; (B) in subparagraph (J), by striking ; and and inserting , or ; and (C) by adding at the end the following new subparagraph: (K) peripheral artery disease screening tests furnished to at-risk beneficiaries (as such terms are defined in section 1905(jj)); and . (2) Application to alternative cost sharing Section 1916A(b)(3)(B) of the Social Security Act ( 42 U.S.C. 1396o–1(b)(3)(B) ) is amended by adding at the end the following new clause: (xv) Peripheral artery disease screening tests furnished to at-risk beneficiaries (as such terms are defined in section 1905(jj)). . (c) Conforming amendments (1) Section 1902(nn)(3) of the Social Security Act ( 42 U.S.C. 1396a(nn)(3) ) is amended by striking following paragraph (31) and inserting following paragraph (32) . (2) Section 1905(a) of the Social Security Act ( 42 U.S.C. 1396d(a) ) is amended by striking following paragraph (31) and inserting following paragraph (32) . 5. Development and implementation of quality measures (a) Development The Secretary of Health and Human Services (referred to in this section as the Secretary ) shall, in consultation with relevant stakeholders, develop quality measures for nontraumatic, lower-limb, major amputation that utilize appropriate diagnostic screening (including peripheral artery disease screening) in order to encourage alternative treatments (including revascularization) in lieu of such an amputation. (b) Implementation Not later than 18 months after the date of enactment of this Act, the Secretary shall complete appropriate testing and validation of the measures developed under subsection (a) and shall incorporate such measures in quality reporting programs for appropriate providers of services and suppliers under the Medicare program under title XVIII of the Social Security Act ( 42 U.S.C. 1395 et seq. ), including for purposes of— (1) the merit-based incentive payment system under section 1848(q) of such Act ( 42 U.S.C. 1395w–4(q) )