42 U.S.C. § 300gg–17 — Ensuring the quality of care

(a) Quality reporting. (1) In general. By 2 years after March 23, 2010, the Secretary — working with quality-of-care experts and stakeholders — had to develop reporting requirements for group health plans and issuers, covering their benefits and how they pay providers. These requirements must push plans to: (A) improve health outcomes, through things like quality reporting, case management, care coordination, chronic disease management, medication and care compliance efforts, and the "medical homes" model; (B) reduce hospital readmissions, through a full discharge program with patient education, discharge planning, and follow-up support after discharge; (C) improve patient safety and cut medical errors, using best clinical practices, evidence-based medicine, and health information technology; and (D) carry out wellness and health promotion activities. (2) Reporting requirements. (A) In general. Each year, a group health plan or issuer must report to the Secretary and to its enrollees on whether its benefits meet the four goals listed above. (B) Timing. This report must be made available to enrollees during each open enrollment period. (C) Availability. The Secretary must post these reports publicly on a website. (D) Penalties. The Secretary may create penalties for plans and issuers that don't comply. (E) Exceptions. The Secretary may exempt plans and issuers that substantially meet this section's goals anyway. (b) Wellness and prevention programs. For the wellness activities in (a)(1)(D), plans may offer personalized wellness and prevention services — run by a health care provider, a wellness plan manager, or an organization that does health risk assessments or ongoing coaching (in person, by phone, or online). These efforts can include: smoking cessation, weight management, stress management, physical fitness, nutrition, heart disease prevention, healthy lifestyle support, and diabetes prevention. (c) Protection of Second Amendment gun rights. (1) Wellness and prevention programs. A wellness activity under (a)(1)(D) cannot require anyone to disclose or allow the collection of information about (A) whether they lawfully keep or store a firearm or ammunition at home or on their property, or (B) their lawful use, possession, or storage of a firearm or ammunition. (2) Limitation on data collection. None of the Secretary's powers under the Affordable Care Act may be used to collect information about the lawful ownership, use, or storage of a firearm or ammunition. (3) Limitation on databases. None of those powers may be used to build or keep records of who lawfully owns or possesses firearms. (4) Limitation on premiums or eligibility. A premium can't be raised, coverage can't be denied, and a wellness discount or reward can't be reduced or withheld, because of someone's lawful ownership, possession, use, or storage of a firearm or ammunition. (5) Limitation on data collection requirements for individuals. No individual can be required to disclose information about lawful firearm or ammunition ownership, possession, use, or storage under any data collection required by the Affordable Care Act. (d) Regulations. By 2 years after March 23, 2010, the Secretary had to issue regulations spelling out how to tell whether a payment structure is one of the kinds described in subsection (a). (e) Study and report. Within 180 days after those regulations were issued, the Government Accountability Office had to review them, study their effects, and report to the Senate committee on health and the House committee on energy and commerce about how the activities under this section affected the quality and cost of health care.