This rule also includes revisions to the hospital and critical access hospital (CAH) conditions of participation for infection prevention and control and antibiotic stewardship programs. lock Applications for NTAP Approved for FY 2023. 2023 Quality Benchmarks. This rule also includes revisions to the hospital and critical access hospital (CAH) conditions of participation for infection prevention and control and antibiotic stewardship programs. CMS believes that it is reasonable to assume that some Medicare beneficiaries will continue to be hospitalized with COVID-19 at IPPS hospitals and LTCHs in FY 2023. CMS has also finalized the inclusion of one new eCQM for the 2023 performance period: CMS951v1: Kidney Health Evaluation. No changes have been made to Value Sets, Direct Reference Codes, or Terminology. ORIGINAL POSTING DATE: October 26, 2022 . QualityNet Home CMS distributes a prospectively determined amount of uncompensated care payments to Medicare DSHs based on their relative share of uncompensated care nationally. These measures will continue to be included in the downloadable resources from the VSAC for 2023 performance period. The 2023 reporting/performance period eCQM value sets are available through the National Library of MedicinesValue Set Authority Center(VSAC). CMS requires the use of the most current version of the eCQMs as specified and intended for the applicable performance periods for all quality reporting programs. Value sets contain lists of codes and corresponding terms used by developers and implementers to accurately capture patient data in the EHR system. At this time, CMS is not finalizing any changes in regard to the treatment of section 1115 demonstration days. Stakeholders have requested that RTPs be afforded the same flexibility as other teaching hospitals to share their RTP cap slots via special RTP affiliation agreements. In this final rule, CMS will distribute roughly $6.8billion in uncompensated care payments for FY 2023, a decrease of approximately $318 million from FY 2022. Each year, CMS makes updates to the eCQMs approved for CMS programs to reflect changes in: Important to the development of eCQMs is the use of value sets. Hospital-Level Total Hip Arthroplasty (THA) and/or Total Knee Arthroplasty (TKA) Patient-Reported Outcome performance measure beginning with two voluntary reporting periods (July 1, 2023 through June 30, 2024 and July 1, 2024 through June 30, 2025), followed by mandatory reporting for the reporting period which runs from July 1, 2025 through June 30, 2026, impacting the FY 2028 payment determination. In response to concerns expressed by commenters that the use of only one year of data would lead to significant variations in year-to-year uncompensated care payments, for FY 2023, CMS is using the two most recent years of audited data on uncompensated care costs from Worksheet S10 of hospitals FY 2018 and FY2019 cost reports to distribute these funds. This should promote workforce development and training in rural areas, where there are known challenges with access to care. Resuming the Hospital 30-Day, All-Cause, Risk-Standardized Readmission Rate following Pneumonia Hospitalization measure beginning with the FY 2024 program year following. CMS is revising the hospital and CAH infection prevention and control CoP requirements that require hospitals and CAHs, after the. Revised eCQM Specification for CMS156, Use of High-Risk Medications in We believe using the charge inflation factors and CCR adjustment factors derived from these data provide a more reasonable approximation of the increase in costs that will occur from FY 2021 to FY 2023, because we do not believe the charge inflation that has occurred during the PHE will continue as the number of higher cost COVID-19 cases declines. You must collect measure data for the 12-month performance period (January 1 - December 31, 2023). The Value Sets for use with CMS334v4 are available on the eCQM Resources Tab in a ZIP file. The Measures Management System (MMS) is a standardized system for developing and maintaining the quality measures used in various CMS initiatives and programs. Federal government websites often end in .gov or .mil. Principles for Measuring Health Care Quality Disparities. This total uncompensated care payment amount reflects CMS Office of the Actuarys projections that incorporate the estimated impact of the COVID-19 pandemic. QualityNet is the only CMS-approved website for secure communications and healthcare quality data exchange between: quality improvement organizations (QIOs), hospitals, physician offices, nursing homes, end stage renal disease (ESRD) networks and facilities, and data vendors. 2023 Merit-based Incentive Payment System (MIPS) Toolkit CMS is not finalizing its proposal to use only National Drug Codes (NDCs) to identify claims involving the administration of therapeutic agents approved for NTAP, rather than ICD-10-PCS codes, after consideration of the concerns raised in public comments. We also used charge inflation factors and cost-to-charge ratio (CCR) adjustment factors based on data from prior to the COVID-19 PHE. Clarifying the removal of the no mapped location policy beginning with the FY 2023 program year. to advance health equity, including by better measuring health care quality disparities, and to improve the safety and quality of maternity care. This policy is effective beginning with the application cycle for FY 2024. In this final rule, we return to our historical practice of using the most recent available data, including the FY 2021 MedPAR claims and the FY 2020 cost reports, for the FY 2023 rate setting, with certain modifications to our usual rate setting methodologies to account for the anticipated decline in COVID-19 