12 2 STA T . 2 5 5 7PUBLIC LA W 11 0– 275 —J UL Y 15 , 200 8exc ee ds)th et o t alp e rf or m a n ce score u nder para g raph (3 ) wi th respect to performance standards esta b lished b y the S ecretary with respect to measures specified in paragraph ( 2 ) .‘ ‘( C ) NOEF FE CTINSUB SE Q UENT Y E AR S. —T he reduction under subparagraph ( A ) shall apply only with respect to the year in v olved , and the Secretary shall not ta k e into account such reduction in computing the single payment amount under the system under paragraph ( 14 )inasubse -q uent year. ‘‘(2) M EASURES.— ‘‘(A) I N G ENERA L .—The measures specified under this paragraph with respect to the year involved shall include— ‘‘(i) measures on anemia management that reflect the labeling approved by the F ood and D rug Adminis- tration for such management and measures on dialysis adequacy
‘‘(ii) to the extent feasible, such measure (or meas- ures) of patient satisfaction as the Secretary shall specify; and ‘‘(iii) such other measures as the Secretary speci- fies, including, to the extent feasible, measures on— ‘‘(I) iron management; ‘‘(II) bone mineral metabolism; and ‘‘(III) vascular access, including for maximi z ing the placement of arterial venous fistula. ‘‘( B ) U SEOFEN D ORSED M EASURES.— ‘‘(i) IN GENERAL.—Sub j ect to clause (ii), any measure specified by the Secretary under subpara- graph (A)(iii) must have been endorsed by the entity with a contract under section 1 890 (a). ‘‘(ii) EX CE P TION.—In the case of a specified area or medical topic determined appropriate by the Sec- retary for which a feasible and practical measure has not been endorsed by the entity with a contract under section 1890(a), the Secretary may specify a measure that is not so endorsed as long as due consideration is given to measures that have been endorsed or adopted by a consensus organization identified by the Secretary. ‘‘(C) UPDATING MEASURES.—The Secretary shall estab- lish a process for updating the measures specified under subparagraph (A) in consultation with interested parties. ‘‘(D) CONSIDERATION.—In specifying measures under subparagraph (A), the Secretary shall consider the avail- ability of measures that address the unique treatment needs of children and young adults with kidney failure. ‘‘(3) P ERFORMANCE SCORES.— ‘‘(A) TOTAL PERFORMANCE SCORE.— ‘‘(i) IN GENERAL.—Subject to clause (ii), the Sec- retary shall develop a methodology for assessing the total performance of each provider of services and renal dialysis facility based on performance standards with respect to the measures selected under paragraph (2) for a performance period established under paragraph (4)(D) (in this subsection referred to as the ‘total performance score ’ ).
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