9 g5]al ,n lat] ?an #ab mon?s aft] ! release ( ! recomm5d$ core set ( mat]nal & infant heal? quality measures "u p>agraph 7#a71 ! ,secret>y %all e/abli% a ,mat]nal & ,infant ,quality ,measurem5t ,program 9 ! same mann] z ! ,secret>y e/abli%$ ! p$iatric quality measures program "u section #aaci;,a7b74 7,b7 ,revis+1 /r5g!n+1 & improv+ initial core measures ,beg9n+ n lat] ?an #bd mon?s aft] ! e/abli%m5t ( ! ,mat]nal & ,infant ,quality ,measurem5t ,program1 & annually !reaft]1 ! ,secret>y %all publi% recomm5d$ *anges to ! initial core set ( mat]nal & infant heal? quality measures t %all reflect ! results ( ! te/+1 validation1 & cons5sus process = ! developm5t ( mat]nal & infant heal? quality measures4 7,c7 e,measures 7i7 ,9 g5]al ,an entity aw>d$ a grant or contract by ! ,secret>y to develop em]g+ & innovative evid5ce-bas$ measures "u ! ,mat]nal & ,infant ,quality ,measurem5t ,program %all "w to advance e,measures t are align$ ) ! measures develop$ "u ! ,p$iatric ,quality ,measures ,program e/abli%$ "u section #aaci;,a7b7 & ! ,m$icaid ,quality ,measurem5t ,program e/abli%$ "u section #aaci;,b7b77#e74 7ii7 ,def9ition ,= purposes ( ?is subp>agraph1 ! t]m e,measure means an electronic measure = :i* measurem5t data 7includ+ cl9ical data7 w be collect$ electronically1 includ+ ?r\gh ! use ( electronic heal? records & o!r electronic data s\rces4 7,d7 ,am\nt available = grants & contracts ,! aggregate am\nt ( funds t may be aw>d$ z grants & contracts "u ! ,mat]nal & ,infant ,quality ,measurem5t ,program = ! developm5t1 te/+1 & validation ( em]g+ & innovative evid5ce-bas$ measures %all n exce$ ! aggregate am\nt ( funds aw>d$ z grants & contracts "u section #aaci;,a7b77#d77;,a74 7c7 ,con/ruction ,no?+ 9 ?is section %all be con/ru$ z support+ ! re/riction ( cov]age1 "u title ,,xix or ,,xxi or o!rwise1 to only ^? s]vices t are evid5ce-bas$1 or 9 any way limit+ available s]vices4 7d7 ,mat]nity consum] assessm5t ( heal? c>e provid]s & sy/ems surveys 7#a7 ,adaption ( surveys ,n lat] ?an ,janu>y #a1 #bjbb1 = ! purpose ( measur+ ! c>e exp]i5ces ( *ildbe>+ wom5 & newborns1 :]e appropriate1 ! ,ag5cy = ,heal?c>e ,rese>* & ,quality %all adapt ,consum] ,assessm5t ( ,heal?c>e ,provid]s & ,sy/ems program surveys (-- 7,a7 provid]s2 7,b7 facilities2 & 7,c7 heal? plans4 7#b7 ,surveys mu/ be effective ,! ,ag5cy = ,heal?c>e ,rese>* & ,quality %all ensure t ! surveys adapt$ "u p>agraph 7#a7 are effective 9 measur+ aspects ( c>e t *ildbe>+ wom5 & newborns exp]i5ce1 :i* may include-- 7,a7 v>i\s types ( c>e sett+s2 7,b7 v>i\s types ( c>egiv]s2 7,c7 consid]ations relat+ to pa92 7,d7 %>$ decisionmak+2 7,e7 supportive c>e ar\nd ! "t ( bir?2 & 7,f7 o!r topics relevant to ! quality ( ! exp]i5ce ( *ildbe>+ wom5 & newborns4 7#c7 ,languages ,! surveys adapt$ "u p>agraph 7#a7 %all be available 9 ,engli% & ,spani%4 7#d7 ,endorsem5t ,! ,ag5cy = ,heal?c>e ,rese>* & ,quality %all submit any ,consum] ,assessm5t ( ,heal?c>e ,provid]s & ,sy/ems surveys adapt$ "u ?is p>agraph to ! cons5sus-bas$ entity ) a contract "u section #ahij7;a77#a7 to be consid]$ = endorsem5t "u section #ahij7;b77#b74 7#e7 ,consultation ,! adaption ( 7& process = apply+7 ! surveys "u p>agraph 7#a7 %all be conduct$ 9 consultation ) ! /akehold]s id5tifi$ 9 p>agraph 7#f77;,a74 7#f7 ,/akehold]s 