,i #aaith ,,congress #b;d ,session ,h4 ,r4 #ajeba ,,in ,,the ,,house ,,of ,,representatives ,september #ba1 #bjbf,mr4 ,kelly of ,pennsylvania 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 direct the ,secretary of ,health and ,human ,services to revise the regulations implementing the #e-star rating system under ,medicare ,advantage4 #a4 ,short title ,this ,act may be cited as the ,medicare ,advantage ,strengthening ,transparency and ,accountability in ,rating ,systems ,act or the ,,ma ,,stars ,act4 #b4 ,revising regulations implementing ,medicare ,advantage #e-star rating system 7a7 ,in general ,the ,secretary of ,health and ,human ,services shall1 through notice and comment rulemaking1 revise sections #dbb4afj through #dbb4aff of title #db1 ,code of ,federal ,regulations1 to provide that1 in implementing the ,star ,ratings program with respect to an ,,ma-only contract or an ,,ma-,,pd contract1 for the #bjca contract year and each subsequent contract year1 the calculation of ,star ,ratings for such year shall-- 7#a7 exclude any measure that-- 7,a7 the ,secretary determines is not related to clinical quality1 patient outcomes1 or patient experience for individuals enrolled under the contract2 7,b7 the ,secretary determines is not reasonably attributable to actions of the issuer and its delegated entities1 consistent with program guidance2 7,c7 is based on data from a survey distributed to individuals enrolled under the contract if such survey-- 7i7 includes more than #aj questions2 7ii7 does not yield responses from a geographically1 demographically1 and socioeconomically diverse set of individuals2 or 7iii7 fails to meet such minimum response1 sampling1 or representativeness criteria as the ,secretary determines necessary to implement clause 7ii72 or 7,d7 the ,secretary determines is no longer competitive as a metric for the majority of ,,ma-only contracts and ,,ma-,,pd contracts1 and the continued inclusion of which would not differentiate performance among such contracts2 7#b7 only include measures newly added to the ,star ,ratings program for such year that the ,secretary determines are related to clinical quality1 patient outcomes1 or patient experience2 and 7#c7 with respect to any measure excluded under paragraph 7#a77;,d71 include such measure in the ,star ,ratings program as a display-only measure1 including by publicly reporting performance on such measure in a form and manner determined appropriate by the ,secretary4 7b7 ,beneficiary survey technical expert panel ,the ,secretary shall establish a technical expert panel1 consistent with subsection 7e71 to evaluate and recommend the use of statistically sound beneficiary survey instruments as data sources for measures in the ,star ,ratings program4 ,such panel shall-- 7#a7 identify survey instruments that-- 7,a7 are developed1 endorsed1 and maintained by a third-party quality measure organization or ,federal agency1 such as the ,national ,committee for ,quality ,assurance or the ,agency for ,healthcare ,research and ,quality2 7,b7 have relevance to clinical quality1 patient outcomes1 or patient experience2 7,c7 yield responses from a geographically1 demographically1 and socioeconomically diverse set of individuals2 and 7,d7 are designed to meet such minimum response1 sampling1 or representativeness criteria as necessary to implement subparagraph 7,c71 with consideration for the number and complexity of questions1 average time to completion1 modality and timing of survey delivery1 and other factors that maximize survey response rates2 7#b7 solicit relevant stakeholder feedback on the findings of its evaluation and recommendations1 and provide opportunities for public comment2 and 7#c7 not later than #b years after the date of enactment of this section1 submit to the ,secretary a report summarizing the findings of the evaluation and recommendations for statistically sound beneficiary survey instruments to use as data sources for measures in the ,star ,ratings program4 7c7 ,distribution of ,star ,ratings technical expert panel ,the ,secretary shall establish a technical expert panel1 consistent with subsection 7e71 to evaluate the methodology for calculating measure-level cut points and assigning overall ,star ,ratings4 ,such panel shall-- 7#a7 solicit relevant stakeholder feedback on the findings of its evaluation and recommendations1 including opportunities for public comment2 and 7#b7 not later than #b years after the date of enactment of this section1 submit to the ,secretary a report on recommendations to reform such methodology in a manner that rewards performance and promotes competition4 7d7 ,annual public report ,for the #bjca contract year and each subsequent contract year1 not later than a date determined appropriate by the ,secretary prior to the beginning of such contract year1 the ,secretary shall make publicly available a report describing the distribution of overall ,star ,ratings and the methodology used to establish cut points and assign such ratings for such contract year4 ,such report shall also include-- 7#a7 a list of measures excluded from the calculation of ,star ,ratings for such contract year2 and 7#b7 for each such excluded measure1 the basis for exclusion1 including the applicable provision under subsection 7a77#a71 and a brief description of the ,secretary's rationale for such exclusion1 including any data or analysis relied upon1 as determined appropriate by the ,secretary4 7e7 ,technical expert panel composition ,in establishing any technical expert panel under subsection 7b7 or 7c71 the ,secretary shall ensure a balanced representation of relevant stakeholders and experts1 including1 as appropriate1 beneficiaries1 caregivers1 clinicians1 provider organizations1 facility representatives1 measure developers1 health insurance providers1 researchers1 government agencies1 quality measurement experts1 survey methodology experts and ,medicare ,advantage organizations of different sizes1 ownership structures1 geographic service areas1 and delivery models4 ,such representation shall include consideration of nonprofit and other mission-driven organizations1 organizations with provider-aligned care delivery arrangements1 and organizations with local and regional market experience4 7f7 ,definitions ,in this section3 7#a7 ,,ma-only contract2 ,,ma-,,pd contract2 ,star ,rating ,the terms ,,ma-only contract1 ,,ma-,,pd contract and ,star ,rating have the meanings given each such term in the regulations under subpart ,d of part #dbb of title #db1 ,code of ,federal ,regulations4 7#b7 ,delegated entity ,the term delegated entity means any provider1 provider organization1 subcontractor1 or other entity to which an issuer delegates functions related to benefits administration1 utilization management1 quality improvement1 or enrollee services4 7#c7 ,newly added ,the term newly added1 with respect to a measure1 means a measure first included in the ,star ,ratings program for the applicable contract year and does not include a measure continued from a prior year1 unless the ,secretary designates such measure as newly added due to a material change in specifications4 7#d7 ,relevant stakeholders ,the term relevant stakeholders means individuals and entities with expertise or direct experience related to the ,star ,ratings program1 including patients1 caregivers1 clinicians1 provider organizations1 facility representatives1 measure developers1 including third-party quality measure organizations and ,federal agencies1 health insurance providers1 ,medicare ,advantage organizations of different sizes1 ownership structures1 geographic service areas and delivery models1 including nonprofit and other mission-driven organizations1 organizations with provider-aligned care delivery arrangements1 and organizations with local and regional market experience1 quality measurement experts1 survey methodology experts1 researchers1 government agencies1 and individuals with expertise in rural and urban health care delivery4 7#e7 ,secretary ,the term ,secretary means the ,secretary of ,health and ,human ,services4 7#f7 ,star ,ratings program ,the term ,star ,ratings program means the #e-star rating system under section #ahec7o77#d7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#bc7o77#d774