Sections addressing SNF VBP changes and access to services for hemophilia residents:
SEC. 111. IMPROVING MEASUREMENTS UNDER THE SKILLED NURSING FACILITY VALUE-BASED PURCHASING PROGRAM UNDER THE MEDICARE PROGRAM.
(a) In General.--Section 1888(h) of the Social Security Act (42
U.S.C. 1395yy(h)) is amended--
(1) in paragraph (1), by adding at the end the following new
subparagraph:
``(C) Exclusions.--With respect to payments for services
furnished on or after October 1, 2022, this subsection shall
not apply to a facility for which there are not a minimum
number (as determined by the Secretary) of--
``(i) cases for the measures that apply to the facility
for the performance period for the applicable fiscal year;
or
``(ii) measures that apply to the facility for the
performance period for the applicable fiscal year.'';
(2) in paragraph (2)(A)--
(A) by striking ``The Secretary shall apply'' and inserting
``The Secretary--
``(i) shall apply'';
(B) by striking the period at the end and inserting ``;
and''; and
(C) by adding at the end the following:
``(ii) may, with respect to payments for services
furnished on or after October 1, 2023, apply additional
measures determined appropriate by the Secretary, which may
include measures of functional status, patient safety, care
coordination, or patient experience.
Subject to the succeeding sentence, in the case that the
Secretary applies additional measures under clause (ii), the
Secretary shall consider and apply, as appropriate, quality
measures specified under section 1899B(c)(1). In no case may
the Secretary apply more than 10 measures under this
subparagraph.'';
(3) in subparagraph (A) of each of paragraphs (3) and (4), by
striking ``measure'' and inserting ``measures''; and
(4) by adding at the end the following new paragraph:
``(12) Validation.--
``(A) In general.--The Secretary shall apply to the
measures applied under this subsection and the data submitted
under subsection (e)(6) a process to validate such measures and
data, as appropriate, which may be similar to the process
specified in section 1886(b)(3)(B)(viii)(XI) for validating
inpatient hospital measures.
``(B) Funding.--For purposes of carrying out this
paragraph, the Secretary shall provide for the transfer, from
the Federal Hospital Insurance Trust Fund established under
section 1817, of $5,000,000 to the Centers for Medicare &
Medicaid Services Program Management Account for each of fiscal
years 2023 through 2025, to remain available until expended.''.
(b) Report by MedPAC.--Not later than March 15, 2022, the Medicare
Payment Advisory Commission shall submit to Congress a report on
establishing a prototype value-based payment program under a unified
prospective payment system for post-acute care services under the
Medicare program under title XVIII of the Social Security Act (42
U.S.C. 1395 et seq.). Such report--
(1) shall--
(A) consider design elements such as--
(i) measures that are important to the Medicare program
and to beneficiaries under such program;
(ii) methodologies for scoring provider performance and
effects on payment; and
(iii) other elements determined appropriate by the
Commission; and
(B) analyze the effects of implementing such prototype
program; and
(2) may--
(A) discuss the possible effects, with respect to the
Medicare program, on program spending, post-acute care
providers, patient outcomes, and other effects determined
appropriate by the Commission; and
(B) include recommendations with respect to such prototype
program, as determined appropriate by the Commission, to
Congress and the Secretary of Health and Human Services.
SEC. 134. IMPROVING ACCESS TO SKILLED NURSING FACILITY SERVICES FOR HEMOPHILIA PATIENTS.
(a) In General.--Section 1888(e)(2)(A)(iii) of the Social Security
Act (42 U.S.C. 1395yy(e)(2)(A)(iii)) is amended by adding at the end
the following:
``(VI) Blood clotting factors indicated for the
treatment of patients with hemophilia and other
bleeding disorders (identified as of July 1, 2020, by
HCPCS codes J7170, J7175, J7177-J7183, J7185-J7190,
J7192-J7195, J7198-J7203, J7205, J7207-J7211, and as
subsequently modified by the Secretary) and items and
services related to the furnishing of such factors
under section 1842(o)(5)(C), and any additional blood
clotting factors identified by the Secretary and items
and services related to the furnishing of such factors
under such section.''.
(b) Effective Date.--The amendment made by subsection (a) shall
apply to items and services furnished on or after October 1, 2021.