hospitalizations of Medicare beneficiaries at IPPS hospitals and LTCHs, as compared to FY 2021. The direct reference codes specified within the eCQM HQMF files are also available in a separate file for download. In response to concerns expressed by commenters that the use of only one year of data would lead to significant variations in year-to-year uncompensated care payments, for FY 2023, CMS is using the two most recent years of audited data on uncompensated care costs from Worksheet S10 of hospitals FY 2018 and FY2019 cost reports to distribute these funds. In addition to these measure pauses for the Hospital VBP Program, we are implementing a special scoring methodology for FY 2023 that results in each hospital receiving a value-based incentive payment amount that matches their 2% reduction to the base operating MS-DRG payment amount. Beginning in 2023, reporting a . For the FY 2023 HAC Reduction Program, participating hospitals will not be given a measure score, a Total HAC score, nor a payment adjustment. In this final rule, CMS acknowledges that we received comments on what HHS and CMS can do to help hospitals more effectively: (a) determine likely climate impacts on their patients so that they can develop plans to mitigate those impacts; (b) understand the threats that climate change presents to their operations and better prepare for continuous operations should there be climate-related emergencies; and (c) understand how to take action to reduce emissions and track their progress. means youve safely connected to the .gov website. , CMS will pause or refine several measures in the Hospital Readmissions Reduction Program (HRRP), Hospital-Acquired Condition (HAC) Reduction Program, and Hospital Value-Based Purchasing (VBP) Program. We believe the costs of technologies, for which the three-year anniversary date of the products entry into the U.S. market occurs prior to the latter half of the upcoming fiscal year (and therefore are no longer new), may now be fully reflected in the MedPAR claims data used to recalibrate the MS-DRG relative weights for FY 2023. CMS notes in the final rule that it received comments on key considerations in five specific areas that could inform our approach: identification of goals and approaches for measuring health care disparities and using measure stratification across CMS quality programs; guiding principles for selecting and prioritizing measures for disparity reporting across CMS quality programs; principles for social risk factor and demographic data selection and use; identification of meaningful performance differences; and guiding principles for reporting disparity results. Electronic Clinical Quality Measures (eCQM) Resources You can decide how often to receive updates. Year(s) Measures will not be eligible for 2023 reporting unless and until they are proposed and finalized through notice-and-comment rulemaking for each applicable program. CMS will continue policies finalized in the FY 2020 IPPS/LTCH PPS final rule to address wage index disparities affecting low wage index hospitals. July 18: CMS posted a fact sheet updating the agency's efforts to assist states as they continue renewing eligibility for all Medicaid and CHIP enrollees following the end of the continuous enrollment condition on March 31, 2023, under the Consolidated Appropriations Act, 2023. The 2023 MIPS performance year spans from January 1-December 31, and data collected for this timeframe must be reported to CMS by March 31, 2024. The LTCH QRP is a pay-for-reporting program. CY2022_Available_eCQMs_Table.pdf will begin downloading shortly. To build on the White House Blueprint for Addressing the Maternal Health Crisis, CMS will establish a Birthing-Friendly hospital designation a publicly-reported, public-facing hospital designation on the quality and safety of maternity care. Where to Find the 2023 eCQM Value Sets, Direct Reference Codes, and Terminology. Medicare Spending Per Beneficiary Hospital measure beginning with the FY 2024 payment determination. Calendar Year (CY) 2023 Reporting Period For the CY 2023 reporting period, hospitals participating in the Hospital Inpatient Quality (IQR) Program are required to report electronic clinical quality measure (eCQM) data, per the FY 2023 IPPS/LTCH PPS Final Rule. About 2023 Performance Period Eligible Clinician Resources Filter Resources by - Any - Implementation Guidance Reporting References Standards References Technical Specifications Last Updated: May 24, 2023 Specifically, effective for cost reporting periods beginning on or after October 1, 2022, if the hospitals unweighted number of FTE residents exceeds the FTE cap, and the number of weighted FTE residents also exceeds that FTE cap, the respective primary care and obstetrics and gynecology weighted FTE counts and other weighted FTE counts are adjusted to make the total weighted FTE count equal the FTE cap. CMS also solicited and received comment on potential names for the designation and additional potential data sources for CMS to consider in the future for purposes of awarding this designation. CMS revised the age criteria from the previously published specification on May 5, 2022, to better align with clinical guidelines. TO: State Survey Agency . Hospitals - Inpatient Hospitals - Outpatient Hospitals - Rural Emergency Ambulatory Surgical Centers PPS-Exempt Cancer Hospitals ESRD Facilities CMS will also update the baseline periods for certain measures for the FY 2025 program year. For calendar year (CY) 2022, Medicare Promoting Interoperability Program participants are required to report onthree self-selected eCQMs and the Safe Use of Opioids Concurrent Prescribing eCQM from the set of nineavailable.
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