7,a7 ,9 g5]al ,! /akehold]s id5tifi$ 9 ?is subp>agraph are-- 7i7 ! v>i\s cl9ical discipl9es & specialties involv$ 9 provid+ mat]nity c>e2 7ii7 ,/ate ,m$icaid adm9i/rators2 7iii7 mat]nity c>e consum]s & _! advocates2 7iv7 te*nical exp]ts 9 quality measurem5t2 7v7 hospital1 facility1 & heal? sy/em lead]s2 7vi7 employ]s & pur*as]s2 & 7vii7 o!r individuals :o are involv$ 9 ! advancem5t ( evid5ce-bas$ mat]nity c>e quality measures4 7,b7 ,pr(essional organizations ,! /akehold]s id5tifi$ "u subp>agraph 7,a7 may include repres5tatives f relevant national m$ical specialty & pr(essional organizations & specialty societies4 7e7 ,annual ,/ate reports reg>d+ ,/ate-,specific mat]nal & infant quality ( c>e measures appli$ "u ,m$icaid or ,,*ip 7#a7 ,9 g5]al ,ea* ,/ate ) a plan or waiv] approv$ "u title ,,xix or ,,xxi %all annually report 7sep>ately or z "p ( ! annual report requir$ "u section #aaci;,a7c77 to ! ,secret>y on-- 7,a7 ! ,/ate-specific mat]nal & infant heal? quality measures appli$ by ! ,/ate "u su* plan or waiv]1 includ+ measures describ$ 9 subsection 7b77#e77;,b72 & 7,b7 ! ,/ate-specific in=mation on ! quality ( heal? c>e furni%$ to ,m$icaid & ,,*ip eligible mo!rs & infants "u su* plan or waiv]1 includ+ in=mation collect$ ?r\gh ext]nal quality reviews ( manag$ c>e organizations "u section #aicb & b5*m>k plans "u section #aicg4 7#b7 ,publication ,n lat] ?an ,septemb] #cj1 #bjbd1 & annually !reaft]1 ! ,secret>y %all collect1 analyze1 & make publicly available ! in=mation report$ by ,/ates "u p>agraph 7#a74 7f7 ,au?orization ( appropriations ,!re are au?oriz$ to be appropriat$ #af1jjj1jjj to c>ry out ?is section4 ,funds appropriat$ "u ?is subsection %all rema9 available until exp5d$4 4 7b7 ,te*nical am5dm5t ,section #aaci;,b7d77#a77;,a7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acbj;b-#i;b7d77#a77;,a77 is am5d$ by /rik+ subsection 7a77#e7 & ins]t+ subsection 7b77#e74 #c4 ,quality collaboratives 7a7 ,grants ,! ,secret>y ( ,heal? & ,human ,s]vices 79 ?is section ref]r$ to z ! ,secret>y7 may make grants to eligible entities to support-- 7#a7 ! developm5t ( new ,/ate & regional mat]nity & infant c>e quality collaboratives2 7#b7 exp&$ activities ( exi/+ mat]nity & infant c>e quality collaboratives2 & 7#c7 mat]nity & infant c>e initiatives )9 e/abli%$ ,/ate & regional quality collaboratives t are n focus$ exclusively on mat]nity c>e4 7b7 ,eligible entity ,! foll[+ entities %all be eligible = a grant "u subsection 7a73 7#a7 ,quality collaboratives t focus entirely1 or 9 "p1 on mat]nity & infant c>e initiatives1 to ! ext5t t su* collaboratives use su* grant only = su* initiatives4 7#b7 ,entities seek+ to e/abli% a mat]nity & infant c>e quality collaborative4 7#c7 ,/ate ,m$icaid ag5cies4 7#d7 ,/ate dep>tm5ts ( heal?4 7#e7 ,heal? insurance issu]s 7z su* t]m is def9$ 9 section #bgia ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjj;gg-#ia774 7#f7 ,provid] organizations1 includ+ associations repres5t+-- 7,a7 heal? pr(essionals2 & 7,b7 hospitals4 7c7 ,eligible projects & programs ,9 ord] = a project or program ( an eligible entity to be eligible = fund+ "u subsection 7a71 ! project or program mu/ h goals t are design$ to improve ! quality ( mat]nity c>e deliv]$1 su* z-- 7#a7 improv+ ! appropriate use ( caes>ean section2 