; and (II) with respect to a performance period with respect to a consequence year beginning with the fourth consequence year, at least 6 patient safety measures for providers and suppliers of air ambulance services. (iii) Clinical quality measures The Secretary shall, in consultation with providers and suppliers of air ambulance services, establish— (I) with respect to a performance period with respect to a consequence year before the fourth consequence year, at least 3 clinical quality measures for providers and suppliers of air ambulance services