---
kind: "section"
citation: "42 U.S.C. § 1395w–5"
title: "42"
title_heading: "The Public Health and Welfare"
number: "1395w–5"
heading: "Public reporting of performance information"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/42/1395w-5"
units:
  - "Chapter 7 — Social Security"
  - "Subchapter XVIII — Health Insurance for Aged and Disabled"
  - "Part B — Supplementary Medical Insurance Benefits for Aged and Disabled"
---

# §1395w–5. Public reporting of performance information

- (a) **In general—**
  - (1) **Development—** Not later than January 1, 2011, the [Secretary](/usc/42/1301.md?p=a-6) shall develop a [Physician](/usc/42/1301.md?p=a-7) Compare Internet website with information on [physicians](/usc/42/1301.md?p=a-7) enrolled in the Medicare program under section 1866(j) of the [Social](/usc/42/1397j.md?p=20) Security Act ([42 U.S.C. 1395cc(j)](/usc/42/1395cc.md?p=j)) and other eligible professionals who participate in the [Physician](/usc/42/1301.md?p=a-7) Quality Reporting Initiative under section 1848 of such Act ([42 U.S.C. 1395w–4](/usc/42/1395w–4.md)).
  - (2) **Plan—** Not later than January 1, 2013, and with respect to reporting periods that begin no earlier than January 1, 2012, the [Secretary](/usc/42/1301.md?p=a-6) shall also implement a plan for making publicly available through [Physician](/usc/42/1301.md?p=a-7) Compare, consistent with [subsection (c)](#c), information on [physician](/usc/42/1301.md?p=a-7) performance that provides comparable information for the public on quality and patient experience measures with respect to [physicians](/usc/42/1301.md?p=a-7) enrolled in the Medicare program under such [section 1866(j)](/usc/42/1866.md). To the extent scientifically sound measures that are developed consistent with the requirements of this section are available, such information, to the extent practicable, shall include—
    - (A) measures collected under the [Physician](/usc/42/1301.md?p=a-7) Quality Reporting Initiative;
    - (B) an assessment of patient health outcomes and the functional status of patients;
    - (C) an assessment of the continuity and coordination of care and care transitions, [including](/usc/42/1301.md?p=b) episodes of care and risk-adjusted resource use;
    - (D) an assessment of efficiency;
    - (E) an assessment of patient experience and patient, [caregiver](/usc/42/1397j.md?p=3), and family engagement;
    - (F) an assessment of the safety, effectiveness, and timeliness of care; and
    - (G) other information as determined appropriate by the [Secretary](/usc/42/1301.md?p=a-6).
- (b) **Other required considerations—** In developing and implementing the plan described in [subsection (a)(2)](#a-2), the [Secretary](/usc/42/1301.md?p=a-6) shall, to the extent practicable, include—
  - (1) processes to assure that data made public, either by the Centers for Medicare & Medicaid Services or by other entities, is statistically valid and reliable, [including](/usc/42/1301.md?p=b) risk adjustment mechanisms used by the [Secretary](/usc/42/1301.md?p=a-6);
  - (2) processes by which a [physician](/usc/42/1301.md?p=a-7) or other eligible professional whose performance on measures is being publicly reported has a reasonable opportunity, as determined by the [Secretary](/usc/42/1301.md?p=a-6), to review his or her individual results before they are made public;
  - (3) processes by the [Secretary](/usc/42/1301.md?p=a-6) to assure that the implementation of the plan and the data made available on [Physician](/usc/42/1301.md?p=a-7) Compare provide a robust and accurate portrayal of a [physician](/usc/42/1301.md?p=a-7)’s performance;
  - (4) data that reflects the care provided to all patients seen by [physicians](/usc/42/1301.md?p=a-7), under both the Medicare program and, to the extent practicable, other payers, to the extent such information would provide a more accurate portrayal of [physician](/usc/42/1301.md?p=a-7) performance;
  - (5) processes to ensure appropriate attribution of care when multiple [physicians](/usc/42/1301.md?p=a-7) and other providers are involved in the care of a patient;
  - (6) processes to ensure timely statistical performance feedback is provided to [physicians](/usc/42/1301.md?p=a-7) concerning the data reported under any program subject to public reporting under this section; and
  - (7) implementation of computer and data systems of the Centers for Medicare & Medicaid Services that support valid, reliable, and accurate public reporting activities authorized under this section.
- (c) **Ensuring patient privacy—** The [Secretary](/usc/42/1301.md?p=a-6) shall ensure that information on [physician](/usc/42/1301.md?p=a-7) performance and patient experience is not disclosed under this section in a manner that violates sections[^1] 552 or [552a](/usc/5/552a.md) of title 5 with regard to the privacy of [individually identifiable health information](/usc/42/1320d.md?p=6).
