; providing for meaningful measures (a) Removal for inpatient hospitals (1) In general Section 1886(b)(3)(B)(viii) of the Social Security Act ( 42 U.S.C. 1395ww(b)(3)(B)(viii) ) is amended by adding at the end the following new subclause: (XII) For purposes of this clause, in considering the removal of a quality measure, the Secretary shall base such consideration on factors such as the following: (aa) Measure performance is so high and unvarying that meaningful distinctions in improvements in performance can no longer be made. (bb) Performance or improvement on such measure does not result in better patient outcomes. (cc) Such measure does not align with clinical guidelines or practice. (dd) Another measure is available that, with respect to a particular topic, is more broadly applicable (across settings, populations, or conditions) than the measure that is being considered for removal for the particular topic. (ee) Another measure is available that, with respect to a particular topic, is more proximal in time to desired patient outcomes than the measure that is being considered for removal for the particular topic. (ff) Another measure is available that, with respect to a particular topic, is more strongly associated with desired patient outcomes than the measure that is being considered for removal for the particular topic. (gg) Collection or public reporting of the measure leads to negative unintended consequences. (hh) The costs (including costs associated with administrative burden to providers of services and suppliers) associated with the measure outweigh the benefit of the continued use of the measure. (ii) Such other factors determined appropriate by the Secretary. . (2) Value-based purchasing program Section 1886(o)(2)(D) of the Social Security Act ( 42 U.S.C. 1395ww(o)(2)(D) ) is amended— (A) in the heading, by inserting and removal of after Replacing ; (B) by striking Subclause (VI) and inserting Subclauses (VI) and (XII)