,i  #aai? ,,congress  #a/ ,session  ,h4 
,r4 #dhc  ,,9 ,,! ,,h\se ,,(            
,,repres5tatives  ,janu>y #af1 #bjbe,mr4
 ,bu*anan 7= himself1 ,mr4 ,panetta1 &  
,mr4 ,cr5%aw7 introduc$ ! foll[+ bill2  
:i* 0 ref]r$ to ! ,committee on ,en]gy &
 ,comm]ce1 & 9 addition to ! ,committee 
on ,ways & ,means1 = 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 direct !        
,secret>y ( ,heal? & ,human ,s]vices to 
delay ! implem5tation ( electronic      
cl9ical quality metrics = acc\ntable c>e
 organizations1 & = o!r purposes4  #a4  
,%ort title ,?is ,act may be cit$ z !   
,heal? ,c>e ,effici5cy ,?r\gh           
,flexibility ,act4  #b4 ,delay 9        
implem5tation ( e,c,q,ms = ,a,c,os  7a7 
,delay ( e,c,q,m implem5tation ,!       
,secret>y ( ,heal? & ,human ,s]vices 79 
?is section ref]r$ to z ! ,secret>y7    
%all delay ! implem5tation ( !          
requirem5t = ,a,c,os to transition f    

report+ quality measures via ! ,c5t]s = 
,m$ic>e  ,m$ic>e ,s]vices ,web ,int]face
 portal to electronic ,cl9ical ,quality 
,metrics 7e,c,q,ms71 z describ$ 9 ! rule
 titl$ ,m$ic>e & ,m$icaid ,programs2    
,,cy #bjbe ,paym5t ,policies "u !       
,physician ,fee ,s*$ule & ,o!r ,*anges  
to ,"p ,b ,paym5t & ,cov]age ,policies2 
,m$ic>e ,%>$ ,sav+s ,program            
,requirem5ts2 ,m$ic>e ,prescription     
,drug ,inflation ,rebate ,program2 &    
,m$ic>e ,ov]paym5ts 7#hi ,f$4 ,reg4     
#iggaj 7,decemb] #i1 #bjbd771 until     
,janu>y #a1 #bjcj4  7b7 ,pilot program =
 digital report+ me?ods  7#a7 ,9 g5]al  
,n lat] ?an ,janu>y #a1 #bjbf1 !        
,secret>y %all e/abli% & comm5ce a pilot
 program to te/ digital report+ me?ods =
 quality measures on a subset ( ,a,c,os 
& ,,aco p>ticipants t submit an         
application to p>ticipate 9 su* pilot   
program at su* "t & 9 su* =m z !        
,secret>y det]m9es appropriate4  7#b7   
,tempor>y exemption f e,c,q,m           
requirem5ts ,an ,,aco or an ,,aco       

p>ticipant p>ticipat+ 9 ! pilot program 
%all be exempt f m&atory e,c,q,m report+
 requirem5ts dur+ ! duration ( ! pilot  
program4  7#c7 ,no effect on paym5t     
inc5tives ,p>ticipation 9 ! pilot       
program %all h no effect on !           
eligibility ( an ,,aco or an ,,aco      
p>ticipant to qualify = or e>n an       
inc5tive paym5t "u section #ahcc7z7 ( ! 
,social ,security ,act 7#db ,u4,s4,c4   
#aciel7z77 or a paym5t adju/m5t "u      
section #ahdh7q7 ( su* ,act 7#db        
,u4,s4,c4 #aciew-#d7q774  7#d7 ,te*nical
 assi/ance ,! ,secret>y %all provide    
te*nical assi/ance1 includ+ waiv]s f any
 applicable quality report+ requirem5ts1
 to ,a,c,os & provid]s p>ticipat+ 9 !   
pilot program to inc5tivize _!          
p>ticipation & to evaluate ! efficacy ( 
digital report+ me?ods4  7#e7 ,report ,n
 lat] ?an ,janu>y #a1 #bjbh1 ! ,secret>y
 %all submit to ,congress a report t    
includes-- 7,a7 ! f9d+s & results ( !   
pilot program c>ri$ out "u p>agraph     
7#a72 &  7,b7 any recomm5dations =      

increas+ ! adoption by additional       
,a,c,os ( ! digital report+ me?ods te/$ 
"u su* pilot program4  7c7 ,developm5t (
 long-,t]m digital quality report+ /&>ds
  7#a7 ,9 g5]al ,n lat] ?an ,janu>y #a1 
#bjcj1 ! ,secret>y %all implem5t /&>ds =
 digital quality report+ metrics &      
=mats4 ,su* /&>ds %all ensure t all     
,,ehr sy/ems us$ by an ,,aco are capable
 ( support+ digital report+ me?ods      
across a div]se range ( practice sizes1 
specialties1 & geographic locations4    
7#b7 ,consultation ,9 develop+ ! /&>ds  
describ$ 9 p>agraph 7#a71 ! ,secret>y   
%all collaborate ) relevant /akehold]s1 
includ+ repres5tatives ( ! ,national    
,committee = ,quality ,assurance1 ,,ehr 
v5dors1 ,a,c,os1 pay]s1 & national      
m$ical & specialty physician gr\ps4  7d7
 ,cont9u$ use ( exi/+ report+ me?ods    
7#a7 ,9 g5]al ,an ,,aco or ,,aco        
p>ticipant may use ! ,,cms ,web         
,int]face portal1 ,,mips ,c,q,ms1       
,m$ic>e ,c,q,ms1 e,c,q,ms1 or any o!r   
previ\sly e/abli%$ quality report+      

me?ods1 = ! purpose ( meet+ su*         
requirem5ts until ! date on :i* !       
,secret>y promulgates ! /&>diz$ digital 
quality report+ me?ods "u subsection    
7c74  7#b7 ,exemption ,no p5alties %all 
be impos$ on ,a,c,os or ,,aco           
p>ticipants = failure to comply )       
e,c,q,m requirem5ts dur+ ! p]iod prior  
to ,janu>y #a1 #bjcj1 provid$ !y are 9  
compliance ) exi/+ report+ me?ods4  7e7 
,def9itions ,9 ?is section3 7#a7 ,,aco  
,! t]m ,,aco has ! mean+ giv5 ! t]m     
acc\ntable c>e organization 9 section   
#dbe4bj ( title #db1 ,code ( ,f$]al     
,regulations4  7#b7 ,,aco p>ticipant ,! 
t]m ,,aco p>ticipant has ! mean+ giv5   
su* t]m 9 section #dbe4bj ( title #db1  
,code ( ,f$]al ,regulations4  7#c7 ,,ehr
 ,! t]m ,,ehr has ! mean+ giv5 ! t]m    
c]tifi$ ,,ehr te*nology 9 section       
#ahdh7o7 ( ! ,social ,security ,act 7#db
 ,u4,s4,c4 #aciew-#d7o774