; (B) in paragraph (3), by adding at the end the following new clauses: (v) Equitable care. (vi) Outcomes relating to patient quality of life. ; (C) in paragraph (4)— (i) by striking and the Centers for Medicare & Medicaid Services and inserting the Centers for Medicare & Medicaid Services, and the Indian Health Service ; and (ii) by striking and other nongovernmental entities and inserting and other non-governmental entities including Third Party Administrators ; and (D) by striking paragraph (5) and inserting the following new paragraphs: (5) When collecting, considering, and applying data related to patient care for purposes of establishing standards for quality under paragraph (1), the Secretary shall ensure no metric is being over or under analyzed. (6) In establishing standards for quality under paragraph (1), the Secretary shall— (A) utilize the most up-to-date practices for extracting and analyzing relevant data; (B) utilize all relevant data available to the Secretary; (C) ensure the most efficient use of time and resources related to the use of data scientists employed by the Department; and (D) collaborate, as appropriate, with entities specified in paragraph (4). (7) (A) Not less frequently than once every five years, the Secretary shall update the standards for quality established under paragraph (1) pursuant to the requirements for the establishment of such standards under this subsection. (B) Not later than 30 days after any date on which the Secretary updates, pursuant to subparagraph (A), the standards for quality under paragraph (1), the Secretary shall submit to the appropriate committees of Congress a report on such updated standards for quality. ; and (2) in subsection (b)— (A) in paragraph (1)— (i) by striking Not later than 1 year after the date on which the Secretary establishes standards for quality under subsection (a) and inserting Not less frequently than once every three years