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42 U.S.C. § 280j — National strategy for quality improvement in health care

Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 280j — National strategy for quality improvement in health care

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Source file: Laws/federal/codes/united-states-code/title-42/section-280j-national-strategy-for-quality-improvement-in-health-care--df5628d5fe.md
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Source location: Title 42, Chapter 6A, § 280j; chapter-6a-public-health-service.md

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**(a) Establishment of national strategy and priorities** (1) **National strategy** — The Secretary, through a transparent collaborative process, shall establish a national strategy to improve the delivery of health care services, patient health outcomes, and population health. (2) **Identification of priorities** (A) *In general* — The Secretary shall identify national priorities for improvement in developing the strategy under paragraph (1). (B) *Requirements* — The Secretary shall ensure that priorities identified under subparagraph (A) will— (i) have the greatest potential for improving the health outcomes, efficiency, and patient-centeredness of health care for all populations, including children and vulnerable populations; (ii) identify areas in the delivery of health care services that have the potential for rapid improvement in the quality and efficiency of patient care; (iii) address gaps in quality, efficiency, comparative effectiveness information (taking into consideration the limitations set forth in subsections (c) and (d) of section 1182 of the Social Security Act [[42 U.S.C. 1320e–1(c)](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1320e–1/c&num=0&edition=prelim), (d)]), and health outcomes measures and data aggregation techniques; (iv) improve Federal payment policy to emphasize quality and efficiency; (v) enhance the use of health care data to improve quality, efficiency, transparency, and outcomes; (vi) address the health care provided to patients with high-cost chronic diseases; (vii) improve research and dissemination of strategies and best practices to improve patient safety and reduce medical errors, preventable admissions and readmissions, and health care-associated infections; (viii) reduce health disparities across health disparity populations (as defined in section 285t 11 See References in Text note below. of this title) and geographic areas; and (ix) address other areas as determined appropriate by the Secretary. (C) *Considerations* — In identifying priorities under subparagraph (A), the Secretary shall take into consideration the recommendations submitted by the entity with a contract under section 1890(a) of the Social Security Act [[42 U.S.C. 1395aaa(a)](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395aaa/a&num=0&edition=prelim)] and other stakeholders. (D) *Coordination with State agencies* — The Secretary shall collaborate, coordinate, and consult with State agencies responsible for administering the Medicaid program under title XIX of the Social Security Act [[42 U.S.C. 1396](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1396&num=0&edition=prelim) et seq.] and the Children’s Health Insurance Program under title XXI of such Act [[42 U.S.C. 1397aa](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397aa&num=0&edition=prelim) et seq.] with respect to developing and disseminating strategies, goals, models, and timetables that are consistent with the national priorities identified under subparagraph (A). **(b) Strategic plan** (1) **In general** — The national strategy shall include a comprehensive strategic plan to achieve the priorities described in subsection (a). (2) **Requirements** — The strategic plan shall include provisions for addressing, at a minimum, the following: (A) Coordination among agencies within the Department, which shall include steps to minimize duplication of efforts and utilization of common quality measures, where available. Such common quality measures shall be measures identified by the Secretary under section 1139A or 1139B of the Social Security Act [[42 U.S.C. 1320b–9a](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1320b-9a&num=0&edition=prelim), 1320b–9b] or endorsed under section 1890 of such Act [[42 U.S.C. 1395aaa](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395aaa&num=0&edition=prelim)]. (B) Agency-specific strategic plans to achieve national priorities. (C) Establishment of annual benchmarks for each relevant agency to achieve national priorities. (D) A process for regular reporting by the agencies to the Secretary on the implementation of the strategic plan. (E) Strategies to align public and private payers with regard to quality and patient safety efforts. (F) Incorporating quality improvement and measurement in the strategic plan for health information technology required by the American Recovery and Reinvestment Act of 2009 (Public Law 111–5). **(c) Periodic update of national strategy** The Secretary shall update the national strategy not less than annually. Any such update shall include a review of short- and long-term goals. **(d) Submission and availability of national strategy and updates** (1) **Deadline for initial submission of national strategy** — Not later than January 1, 2011, the Secretary shall submit to the relevant committees of Congress the national strategy described in subsection (a). (2) **Updates** (A) *In general* — The Secretary shall submit to the relevant committees of Congress an annual update to the strategy described in paragraph (1). (B) *Information submitted* — Each update submitted under subparagraph (A) shall include— (i) a review of the short- and long-term goals of the national strategy and any gaps in such strategy; (ii) an analysis of the progress, or lack of progress, in meeting such goals and any barriers to such progress; (iii) the information reported under section 1139A of the Social Security Act [[42 U.S.C. 1320b–9a](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1320b-9a&num=0&edition=prelim)], consistent with the reporting requirements of such section; and (iv) in the case of an update required to be submitted on or after January 1, 2014, the information reported under section 1139B(b)(4) of the Social Security Act [[42 U.S.C. 1320b–9b(b)(4)](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1320b–9b/b/4&num=0&edition=prelim)], consistent with the reporting requirements of such section. (C) *Satisfaction of other reporting requirements* — Compliance with the requirements of clauses (iii) and (iv) of subparagraph (B) shall satisfy the reporting requirements under sections 1139A(a)(6) and 1139B(b)(4), respectively, of the Social Security Act [[42 U.S.C. 1320b–9a(a)(6)](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1320b–9a/a/6&num=0&edition=prelim), 1320b–9b(b)(4)]. **(e) Health care quality Internet website** Not later than January 1, 2011, the Secretary shall create an Internet website to make public information regarding— (1) the national priorities for health care quality improvement established under subsection (a)(2); (2) the agency-specific strategic plans for health care quality described in subsection (b)(2)(B); and (3) other information, as the Secretary determines to be appropriate.

