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 100 STAT. 2004

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42 USC 1395// ^°^-

nance organizations and competitive medical plans to physicians. The report shall— (A) review the type of incentive arrangements in common use, (B) evaluate their potential to pressure improperly physicians to reduce or limit services in a medically inappropriate manner, and (C) make recommendations concerning providing for an exception, to the prohibition contained in section 1128A(b) > of the Social Security Act, for incentive arrangements that may be used by such organizations and plans to encourage efficiency in the utilization of medical and other services but that do not have a substantial potential for adverse effect on quality. (d) STUDY TO DEVELOP A STRATEGY FOR QUALITY REVIEW AND ASSURANCE.—

42 USC 1395.

?' Research and development.

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PUBLIC LAW 99-509—OCT. 21, 1986



(1) IN GENERAL.—The Secretary of Health and Human Services shall arrange for a study to design a strategy for reviewing and assuring the quality of care for which payment may be made under title XVIII of the Social Security Act. (2) ITEMS INCLUDED IN STUDY.—Among other items, the study shall— (A) identify the appropriate considerations which should be used in defining "quality of care"; (B) evaluate the relative roles of structure, process, and outcome standards in assuring quality of care; (C) develop prototype criteria and standards for defining and measuring quality of care; (D) evaluate the adequacy and focus of the current methods for measuring, reviewing, and assuring quality of care; (E) evaluate the current research on methodologies for measuring quality of care, and suggest areas of research needed for further progress; (F) evaluate the adequacy and range of methods available to correct or prevent identified problems with quality of care; V > (G) review mechanisms available for promoting, coordinating, and supervising at the national level quality review and assurance activities; and « • (H) develop general criteria which may be used in establishing priorities in the allocation of funds and personnel in reviewing and assuring quality of care. (3) REPORT.—The Secretary shall submit to Congress, not later than 2 years after the date of the enactment of this Act, a report on the study. Such report shall address the items described in paragraph (2) and shall include recommendations with respect to strengthening quality assurance and review activities for services furnished under the medicare program. (4) ARRANGEMENTS FOR STUDY.—(A) The Secretary shall request the National Academy of Sciences, acting through appropriate units, to submit an application to conduct the study described in this subsection. If the Academy submits an acceptable application, the Secretary shall enter into an appropriate arrangement with the Academy for the conduct of the study. If the Academy does not submit an acceptable application to conduct the study, the Secretary may request one or more appropriate nonprofit private entities to submit an application

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