Medicare Quality Improvement Act of 2004

Summary

Medicare Quality Improvement Act of 2004 - Amends part C (Medicare+Choice) of title XVIII (Medicare) of the Social Security Act (SSA), as amended by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, to direct the Secretary of Health and Human Services to establish a quality performance incentive payment program to provide annual financial incentive payments, consisting of National Performance Quality Payments and National Quality Improvement Payments, to Medicare Advantage organizations offering Medicare Advantage plans and organizations providing benefits under a reasonable cost reimbursement contract that demonstrate superior quality health care to enrollees. Provides for a reduction in payments to such organizations in order to fund the program. Directs the Secretary to establish a corresponding renal dialysis performance incentive payment program, also including National Performance Quality Payments and National Quality Improvement Payments. Requires the Secretary to establish a program for award of bonus payments to Medicare providers that demonstrate innovative practices, structural improvements, or capacity enhancements that improve the quality of health care provided Medicare beneficiaries. Directs the Secretary to conduct a three-year demonstration program of projects for pediatric dialysis facilities. Requires the Secretary to establish a Medicare Quality Advisory Board. Requires a Medicare Payment Advisory Commission (MEDPAC) study and report to Congress on the use of adjuster mechanisms under the Medicare quality performance incentive payment programs. Directs the Secretary to conduct a three-year demonstration program to measure the quality of health care furnished to individuals under 18 years of age under the SSA title XIX (Medicaid) and title XXI (SCHIP) programs. Authorizes the Secretary to hire five full-time employees within the Center for Medicaid and State Operations from among health professionals experienced in quality improvement, chronic care management, and care coordination (at least one of them also experienced with pediatric populations). Requires the Secretary to study and report to Congress on the efforts to coordinate and integrate data from the Medicare and Medicaid programs. Directs MEDPAC to study and report to Congress on care coordination programs for Medicare and Medicaid dual-eligibles. Requires the Secretary to establish a five-year program of grants for demonstration projects to develop and use Medical Smart Cards and examine their impact on health care costs, quality of care, and patient safety.

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3 official files

• Introduced in Senate (text)

  Introduced in Senate · EN · 23 June 2004

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• Introduced in Senate (PDF)

  Introduced in Senate · EN · 23 June 2004

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• Introduced in Senate

  summary · EN · 23 June 2004

  Open at official source

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