measures specified under this paragraph with respect to the year involved shall be selected in consultation with stakeholders to promote improvement in beneficiary outcomes and shared decision-making with beneficiaries and their caregivers. When selecting measures specified under this paragraph, the Secretary shall take into account clinical gaps in care, underutilization that may lead to beneficiary harm, patient safety, and outcomes. . (2) by adding at the end the following new subparagraphs: (F) Weighting limitation No single measure specified by the Secretary or individual measure within a composite measure so specified may be weighted less than 10 percent of the total performance score. (G) Statistically valid and reliable In specifying measures under subparagraph (A), the Secretary shall only specify measures that have been shown to be statistically valid and reliable through testing. . (b) Endorsement Section 1881(h)(2)(B) of the Social Security Act ( 42 U.S.C. 1395rr(h)(2)(B) ) is amended— (1) in clause (ii), by adding at the end the following new sentence: The exception under the preceding sentence shall not apply to a measure that the entity with a contract under section 1890(a) (or a similar entity) considered but failed to endorse.