7#b7 r$uc+ mat]nal & newborn morbidity rates2 7#c7 improv+ brea/-fe$+ rates2 7#d7 r$uc+ hospital readmission rates2 7#e7 id5tify+ improvem5t priorities ?r\gh %>$ pe] review & ?ird-p>ty reviews ( qualitative & quantitative data1 & develop+ & c>ry+ out projects or programs to address su* priorities2 or 7#f7 deliv]+ risk-appropriate levels ( c>e4 7d7 ,activities ,activities t may be support$ by ! fund+ "u subsection 7a7 include ! foll[+3 7#a7 ,facilitat+ p]=mance data collection & fe$back reports to provid]s ) respect to _! p]=mance1 relative to pe]s & b5*m>ks1 if any4 7#b7 ,develop+1 implem5t+1 & evaluat+ protocols & *eckli/s to fo/] safe1 evid5ce-bas$ practice4 7#c7 ,develop+1 implem5t+1 & evaluat+ programs t translate into practice cl9ical recomm5dations support$ by high-quality evid5ce 9 national guidel9es1 sy/ematic reviews1 or o!r well-conduct$ cl9ical /udies4 7#d7 ,develop+ und]ly+ infra/ructure ne$$ to support quality collaborative activities "u ?is subsection4 7#e7 ,provid+ te*nical assi/ance to provid]s & in/itutions to build quality improvem5t capacity & facilitate p>ticipation 9 collaborative activities4 7#f7 ,develop+ ! capability to access ! foll[+ data s\rces3 7,a7 ,a "m's pr5atal1 intrap>tum1 & po/p>tum records4 7,b7 ,a "m's m$ical records4 7,c7 ,an infant's m$ical records s9ce bir?4 7,d7 ,bir? & dea? c]tificates4 7,e7 ,any o!r relevant ,/ate-level g5]at$ data 7su* z data f ! ,pregnancy ,risk ,assessm5t ,monitor+ ,sy/em 7,,prams774 7#g7 ,develop+ access to bl9d$ liability claims data1 analyz+ ! data1 & us+ ! results ( su* analysis to improve practice4 7e7 ,special rule = bir?s 7#a7 ,9 g5]al ,subject to p>agraph 7#b71 if a grant "u subsection 7a7 is = a project or program t focuses on bir?s1 at lea/ #be p]c5t ( ! bir?s address$ by su* project or program mu/ occur 9 heal? facilities t p]=m few] ?an #a1jjj bir?s p] ye>4 7#b7 ,exception ,9 ! case ( a grant "u subsection 7a7 = a project or program locat$ 9 a ,/ate 9 :i* less ?an #be p]c5t ( ! heal? facilities 9 ! ,/ate p]=m less ?an #a1jjj bir?s p] ye>1 ! p]c5tage ( bir?s 9 su* facilities address$ by su* project or program %all be comm5surate ) ! ,/atewide p]c5tage ( bir?s p]=m$ at su* facilities4 7f7 ,use ( quality measures ,projects & programs = :i* su* a grant is made %all-- 7#a7 include data collection ) rapid analysis & fe$back to p>ticipants ) a focus on improv+ practice & heal? outcomes2 7#b7 develop a plan to id5tify & resolve data collection problems2 7#c7 id5tify & docum5t evid5ce-bas$ /rategies t w be us$ to improve p]=mance on quality measures & o!r metrics2 & 7#d7 exclude f quality measure collection & report+ physicians & midwives :o att5d few] ?an #cj bir?s p] ye>4 7g7 ,report+ on quality measures ,any report+ requirem5ts e/abli%$ by a project or program fund$ "u subsection 7a7 %all be design$ to-- 7#a7 m9imize co/s & adm9i/rative ef=t2 & 7#b7 use exi/+ data res\rces :5 feasible4 7h7 ,cle>+h\se ,! ,secret>y %all e/abli% an onl9e1 op5-access cle>+h\se to make protocols1 proc$ures1 reports1 tools1 & o!r res\rces ( individual collaboratives available to collaboratives & o!r entities t are work+ to improve mat]nity & infant c>e quality4 7i7 ,evaluation ,a quality collaborative 7or o!r entity receiv+ a grant "u subsection 7a77 %all-- 7#a7 