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 1397aa — Purpose; State child health plans

**(a) Purpose** Except with respect to the rural health transformation program established in [section 1397ee(h) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397ee/h&num=0&edition=prelim), the purpose of this subchapter is to provide funds to States to enable them to initiate and expand the provision of child health assistance to uninsured, low-income children in an effective and efficient manner that is coordinated with other sources of health benefits coverage for children. Such assistance shall be provided primarily for obtaining health benefits coverage through— (1) obtaining coverage that meets the requirements of [section 1397cc of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397cc&num=0&edition=prelim), or (2) providing benefits under the State’s medicaid plan under subchapter XIX, or a combination of both. **(b) State child health plan required** A State is not eligible for payment under subsection (a) or (g) of [section 1397ee of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397ee&num=0&edition=prelim) unless the State has submitted to the Secretary under [section 1397ff of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397ff&num=0&edition=prelim) a plan that— (1) sets forth how the State intends to use the funds provided under this subchapter to provide child health assistance to needy children consistent with the provisions of this subchapter, and (2) has been approved under [section 1397ff of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1397ff&num=0&edition=prelim). **(c) State entitlement** This subchapter constitutes budget authority i

Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1397aa

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 285t — Purpose of Institute

**(a) In general** The general purpose of the National Institute on Minority Health and Health Disparities (in this subpart referred to as the “Institute”) is the conduct and support of research, training, dissemination of information, and other programs with respect to minority health conditions and other populations with health disparities. **(b) Priorities** The Director of the Institute shall in expending amounts appropriated under this subpart give priority to conducting and supporting minority health disparities research. **(c) Minority health disparities research** For purposes of this subpart: (1) The term “minority health disparities research” means basic, clinical, and behavioral research on minority health conditions (as defined in paragraph (2)), including research to prevent, diagnose, and treat such conditions. (2) The term “minority health conditions”, with respect to individuals who are members of minority groups, means all diseases, disorders, and conditions (including with respect to mental health and substance abuse)— (A) unique to, more serious, or more prevalent in such individuals; (B) for which the factors of medical risk or types of medical intervention may be different for such individuals, or for which it is unknown whether such factors or types are different for such individuals; or (C) with respect to which there has been insufficient research involving such individuals as subjects or insufficient data on such individuals. (3) The term “minority group” has the meaning given the term “racial and ethnic minority group” in [section 300u–6 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section300u-6&num=0&edition=prelim). (4) The terms “minority” and “minorities” refer to individuals from a mino

Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 285t

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Federal law — U.S. Code and appendices · legal_authorities

26 U.S.C. § 1 — Tax imposed

**(a) Married individuals filing joint returns and surviving spouses** There is hereby imposed on the taxable income of— (1) every married individual (as defined in section 7703) who makes a single return jointly with his spouse under section 6013, and (2) every surviving spouse (as defined in section 2(a)), a tax determined in accordance with the following table: If taxable income is:The tax is: Not over $36,90015% of taxable income. Over $36,900 but not over $89,150$5,535, plus 28% of the excess over $36,900. Over $89,150 but not over $140,000$20,165, plus 31% of the excess over $89,150. Over $140,000 but not over $250,000$35,928.50, plus 36% of the excess over $140,000. Over $250,000$75,528.50, plus 39.6% of the excess over $250,000. **(b) Heads of households** There is hereby imposed on the taxable income of every head of a household (as defined in section 2(b)) a tax determined in accordance with the following table: If taxable income is:The tax is: Not over $29,60015% of taxable income. Over $29,600 but not over $76,400$4,440, plus 28% of the excess over $29,600. Over $76,400 but not over $127,500$17,544, plus 31% of the excess over $76,400. Over $127,500 but not over $250,000$33,385, plus 36% of the excess over $127,500. Over $250,000$77,485, plus 39.6% of the excess over $250,000. **(c) Unmarried individuals (other than surviving spouses and heads of households)** There is hereby imposed on the taxable income of every individual (other than a surviving spouse as defined in section 2(a) or the head of a household as defined in section 2(b)) who is not a married individual (as defined in section 7703) a tax determined in accordance with the following table: If taxable income is:The tax is: Not over $22,10015% of taxable income. Over $22,100 but not over $53,50

