CMS proposes rule for collecting, submitting quality data

Proposed rule eases requirements for eligible professionals, and request for information asks guidance on improving healthcare delivery.

The Centers for Medicare and Medicaid Services has set out proposed guidelines for collecting and submitting quality information through electronic health records systems for 2017 and 2018, showing some flexibility in meeting industry demands regarding collection periods.

The guidelines are included in a newly released proposed rule that the agency issued on Friday, in conjunction with a request for information on other aspects of federal health policy.

The rule, CMS says, is part of an effort to “relieve regulatory burdens, support the patient-doctor relationship in healthcare and promote transparency, flexibility and innovation in the delivery of care.”

The rule’s proposed changes would impact hospitals and long-term care hospitals that are required to collect clinical quality measures as part of the prospective payment system and participating in the Electronic Health Records Incentive Program

For 2017, eligible hospitals and critical access hospitals that are demonstrating meaningful use for the first time in 2017 or have done so in any year prior to 2017 would have a reporting period of two self-selected quarters. Facilities would have to report on at least six clinical quality measures that they choose.

For 2018, the reporting period would expand to the first three quarters of the year. For those facilities participating in the Medicare EHR Incentive Program only, the submission period for reporting CQMs electronically would be the two months after the close of the calendar year, ending Feb. 28, 2019.

The proposed rule is further relaxed for eligible professionals. For 2017, CMS wants to modify the CQM reporting period for EPs electronically reporting CQMs under the Meaningful Use program to a minimum of a continuous 90-day period during the calendar year. CMS further wants to ease reporting requirements by aligning the quality measures available to EPs participating in the EHR Incentive Program with those available to physicians participating in the new Merit-based Incentive Payment System (MIPS).

Also See: Provider groups seek indefinite halt to Meaningful Use, parts of MIPS

In 2018, CMS is proposing modifications to the EHR reporting periods for new and returning participants attesting to MU, to any continuous 90-day period during the calendar, an easing of requirements from a full year of data. This aligns it with requirements CMS set for providers for 2017.

CMS also says it intends to ease requirements for providers whose EHR technology has been decertified under ONC’s Health IT Certification Program, adding an exception that does not penalize them for being unable to comply with MU requirements. This form of exception was mandated by the 21st Century Cure Act, CMS notes.

The agency is also proposing several changes regarding reporting electronic clinical quality measures (eCQMs).

The rule would modify previously finalized eCQM reporting requirements for 2017 that would affect reimbursement for Fiscal Year 2019 by requiring hospitals to submit six of the available eCQMs included in the hospital Inpatient Quality Reporting Program (IQR), to better align the requirements with the electronic reporting requirements for CQMs in the MU program for hospitals.

Further, the rule seeks similar alignment for 2018, which would affect payment determinations in 2020.

The rule also proposes changes for payment rates under the Inpatient Prospective Payment System, that would set the proposed increase of about 1.6 percent in operating payment rates for general acute care hospitals paid under that program that participate in the Hospital Inpatient Quality Reporting Program and are meaningful users of EHRs.

In addition to the payment and policy proposals, CMS issued a request for information to gain feedback on solutions to “achieve transparency, flexibility, program simplification and innovation.” CMS says it’s looking for ideas to help it make regulatory action for inpatient and long-term care hospitals.

“We would like to start a national conversation about improving the healthcare delivery system, how Medicare can contribute to making the delivery system less bureaucratic and complex, and how we can reduce burden for clinicians, providers and patients in a way that increases quality of care and decreases costs,” the RFI announcement indicates.

CMS is looking for input on a variety of factors, including “data sharing.”

A fact sheet on the proposed rule can be found here.

The proposed rule and request for information can be downloaded here from the Federal Register.

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