develop & c>ry out plans = evaluat+ its mat]nity & infant c>e quality improvem5t programs & projects2 & 7#b7 publi% its exp]i5ces & results 9 articles1 te*nical reports1 or o!r =mats = ! b5efit ( o!rs work+ on mat]nity & infant c>e quality improvem5t activities4 7j7 ,annual reports to ,secret>y ,a quality collaborative or o!r eligible entity t receives a grant "u subsection 7a7 %all submit an annual report to ! ,secret>y conta9+ ! foll[+3 7#a7 ,a description ( ! activities c>ri$ out us+ ! fund+ f su* grant4 7#b7 ,a description ( any b>ri]s t limit$ ! ability ( ! collaborative or entity to a*ieve its goals4 7#c7 ,! a*ievem5ts ( ! collaborative or entity "u ! grant ) respect to ! quality1 heal? outcomes1 & value ( mat]nity & infant c>e4 7#d7 ,a li/ ( lessons le>n$ f ! grant4 ,su* reports %all be made available to ! public4 7k7 ,gov]nance 7#a7 ,9 g5]al ,a mat]nity & infant c>e quality collaborative or a mat]nity & infant c>e program )9 a broad] quality collaborative t is support$ "u subsection 7a7 %all be gov]n$ by a multi-/akehold] executive committee4 7#b7 ,composition ,su* executive committee %all include individuals :o repres5t-- 7,a7 physicians1 includ+ physicians 9 ! fields ( g5]al ob/etrics1 mat]nal-fetal m$ic9e1 family m$ic9e1 neonatology1 & p$iatrics2 7,b7 nurse-practition]s & nurses2 7,c7 c]tifi$ nurse-midwives & c]tifi$ midwives2 7,d7 heal? facilities & heal? sy/ems2 7,e7 consum]s2 7,f7 employ]s & o!r private pur*as]s2 7,g7 ,m$icaid programs2 & 7,h7 o!r public heal? ag5cies & organizations1 z appropriate4 ,su* committee also may include o!r individuals1 su* z individuals ) exp]tise 9 heal? quality measurem5t & o!r types ( exp]tise z recomm5d$ by ! ,secret>y4 ,su* committee also may be compos$ ( a comb9ation ( g5]al collaborative executive committee memb]s & mat]nity & infant specific project executive committee memb]s4 7l7 ,consultation ,a quality collaborative or o!r eligible entity t receives a grant "u subsection 7a7 %all engage 9 regul> ongo+ consultation )-- 7#a7 regional & ,/ate public heal? ag5cies & organizations2 7#b7 public & private heal? insur]s2 & 7#c7 regional & ,/ate organizations repres5t+ physicians1 midwives1 & nurses :o provide mat]nity & infant s]vices4 7m7 ,au?orization ( appropriations ,!re are au?oriz$ to be appropriat$ #ae1jjj1jjj to c>ry out ?is section4 ,funds appropriat$ "u ?is subsection %all rema9 available until exp5d$4 #d4 ,facilitation ( increas$ coord9ation & alignm5t betwe5 ! public & private sector ) respect to quality & effici5cy measures 7a7 ,9 g5]al ,section #ahij7;b7 ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acie;aaa7b77 is am5d$ by ins]t+ aft] p>agraph 7#c7 ! foll[+ new p>agraph3 7#d7 ,facilitation ( increas$ coord9ation & alignm5t betwe5 ! public & private sector ) respect to quality & effici5cy measures 7,a7 ,9 g5]al ,! entity %all facilitate increas$ coord9ation & alignm5t betwe5 ! public & private sector ) respect to quality & effici5cy measures4 7,b7 ,annual reports ,! entity %all prep>e & make available to ! public its f9d+s "u ?is p>agraph 9 its annual report4 ,su* public availability %all include po/+ ea* report on ! ,int]net website ( ! entity4 4 7b7 ,effective date ,! am5dm5t made by subsection 7a7 %all take effect on ! date ( enactm5t ( ?is ,act4