- (d) **Feedback from multi-stakeholder groups—** The [Secretary](/usc/42/1301.md?p=a-6) shall take into consideration input provided by multi-stakeholder groups, consistent with sections 1890(b)(7) and 1890A of the [Social](/usc/42/1397j.md?p=20) Security Act [[42 U.S.C. 1395aaa(b)(7)](/usc/42/1395aaa.md?p=b-7), 1395aaa–1], as added by [section 3014](/usc/42/3014.md) of this Act, in selecting quality measures for use under this section.
- (e) **Consideration of transition to value-based purchasing—** In developing the plan under this[^2] [subsection (a)(2)](#a-2), the [Secretary](/usc/42/1301.md?p=a-6) shall, as the [Secretary](/usc/42/1301.md?p=a-6) determines appropriate, consider the plan to transition to a value-based purchasing program for [physicians](/usc/42/1301.md?p=a-7) and other practitioners developed under section 131 of the Medicare Improvements for Patients and Providers Act of 2008 (Public Law 110–275).
- (f) **Report to Congress—** Not later than January 1, 2015, the [Secretary](/usc/42/1301.md?p=a-6) shall submit to Congress a report on the [Physician](/usc/42/1301.md?p=a-7) Compare Internet website developed under [subsection (a)(1)](#a-1). Such report shall include information on the efforts of and plans made by the [Secretary](/usc/42/1301.md?p=a-6) to collect and publish data on [physician](/usc/42/1301.md?p=a-7) quality and efficiency and on patient experience of care in support of value-based purchasing and consumer choice, together with recommendations for such legislation and administrative action as the [Secretary](/usc/42/1301.md?p=a-6) determines appropriate.
- (g) **Expansion—** At any time before the date on which the report is submitted under [subsection (f)](#f), the [Secretary](/usc/42/1301.md?p=a-6) may expand ([including](/usc/42/1301.md?p=b) expansion to other providers of services and suppliers under title XVIII of the [Social](/usc/42/1397j.md?p=20) Security Act [[42 U.S.C. 1395](/usc/42/1395.md) et seq.]) the information made available on such website.
- (h) **Financial incentives to encourage consumers to choose high quality providers—** The [Secretary](/usc/42/1301.md?p=a-6) may establish a demonstration program, not later than January 1, 2019, to provide financial incentives to Medicare beneficiaries who are furnished services by high quality [physicians](/usc/42/1301.md?p=a-7), as determined by the [Secretary](/usc/42/1301.md?p=a-6) based on factors in subparagraphs [(A)](#a-2-A) through [(G)](#a-2-G) of subsection (a)(2). In no case may Medicare beneficiaries be required to pay increased premiums or cost sharing or be subject to a reduction in benefits under title XVIII of the [Social](/usc/42/1397j.md?p=20) Security Act as a result of such demonstration program. The [Secretary](/usc/42/1301.md?p=a-6) shall ensure that any such demonstration program does not disadvantage those beneficiaries without reasonable access to high performing [physicians](/usc/42/1301.md?p=a-7) or create financial inequities under such title.
- (i) **Definitions—** In this section:
  - (1) **Eligible professional—** The term “eligible professional” has the meaning given that term for purposes of the [Physician](/usc/42/1301.md?p=a-7) Quality Reporting Initiative under section 1848 of the [Social](/usc/42/1397j.md?p=20) Security Act ([42 U.S.C. 1395w–4](/usc/42/1395w–4.md)).
  - (2) **Physician—** The term “[physician](/usc/42/1301.md?p=a-7)” has the meaning given that term in [section 1861(r)](/usc/42/1861.md) of such Act ([42 U.S.C. 1395x(r)](/usc/42/1395x.md?p=r)).
  - (3) **Physician Compare—** The term “[Physician](/usc/42/1301.md?p=a-7) Compare” means the Internet website developed under [subsection (a)(1)](#a-1).
  - (4) **Secretary—** The term “[Secretary](/usc/42/1301.md?p=a-6)” means the [Secretary](/usc/42/1301.md?p=a-6) of Health and Human Services.

## Footnotes

[^1]: So in original. Probably should be “section”.
[^2]: So in original. The word “this” probably should not appear.

## Source credit

(Pub. L. 111–148, title X, § 10331, Mar. 23, 2010, 124 Stat. 966.)

## Notes

### Editorial Notes

### References in Text

Section 3014 of this Act, referred to in subsec. (d), is section 3014 of Pub. L. 111–148 which enacted section 1395aaa–1 of this title and amended section 1395aaa of this title.

Section 131 of the Medicare Improvements for Patients and Providers Act of 2008, referred to in subsec. (e), is section 131 of Pub. L. 110–275, 122 Stat. 2520, which amended section 1395w–4 of this title, enacted provisions set out as notes under section 1395w–4 of this title, and redesignated provisions formerly set out as a note under section 1395w–4 of this title as section 1395w–4(m).

The Social Security Act, referred to in subsecs. (g) and (h), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Title XVIII of the Act is classified generally to this subchapter. For complete classification of this Act to the Code, see section 1305 of this title and Tables.

### Codification

Section was enacted as part of the Patient Protection and Affordable Care Act, and not as part of the Social Security Act which comprises this chapter.