§300gg–17 Ensuring the Quality of Care

Summary

Create annual reports and rules so health plans and insurers show how their benefits and payment methods try to improve care. Not later than 2 years after March 23, 2010, the Secretary must work with experts and stakeholders to write reporting rules that cover efforts to improve health outcomes (like care coordination, chronic disease management, medication adherence, and medical homes), prevent hospital readmissions with good discharge planning and follow-up, improve patient safety and cut medical errors using best clinical practices and health IT, and provide wellness and health-promotion activities. Plans and insurers must send a yearly report to the Secretary and to their enrollees, make the report available during each open enrollment, and the Secretary must post reports online. The Secretary may add penalties for not following the rules and may allow exceptions for plans that largely meet the goals. Wellness programs can be personalized and run by providers or program managers and may include things like smoking cessation, weight and stress management, fitness, nutrition, heart disease and diabetes prevention, and healthy lifestyle support. Wellness programs may not require asking about or collecting information on lawful firearm or ammunition ownership, use, or storage. Authorities under the Affordable Care Act cannot be used to collect or keep records on lawful firearms, or to raise premiums, deny coverage, or reduce rewards based on lawful firearm information. Not later than 180 days after the date on which regulations are promulgated under subsection (c), the Government Accountability Office must study the rules’ impact on health care quality and cost and report to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives.