2015 US Code
Title 42 - The Public Health and Welfare (Sections 1 - 18445)
Chapter 7 - Social Security (Sections 301 - 1397mm)
Subchapter XVIII - Health Insurance for Aged and Disabled (Sections 1395 - 1395lll)
Part E - Miscellaneous Provisions (Sections 1395x - 1395lll)
Sec. 1395ee - Practicing Physicians Advisory Council; Council for Technology and Innovation
Publication Title | United States Code, 2012 Edition, Supplement 3, Title 42 - THE PUBLIC HEALTH AND WELFARE |
Category | Bills and Statutes |
Collection | United States Code |
SuDoc Class Number | Y 1.2/5: |
Contained Within | Title 42 - THE PUBLIC HEALTH AND WELFARE CHAPTER 7 - SOCIAL SECURITY SUBCHAPTER XVIII - HEALTH INSURANCE FOR AGED AND DISABLED Part E - Miscellaneous Provisions Sec. 1395ee - Practicing Physicians Advisory Council; Council for Technology and Innovation |
Contains | section 1395ee |
Date | 2015 |
Laws In Effect As Of Date | January 3, 2016 |
Positive Law | No |
Disposition | standard |
Source Credit | Aug. 14, 1935, ch. 531, title XVIII, §1868, as added Pub. L. 101-508, title IV, §4112, Nov. 5, 1990, 104 Stat. 1388-64; amended Pub. L. 108-173, title IX, §942(a), Dec. 8, 2003, 117 Stat. 2420; Pub. L. 111-148, title III, §3134(b)(2), Mar. 23, 2010, 124 Stat. 435; Pub. L. 114-10, title I, §101(e)(1), Apr. 16, 2015, 129 Stat. 115. |
Statutes at Large References | 79 Stat. 329 81 Stat. 874 86 Stat. 770 92 Stat. 1824 104 Stat. 1388-64 117 Stat. 2420 124 Stat. 435 129 Stat. 115 |
Public and Private Laws | Public Law 89-97, Public Law 90-248, Public Law 92-463, Public Law 95-521, Public Law 101-508, Public Law 108-173, Public Law 111-148, Public Law 114-10 |
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The Secretary shall establish a Council for Technology and Innovation within the Centers for Medicare & Medicaid Services (in this section referred to as "CMS").
(2) CompositionThe Council shall be composed of senior CMS staff and clinicians and shall be chaired by the Executive Coordinator for Technology and Innovation (appointed or designated under paragraph (4)).
(3) DutiesThe Council shall coordinate the activities of coverage, coding, and payment processes under this subchapter with respect to new technologies and procedures, including new drug therapies, and shall coordinate the exchange of information on new technologies between CMS and other entities that make similar decisions.
(4) Executive Coordinator for Technology and InnovationThe Secretary shall appoint (or designate) a noncareer appointee (as defined in section 3132(a)(7) of title 5) who shall serve as the Executive Coordinator for Technology and Innovation. Such executive coordinator shall report to the Administrator of CMS, shall chair the Council, shall oversee the execution of its duties, and shall serve as a single point of contact for outside groups and entities regarding the coverage, coding, and payment processes under this subchapter.
(c) Physician-focused payment models(1) Technical Advisory Committee(A) EstablishmentThere is established an ad hoc committee to be known as the "Physician-Focused Payment Model Technical Advisory Committee" (referred to in this subsection as the "Committee").
(B) Membership(i) Number and appointmentThe Committee shall be composed of 11 members appointed by the Comptroller General of the United States.
(ii) QualificationsThe membership of the Committee shall include individuals with national recognition for their expertise in physician-focused payment models and related delivery of care. No more than 5 members of the Committee shall be providers of services or suppliers, or representatives of providers of services or suppliers.
(iii) Prohibition on Federal employmentA member of the Committee shall not be an employee of the Federal Government.
(iv) Ethics disclosureThe Comptroller General shall establish a system for public disclosure by members of the Committee of financial and other potential conflicts of interest relating to such members. Members of the Committee shall be treated as employees of Congress for purposes of applying title I of the Ethics in Government Act of 1978 (Public Law 95–521).
(v) Date of initial appointmentsThe initial appointments of members of the Committee shall be made by not later than 180 days after April 16, 2015.
(C) Term; vacancies(i) TermThe terms of members of the Committee shall be for 3 years except that the Comptroller General shall designate staggered terms for the members first appointed.
(ii) VacanciesAny member appointed to fill a vacancy occurring before the expiration of the term for which the member's predecessor was appointed shall be appointed only for the remainder of that term. A member may serve after the expiration of that member's term until a successor has taken office. A vacancy in the Committee shall be filled in the manner in which the original appointment was made.
(D) DutiesThe Committee shall meet, as needed, to provide comments and recommendations to the Secretary, as described in paragraph (2)(C), on physician-focused payment models.
(E) Compensation of members(i) In generalExcept as provided in clause (ii), a member of the Committee shall serve without compensation.
(ii) Travel expensesA member of the Committee shall be allowed travel expenses, including per diem in lieu of subsistence, at rates authorized for an employee of an agency under subchapter I of chapter 57 of title 5 while away from the home or regular place of business of the member in the performance of the duties of the Committee.
(F) Operational and technical support(i) In generalThe Assistant Secretary for Planning and Evaluation shall provide technical and operational support for the Committee, which may be by use of a contractor. The Office of the Actuary of the Centers for Medicare & Medicaid Services shall provide to the Committee actuarial assistance as needed.
(ii) FundingThe Secretary shall provide for the transfer, from the Federal Supplementary Medical Insurance Trust Fund under section 1395t of this title, such amounts as are necessary to carry out this paragraph (not to exceed $5,000,000) for fiscal year 2015 and each subsequent fiscal year. Any amounts transferred under the preceding sentence for a fiscal year shall remain available until expended.
(G) ApplicationSection 14 of the Federal Advisory Committee Act (5 U.S.C. App.) shall not apply to the Committee.
(2) Criteria and process for submission and review of physician-focused payment models(A) Criteria for assessing physician-focused payment models(i) RulemakingNot later than November 1, 2016, the Secretary shall, through notice and comment rulemaking, following a request for information, establish criteria for physician-focused payment models, including models for specialist physicians, that could be used by the Committee for making comments and recommendations pursuant to paragraph (1)(D).
(ii) MedPAC submission of commentsDuring the comment period for the proposed rule described in clause (i), the Medicare Payment Advisory Commission may submit comments to the Secretary on the proposed criteria under such clause.
(iii) UpdatingThe Secretary may update the criteria established under this subparagraph through rulemaking.
(B) Stakeholder submission of physician-focused payment modelsOn an ongoing basis, individuals and stakeholder entities may submit to the Committee proposals for physician-focused payment models that such individuals and entities believe meet the criteria described in subparagraph (A).
(C) Committee review of models submittedThe Committee shall, on a periodic basis, review models submitted under subparagraph (B), prepare comments and recommendations regarding whether such models meet the criteria described in subparagraph (A), and submit such comments and recommendations to the Secretary.
(D) Secretary review and responseThe Secretary shall review the comments and recommendations submitted by the Committee under subparagraph (C) and post a detailed response to such comments and recommendations on the Internet website of the Centers for Medicare & Medicaid Services.
(3) Rule of constructionNothing in this subsection shall be construed to impact the development or testing of models under this subchapter or subchapters XI, XIX, or XXI.
(Aug. 14, 1935, ch. 531, title XVIII, §1868, as added Pub. L. 101–508, title IV, §4112, Nov. 5, 1990, 104 Stat. 1388–64; amended Pub. L. 108–173, title IX, §942(a), Dec. 8, 2003, 117 Stat. 2420; Pub. L. 111–148, title III, §3134(b)(2), Mar. 23, 2010, 124 Stat. 435; Pub. L. 114–10, title I, §101(e)(1), Apr. 16, 2015, 129 Stat. 115.)
REFERENCES IN TEXTThe Ethics in Government Act of 1978, referred to in subsec. (c)(1)(B)(iv), is Pub. L. 95–521, Oct. 26, 1978, 92 Stat. 1824. Title I of the Act is set out in the Appendix to Title 5, Government Organization and Employees. For complete classification of this Act to the Code, see Short Title note set out under section 101 of Pub. L. 95–521 in the Appendix to Title 5 and Tables.
Section 14 of the Federal Advisory Committee Act, referred to in subsec. (c)(1)(G), is section 14 of Pub. L. 92–463, which is set out in the Appendix to Title 5, Government Organization and Employees.
PRIOR PROVISIONSA prior section 1395ee, act Aug. 14, 1935, ch. 531, title XVIII, §1868, as added July 30, 1965, Pub. L. 89–97, title I, §102(a), 79 Stat. 329, provided for creation of a National Medical Review Committee, functions of such Committee, including submission of annual reports to the Secretary and Congress, employment of technical assistance, and for availability of assistance and data, prior to repeal by Pub. L. 90–248, title I, §164(c), Jan. 2, 1968, 81 Stat. 874.
AMENDMENTS2015—Subsec. (c). Pub. L. 114–10 added subsec. (c).
2010—Subsec. (a). Pub. L. 111–148 struck out subsec. (a) which related to the Practicing Physicians Advisory Council.
2003—Pub. L. 108–173, §942(a)(1), inserted "; Council for Technology and Innovation" in section catchline.
Subsec. (a). Pub. L. 108–173, §942(a)(2)–(4), inserted subsec. heading, redesignated existing provisions as par. (1), substituted "in this subsection" for "in this section", and redesignated former subsecs. (b) and (c) as pars. (2) and (3), respectively.
Subsec. (b). Pub. L. 108–173, §942(a)(5), added subsec. (b). Former subsec. (b) redesignated par. (2) of subsec. (a).
Subsec. (c). Pub. L. 108–173, §942(a)(4), redesignated subsec. (c) as par. (3) of subsec. (a).
TERMINATION OF ADVISORY COUNCILSAdvisory councils established after Jan. 5, 1973, to terminate not later than the expiration of the 2-year period beginning on the date of their establishment, unless, in the case of a council established by the President or an officer of the Federal Government, such council is renewed by appropriate action prior to the expiration of such 2-year period, or in the case of a council established by Congress, its duration is otherwise provided by law. See sections 3(2) and 14 of Pub. L. 92–463, Oct. 6, 1972, 86 Stat. 770, 776, set out in the Appendix to Title 5, Government Organization and Employees.
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