42 U.S.C. § 1395ee — Practicing Physicians Advisory Council; Council for Technology and Innovation

(a) Repealed. This subsection was repealed by Public Law 111-148, title III, section 3134(b)(2), on March 23, 2010. (b) Council for Technology and Innovation. (1) Establishment. The Secretary must establish a Council for Technology and Innovation within the Centers for Medicare & Medicaid Services (“CMS”). (2) Composition. The Council must include senior CMS staff and clinicians. The Executive Coordinator for Technology and Innovation appointed or designated under paragraph (4) chairs it. (3) Duties. The Council must coordinate Medicare coverage, coding, and payment processes for new technologies and procedures, including new drug therapies. It must also coordinate the exchange of information about new technologies between CMS and other entities that make similar decisions. (4) Executive Coordinator. The Secretary must appoint or designate a noncareer appointee, as defined in 5 U.S.C. 3132(a)(7), to serve as Executive Coordinator. The Coordinator reports to the CMS Administrator, chairs the Council, oversees its duties, and serves as the single contact for outside groups and entities about coverage, coding, and payment processes under this subchapter. (c) Physician-focused payment models. (1) Technical Advisory Committee. (A) Establishment. An ad hoc committee called the “Physician-Focused Payment Model Technical Advisory Committee” is established. It is called the “Committee” in this subsection. (B) Membership. (i) The Committee has 11 members appointed by the Comptroller General. (ii) Members must include nationally recognized experts in physician-focused payment models and related care delivery. No more than 5 members may be providers or suppliers, or representatives of providers or suppliers. (iii) A member may not be a Federal Government employee. (iv) The Comptroller General must create a system for public disclosure of members’ financial and other possible conflicts of interest. For applying subchapter I of chapter 131 of title 5, members are treated as congressional employees. (v) The first appointments had to be made no later than 180 days after April 16, 2015. (C) Terms and vacancies. (i) Members serve 3-year terms. For the first members, the Comptroller General must stagger the terms. (ii) A person appointed to fill a vacancy before the predecessor’s term ends serves only the rest of that term. A member may continue serving after the term ends until a successor takes office. A vacancy is filled in the same way as the original appointment. (D) Duties. The Committee meets as needed to give the Secretary comments and recommendations on physician-focused payment models as described in paragraph (2)(C). (E) Compensation. (i) Members serve without pay unless clause (ii) applies. (ii) A member may receive travel expenses, including a daily subsistence allowance, at the rates authorized for an agency employee under subchapter I of chapter 57 of title 5 while away from home or the regular place of business performing Committee duties. (F) Support. (i) The Assistant Secretary for Planning and Evaluation must provide technical and operational support, directly or through a contractor. CMS’s Office of the Actuary must provide actuarial help when needed. (ii) For fiscal year 2015 and each later fiscal year, the Secretary must transfer from the Federal Supplementary Medical Insurance Trust Fund amounts needed for this paragraph, up to $5,000,000. Transferred amounts remain available until spent. (G) Section 1013 of title 5 does not apply to the Committee. (2) Submission and review of physician-focused payment models. (A) Criteria. (i) By November 1, 2016, after requesting information and using notice-and-comment rulemaking, the Secretary had to establish criteria for physician-focused payment models, including specialist models, that the Committee could use for its comments and recommendations under paragraph (1)(D). (ii) During the proposed-rule comment period, the Medicare Payment Advisory Commission may comment to the Secretary on the proposed criteria. (iii) The Secretary may update the criteria through rulemaking. (B) Stakeholder submissions. At any time, individuals and stakeholder entities may submit proposals to the Committee for physician-focused payment models that they believe meet the criteria. (C) Committee review. Periodically, the Committee must review submitted models. It may give the submitters initial feedback about how well the models meet the criteria and explain the basis for that feedback. It must prepare comments and recommendations on whether the models meet the criteria and send them to the Secretary. (D) Secretary’s response. The Secretary must review the Committee’s comments and recommendations and post a detailed response on CMS’s website. (3) Rule of construction. Nothing in this subsection changes the development or testing of models under this subchapter or subchapters XI, XIX, or XXI.