,,ii  #aagth ,,congress  #b;d ,session  
,s4 #ebdi  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,december #ad1 
#bjbb,mr4 ,barrasso 7for himself and    
,mr4 ,whitehouse7 introduced the        
following bill2 which was read twice and
 referred to the ,committee on ,finance 
,a ,,bill  ,to amend title ,,xviii of   
the ,social ,security ,act to encourage 
participation in advanced payment       
models4  #a4 ,short title ,this ,act may
 be cited as the ,preserving ,patient   
,access to ,value-,based ,care ,act4    
#b4 ,advanced payment model incentive1  
participation1 and threshold            
modifications  7a7 ,in general ,section 
#ahcc7z7 of the ,social ,security ,act  
7#db ,u4,s4,c4 #aciel7z77 is amended--  
7#a7 in paragraph 7#a77;,a71 by striking
 #bjbd and inserting #bjbf2 and  7#b7 in
 paragraph 7#b77;,c7-- 7,a7 in clause   
7i71 by striking #ge percent and        
inserting the applicable percent 7as    
defined in clause 7iv77 for such year2  
7,b7 in clause 7ii77,i7-- 7i7 in the    

matter preceding item 7aa71 by striking 
#ge percent and inserting the applicable
 percent 7as defined in clause 7iv77 for
 such year2 and  7ii7 in item 7bb7--    
7,i7 by striking and other than payments
 made under title ,,xix and inserting   
other than payments made under title    
,,xix2 and  7,,ii7 by striking ,state   
program under that title71 and inserting
 ,state program under that title1 and   
other than payments made by payers in   
which no payment or program meeting the 
requirements described in clause        
7iii77,,ii7 is available from the payer 
for participation by the eligible       
professional72 and  7,c7 by adding at   
the end the following new clause3  7iv7 
,applicable percent defined ,for        
purposes of clauses 7i7 and 7ii71 the   
term applicable percent means-- 7,i7 for
 #bjbe1 a percent specified by the      
,secretary1 but in no case less than #ej
 percent or more than #ee percent2 and  
7,,ii7 for a subsequent year1 a percent 
specified by the ,secretary1 but in no  

case less than the percent specified    
under this clause for the preceding year
 or more than #e percentage points      
higher than the percent specified under 
this clause for such preceding year4  4 
7b7 ,partial qualifying apm participant 
modifications ,section                  
#ahdh7q77#a77;,c77iii77,,iii7 of the    
,social ,security ,act 7#db ,u4,s4,c4   
#aciew-#d7q77#a77;,c77iii77,,iii77 is   
amended-- 7#a7 in item 7aa71 by striking
 #ge percent was instead a reference to 
#ej percent and inserting the applicable
 percent was instead a reference to #aj 
percentage points less than the         
applicable percent2 and  7#b7 in item   
7bb7-- 7,a7 by striking #ge percent and 
inserting the applicable percent2  7,b7 
by striking #ej percent and inserting   
#aj percentage points less than the     
applicable percent4