Source: Supplied U.S. Code snapshot — release unconfirmed · 26 U.S.C. § 1

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 1396 — Medicaid and CHIP Payment and Access Commission

**(a) Establishment** There is hereby established the Medicaid and CHIP Payment and Access Commission (in this section referred to as “MACPAC”). **(b) Duties** (1) **Review of access policies for all States and annual reports** — MACPAC shall— (A) review policies of the Medicaid program established under this subchapter (in this section referred to as “Medicaid”) and the State Children’s Health Insurance Program established under subchapter XXI (in this section referred to as “CHIP”) affecting access to covered items and services, including topics described in paragraph (2); (B) make recommendations to Congress, the Secretary, and States concerning such access policies; (C) by not later than March 15 of each year (beginning with 2010), submit a report to Congress containing the results of such reviews and MACPAC’s recommendations concerning such policies; and (D) by not later than June 15 of each year (beginning with 2010), submit a report to Congress containing an examination of issues affecting Medicaid and CHIP, including the implications of changes in health care delivery in the United States and in the market for health care services on such programs. (2) **Specific topics to be reviewed** — Specifically, MACPAC shall review and assess the following: (A) *Medicaid and CHIP payment policies* — Payment policies under Medicaid and CHIP, including— (i) the factors affecting expenditures for the efficient provision of items and services in different sectors, including the process for updating payments to medical, dental, and health professionals, hospitals, residential and long-term care providers, providers of home and community based services, Federally-qualified health centers and rural health clinics, managed care entities, and providers of ot

Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1396

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 1305 — Short title of chapter

This chapter may be cited as the “Social Security Act”.

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 1395aaa — Limitation on liability where claims are disallowed

**(a) Conditions prerequisite to payment for items and services notwithstanding determination of disallowance** Where— (1) a determination is made that, by reason of section 1395y(a)(1) or (9) of this title or by reason of a coverage denial described in subsection (g), payment may not be made under part A or part B of this subchapter for any expenses incurred for items or services furnished an individual by a provider of services or by another person pursuant to an assignment under [section 1395u(b)(3)(B)(ii) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395u/b/3/B/ii&num=0&edition=prelim), and (2) both such individual and such provider of services or such other person, as the case may be, did not know, and could not reasonably have been expected to know, that payment would not be made for such items or services under such part A or part B, then to the extent permitted by this subchapter, payment shall, notwithstanding such determination, be made for such items or services (and for such period of time as the Secretary finds will carry out the objectives of this subchapter), as though section 1395y(a)(1) and [section 1395y(a)(9) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395y/a/9&num=0&edition=prelim) did not apply and as though the coverage denial described in subsection (g) had not occurred. In each such case the Secretary shall notify both such individual and such provider of services or such other person, as the case may be, of the conditions under which payment for such items or services was made and in the case of comparable situations arising thereafter with respect to such individual or such provider or such other person, each shall, by reason of such notice (or simil

Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1395aaa

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 1320e — Comparative clinical effectiveness research

**(a) Definitions** In this section: (1) **Board** — The term “Board” means the Board of Governors established under subsection (f). (2) **Comparative clinical effectiveness research; research** (A) *In general* — The terms “comparative clinical effectiveness research” and “research” mean research evaluating and comparing health outcomes and the clinical effectiveness, risks, and benefits of 2 or more medical treatments, services, and items described in subparagraph (B). (B) *Medical treatments, services, and items described* — The medical treatments, services, and items described in this subparagraph are health care interventions, protocols for treatment, care management, and delivery, procedures, medical devices, diagnostic tools, pharmaceuticals (including drugs and biologicals), integrative health practices, and any other strategies or items being used in the treatment, management, and diagnosis of, or prevention of illness or injury in, individuals. (3) **Conflict of interest** — The term “conflict of interest” means an association, including a financial or personal association, that have 11 So in original. Probably should be “has”. the potential to bias or have 1 the appearance of biasing an individual’s decisions in matters related to the Institute or the conduct of activities under this section. (4) **Real conflict of interest** — The term “real conflict of interest” means any instance where a member of the Board, the methodology committee established under subsection (d)(6), or an advisory panel appointed under subsection (d)(4), or a close relative of such member, has received or could receive either of the following: (A) A direct financial benefit of any amount deriving from the result or findings of a study conducted under this section. (B) A

Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1320e

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 1395lll — Contract with a consensus-based entity regarding performance measurement

**(a) Contract** (1) **In general** — For purposes of activities conducted under this chapter, the Secretary shall identify and have in effect a contract with a consensus-based entity, such as the National Quality Forum, that meets the requirements described in subsection (c). Such contract shall provide that the entity will perform the duties described in subsection (b). (2) **Timing for first contract** — As soon as practicable after July 15, 2008, the Secretary shall enter into the first contract under paragraph (1). (3) **Period of contract** — A contract under paragraph (1) shall be for a period of 4 years (except as may be renewed after a subsequent bidding process). (4) **Competitive procedures** — Competitive procedures (as defined in [section 132 of title 41](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title41-section132&num=0&edition=prelim)) shall be used to enter into a contract under paragraph (1). **(b) Duties** The duties described in this subsection are the following: (1) **Priority setting process** — The entity shall synthesize evidence and convene key stakeholders to make recommendations, with respect to activities conducted under this chapter, on an integrated national strategy and priorities for health care performance measurement in all applicable settings. In making such recommendations, the entity shall— (A) ensure that priority is given to measures— (i) that address the health care provided to patients with prevalent, high-cost chronic diseases; (ii) with the greatest potential for improving the quality, efficiency, and patient-centeredness of health care; and (iii) that may be implemented rapidly due to existing evidence, standards of care, or other reasons; and (B) take into account measures that—

Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1395lll

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 1395mmm — Quality and efficiency measurement

**(a) Multi-stakeholder group input into selection of quality and efficiency measures** The Secretary shall establish a pre-rulemaking process under which the following steps occur with respect to the selection of quality and efficiency measures described in [section 1395aaa(b)(7)(B) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395aaa/b/7/B&num=0&edition=prelim): (1) **Input** — Pursuant to [section 1395aaa(b)(7) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395aaa/b/7&num=0&edition=prelim), the entity with a contract under [section 1395aaa of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395aaa&num=0&edition=prelim) shall convene multi-stakeholder groups to provide input to the Secretary on the selection of quality and efficiency measures described in subparagraph (B) of such paragraph. (2) **Public availability of measures considered for selection** — Not later than December 1 of each year (beginning with 2011), the Secretary shall make available to the public a list of quality and efficiency measures described in [section 1395aaa(b)(7)(B) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395aaa/b/7/B&num=0&edition=prelim) that the Secretary is considering under this subchapter. (3) **Transmission of multi-stakeholder input** — Pursuant to [section 1395aaa(b)(8) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395aaa/b/8&num=0&edition=prelim), not later than February 1 of each year (beginning with 2012), the entity shall transmit to the Secretary the input of multi-stakeholder groups described in paragraph (1). (4) **Consideration of multi-stakeho

Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1395mmm

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Federal law — U.S. Code and appendices · legal_authorities

42 U.S.C. § 299b–31 — Quality measure development

**(a) Quality measure** In this subpart, the term “quality measure” means a standard for measuring the performance and improvement of population health or of health plans, providers of services, and other clinicians in the delivery of health care services. **(b) Identification of quality measures** (1) **Identification** — The Secretary, in consultation with the Director of the Agency for Healthcare Research and Quality and the Administrator of the Centers for Medicare & Medicaid Services, shall identify, not less often than triennially, gaps where no quality measures exist and existing quality measures that need improvement, updating, or expansion, consistent with the national strategy under [section 280j of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section280j&num=0&edition=prelim), to the extent available, for use in Federal health programs. In identifying such gaps and existing quality measures that need improvement, the Secretary shall take into consideration— (A) the gaps identified by the entity with a contract under section 1890(a) of the Social Security Act [[42 U.S.C. 1395aaa(a)](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1395aaa/a&num=0&edition=prelim)] and other stakeholders; (B) quality measures identified by the pediatric quality measures program under section 1139A of the Social Security Act [[42 U.S.C. 1320b–9a](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1320b-9a&num=0&edition=prelim)]; and (C) quality measures identified through the Medicaid Quality Measurement Program under section 1139B of the Social Security Act [[42 U.S.C. 1320b–9b](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section1320b-9b&num=0&edition=preli

Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 299b–31

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