---
kind: "section"
citation: "42 U.S.C. § 1320b–9b"
title: "42"
title_heading: "The Public Health and Welfare"
number: "1320b–9b"
heading: "Adult health quality measures"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/42/1320b-9b"
units:
  - "Chapter 7 — Social Security"
  - "Subchapter XI — General Provisions, Peer Review, and Administrative Simplification"
  - "Part A — General Provisions"
---

# §1320b–9b. Adult health quality measures

- (a) **Development of core set of health care quality measures for adults eligible for benefits under Medicaid—** The [Secretary](/usc/42/1301.md?p=a-6) shall identify and publish a recommended core set of [adult](/usc/42/619.md?p=1) health quality measures for Medicaid eligible [adults](/usc/42/619.md?p=1) in the same manner as the [Secretary](/usc/42/1301.md?p=a-6) identifies and publishes a core set of [child](/usc/42/1382c.md?p=c) health quality measures under [section 1320b–9a of this title](/usc/42/1320b–9a.md), [including](/usc/42/1301.md?p=b) with respect to identifying and publishing existing [adult](/usc/42/619.md?p=1) health quality measures that are in use under public and privately sponsored health care coverage arrangements, or that are part of reporting systems that measure both the presence and duration of [health insurance coverage](/usc/42/1397jj.md?p=c-3) over time, that may be applicable to Medicaid eligible [adults](/usc/42/619.md?p=1).
- (b) **Deadlines—**
  - (1) **Recommended measures—** Not later than January 1, 2011, the [Secretary](/usc/42/1301.md?p=a-6) shall identify and publish for comment a recommended core set of [adult](/usc/42/619.md?p=1) health quality measures for Medicaid eligible [adults](/usc/42/619.md?p=1).
  - (2) **Dissemination—** Not later than January 1, 2012, the [Secretary](/usc/42/1301.md?p=a-6) shall publish an initial core set of [adult](/usc/42/619.md?p=1) health quality measures that are applicable to Medicaid eligible [adults](/usc/42/619.md?p=1).
  - (3) **Standardized reporting—**
    - (A) **Voluntary reporting—** Not later than January 1, 2013, the [Secretary](/usc/42/1301.md?p=a-6), in consultation with [States](/usc/42/619.md?p=5), shall develop a standardized format for reporting information based on the initial core set of [adult](/usc/42/619.md?p=1) health quality measures and create procedures to encourage [States](/usc/42/619.md?p=5) to use such measures to voluntarily report information regarding the quality of health care for Medicaid eligible [adults](/usc/42/619.md?p=1).
    - (B) **Mandatory reporting with respect to behavioral health measures—** Beginning with the [State](/usc/42/619.md?p=5) report required under [subsection (d)(1)](#d-1) for 2024, the [Secretary](/usc/42/1301.md?p=a-6) shall require [States](/usc/42/619.md?p=5) to use all behavioral health measures included in the core set of [adult](/usc/42/619.md?p=1) health quality measures and any updates or changes to such measures to report information, using the standardized format for reporting information and procedures developed under [subparagraph (A)](#b-3-A), regarding the quality of behavioral health care for Medicaid eligible [adults](/usc/42/619.md?p=1).
  - (4) **Reports to Congress—** Not later than January 1, 2014, and every 3 years thereafter, the [Secretary](/usc/42/1301.md?p=a-6) shall include in the report to Congress required under [section 1320b–9a(a)(6) of this title](/usc/42/1320b–9a.md?p=a-6) information similar to the information required under that section with respect to the measures established under this section.
  - (5) **Establishment of Medicaid quality measurement program—**
    - (A) **In general—** Not later than 12 months after the release of the recommended core set of [adult](/usc/42/619.md?p=1) health quality measures under [paragraph (1)](#b-1))[^1], the [Secretary](/usc/42/1301.md?p=a-6) shall establish a Medicaid Quality Measurement Program in the same manner as the [Secretary](/usc/42/1301.md?p=a-6) establishes the pediatric quality measures program under [section 1320b–9a(b) of this title](/usc/42/1320b–9a.md?p=b).
    - (B) **Revising, strengthening, and improving initial core measures—** Beginning not later than 24 months after the establishment of the Medicaid Quality Measurement Program, and annually thereafter, the [Secretary](/usc/42/1301.md?p=a-6) shall publish recommended changes to the initial core set of [adult](/usc/42/619.md?p=1) health quality measures that shall reflect the results of the testing, validation, and consensus process for the development of [adult](/usc/42/619.md?p=1) health quality measures.
    - (C) **Behavioral health measures—** Beginning with respect to [State](/usc/42/619.md?p=5) reports required under [subsection (d)(1)](#d-1) for 2024, the core set of [adult](/usc/42/619.md?p=1) health quality measures maintained under this paragraph (and any updates or changes to such measures) shall include behavioral health measures.
- (c) **Construction—** Nothing in this section shall be construed as supporting the restriction of coverage, under subchapter XIX or XXI or otherwise, to only those services that are evidence-based, or in anyway limiting available services.
- (d) **Annual State reports regarding State-specific quality of care measures applied under Medicaid—**
  - (1) **Annual State reports—** Each [State](/usc/42/619.md?p=5) with a [State](/usc/42/619.md?p=5) plan or waiver approved under subchapter XIX shall annually report (separately or as part of the annual report required under [section 1320b–9a(c) of this title](/usc/42/1320b–9a.md?p=c)), to the [Secretary](/usc/42/1301.md?p=a-6) on the—
    - (A) [State](/usc/42/619.md?p=5)-specific [adult](/usc/42/619.md?p=1) health quality measures applied by the [State](/usc/42/619.md?p=5) under such plan, [including](/usc/42/1301.md?p=b) measures described in [subsection (b)(5)](#b-5) and, beginning with the report for 2024, all behavioral health measures included in the core set of [adult](/usc/42/619.md?p=1) health quality measures maintained under such [subsection (b)(5)](#b-5) and any updates or changes to such measures (as required under [subsection (b)(3)](#b-3)); and
    - (B) [State](/usc/42/619.md?p=5)-specific information on the quality of health care furnished to Medicaid eligible [adults](/usc/42/619.md?p=1) under such plan, [including](/usc/42/1301.md?p=b) information collected through external quality reviews of managed care organizations under [section 1396u–2 of this title](/usc/42/1396u–2.md) and benchmark plans under [section 1396u–7 of this title](/usc/42/1396u–7.md).
  - (2) **Publication—** Not later than September 30, 2014, and annually thereafter, the [Secretary](/usc/42/1301.md?p=a-6) shall collect, analyze, and make publicly available the information reported by [States](/usc/42/619.md?p=5) under [paragraph (1)](#d-1).
- (e) **Appropriation—** Out of any funds in the Treasury not otherwise appropriated, there is appropriated for each of [fiscal years](/usc/42/619.md?p=3) 2010 through 2014, $60,000,000 for the purpose of carrying out this section. Funds appropriated under this subsection shall remain available until expended. Of the funds appropriated under this subsection, not less than $15,000,000 shall be used to carry out [section 1320b–9a(b) of this title](/usc/42/1320b–9a.md?p=b).

