#aahth ,,congress  #b;d ,session  ,h4   
,r4 #dhe  ,,an ,,act  ,to amend title   
,,xi of the ,social ,security ,act to   
prohibit the use of quality-adjusted    
life years and similar measures in      
coverage and payment determinations     
under ,federal health care programs4    
#a4 ,short title ,this ,act may be cited
 as the ,protecting ,health ,care for   
,all ,patients ,act of #bjbc4  #b4      
,prohibiting the use of quality-adjusted
 life years and similar measures in     
coverage and payment determinations     
under ,federal health care programs  7a7
 ,in general ,section #aahb7;e7 of the  
,social ,security ,act 7#db ,u4,s4,c4   
#acbj;e-#a7;e77 is amended--  7#a7 by   
inserting or treats extending the life  
of an elderly1 disabled1 or terminally  
ill individual as of lower value than   
extending the life of an individual who 
is younger1 non-disabled1 or not        
terminally ill after because of an      
individual's disability2  7#b7 by       
inserting described in the preceding    

sentence after such a similar measure2  
7#c7 by striking ,the ,secretary shall  
not and inserting ,a ,federal agency    
7including the ,,cmi 7as described in   
section #aaae;,a77 or ,state may not2   
7#d7 by striking under title ,,xviii4   
and inserting the following3 under any  
,federal health care program 7as defined
 in section #aabh;,b1 except that such  
term shall include the health program   
established under chapter #hi of title  
#e1 ,united ,states ,code742 and  7#e7  
by adding at the end the following new  
sentence3 ,notwithstanding any other    
provision of law1 a ,federal agency     
7including the ,,cmi7 or ,state may not 
waive the application of the provisions 
of this subsection 7or the provisions of
 section #aheb7o71 section              
#ahfj;,d-#ab7;h71 section               
#aijb7;a77#hh71 section #aicb7;b77#i71  
or section #bajb7;e77 under section     
#aaae1 section #aaae;,a1 or any other   
demonstration or waiver authority44  7b7
 ,conforming amendments  7#a7 ,medicaid 

7,a7 ,in general ,section #aijb7;a7 of  
the ,social ,security ,act 7#db         
,u4,s4,c4 #acif;a7a77 is amended--  7i7 
in paragraph 7#hf71 by striking and at  
the end2  7ii7 in paragraph 7#hg77;,d71 
by striking the period and inserting 2  
and2 and  7iii7 by inserting after      
paragraph 7#hg7 the following new       
paragraph3  7#hh7 provide for compliance
 with the requirements of section       
#aahb7;e7 7relating to prohibiting the  
use of certain measures in coverage     
determinations1 reimbursement1 and      
incentive programs74  4  7,b7 ,managed  
care organizations ,section #aicb7;b7 of
 the ,social ,security ,act 7#db        
,u4,s4,c4 #acifu-#b7;b77 is amended by  
adding at the end the following new     
paragraph3  7#i7 ,prohibition on use of 
quality-adjusted life years ,the        
provisions of section #aahb7;e7 shall   
apply to the utilization of a           
dollars-per-quality adjusted life year  
or similar measure 7as described in such
 section7 by a medicaid managed care    

organization under this title 7or a     
prepaid inpatient health plan or prepaid
 ambulatory health plan1 as defined in  
section #dch4b of title #db1 ,code of   
,federal ,regulations 7or any successor 
regulation71 under a contract with the  
,state7 in the same manner as such      
provisions apply to the utilization of  
such a year or measure by a ,state under
 this title4  4  7#b7 ,,chip ,section   
#bajb of the ,social ,security ,act 7#db
 ,u4,s4,c4 #acig;bb7 is amended by      
adding at the end the following new     
subsection3  7e7 ,prohibition on the use
 of quality-,adjusted life years and    
similar measures ,a ,state child health 
plan shall provide for compliance with  
the requirements of section #aahb7;e7   
7relating to prohibiting the use of     
certain measures in coverage            
determinations1 reimbursement1 and      
incentive programs74  4  7#c7 ,medicare 
,advantage ,section #aheb of the ,social
 ,security ,act 7#db ,u4,s4,c4          
#aciew-#bb7 is amended by adding at the 

end the following new subsection3  7o7  
,prohibition on use of quality-adjusted 
life years ,the provisions of section   
#aahb7;e7 shall apply to the utilization
 of a dollars-per-quality adjusted life 
year or similar measure 7as described in
 such section7 by an ,,ma plan in the   
same manner as such provisions apply to 
the utilization of such a year or       
measure by the ,secretary under this    
title4  4  7#d7 ,medicare part ,d       
,section #ahfj;,d-#ab of the ,social    
,security ,act 7#db ,u4,s4,c4           
#aciew-#aab7 is amended by adding at the
 end the following new subsection3  7h7 
,prohibition on use of quality-adjusted 
life years ,the provisions of section   
#aahb7;e7 shall apply to the utilization
 of a dollars-per-quality adjusted life 
year or similar measure 7as described in
 such section7 by a prescription drug   
plan in the same manner as such         
provisions apply to the utilization of  
such a year or measure by the ,secretary
 under this title4  4  7c7              

,implementation ,the amendments made by 
this section shall apply beginning on   
,january #a1 #bjbe4  #c4 ,prevention and
 ,public ,health ,fund ,section         
#djjb7;b7 of the ,patient ,protection   
and ,affordable ,care ,act 7#db         
,u4,s4,c4 #cjju-#aa7 is amended by      
striking paragraphs 7#g71 7#h71 and 7#i7
 and inserting the following3  7#g7 for 
each of fiscal years #bjbd and #bjbe1   
#a1ajb1jjj1jjj2  7#h7 for each of fiscal
 years #bjbf and #bjbg1 #a1cbg1jjj1jjj2 
7#i7 for each of fiscal years #bjbh and 
#bjbi1 #a1ebf1jjj1jjj2 and  4  #d4      
,report ,not later than #a year after   
the date of the enactment of this ,act1 
and annually thereafter1 the            
,comptroller ,general of the ,united    
,states shall submit to ,congress a     
report on how quality-adjusted life     
years negatively impacts individuals    
with intellectual and developmental     
disabilities and their access to care4  
,passed the ,house of ,representatives  
,february #g1 #bjbd4;,clerk4