## Footnotes

[^1]: So in original. The second closing parenthesis probably should not appear.

## Source credit

(Aug. 14, 1935, ch. 531, title XI, § 1139B, as added Pub. L. 111–148, title II, § 2701, Mar. 23, 2010, 124 Stat. 317; amended Pub. L. 113–93, title II, § 210, Apr. 1, 2014, 128 Stat. 1047; Pub. L. 115–271, title V, § 5001, Oct. 24, 2018, 132 Stat. 3961.)

## Notes

### Editorial Notes

### Amendments

2018—Subsec. (b)(3). Pub. L. 115–271, § 5001(1)(A), designated existing provisions as subpar. (A), inserted heading, and added subpar. (B).

Subsec. (b)(5)(C). Pub. L. 115–271, § 5001(1)(B), added subpar. (C).

Subsec. (d)(1)(A). Pub. L. 115–271, § 5001(2), substituted “such plan” for “the such plan” and “subsection (b)(5) and, beginning with the report for 2024, all behavioral health measures included in the core set of adult health quality measures maintained under such subsection (b)(5) and any updates or changes to such measures (as required under subsection (b)(3))” for “subsection (a)(5)”.

2014—Subsec. (b)(5)(A). Pub. L. 113–93, § 210(b), struck out at end “The aggregate amount awarded by the Secretary for grants and contracts for the development, testing, and validation of emerging and innovative evidence-based measures under such program shall equal the aggregate amount awarded by the Secretary for grants under section 1320b–9a(b)(4)(A) of this title”.

Subsec. (e). Pub. L. 113–93, § 210(a), inserted at end “Of the funds appropriated under this subsection, not less than $15,000,000 shall be used to carry out section 1320b–9a(b) of this title.”