Quality Measures https://www.aha.org/ en AHA comments on home health proposed rule for CY 2022 https://www.aha.org/news/headline/2021-08-27-aha-comments-home-health-proposed-rule-cy-2022 <span class="title">AHA comments on home health proposed rule for CY 2022 </span> <span class="uid"><span>tjordan_drupal</span></span> <span class="created">Aug 27, 2021</span> <div class="field_media_featured_image"><article> <div class="field_media_image"> <img src="/sites/default/files/styles/900x400/public/2018-05/AHA-comment-letter-tax-plan.jpg?itok=WWYuLZPi" width="900" height="400" alt="AHA-comment-letter-tax-plan" /> </div> </article> </div> <div class="body"><p><a href="https://www.aha.org/lettercomment/2021-08-27-aha-comments-cms-home-health-proposed-cy22-rule">Commenting</a> today on the Centers for Medicare &amp; Medicaid Services’ home health prospective payment system proposed rule for calendar year 2022, AHA expressed support for CMS’ decision to forego action in CY 2022 on a behavioral adjustment to the Patient Driven Grouping Model case-mix system, while asking the agency to continue doing so until the end of the COVID-19 public health emergency. The association expressed concern with the accuracy of several of CMS’ key behavioral assumptions, urging the agency to conduct a closer analyses of the gap between projected and actual provider behavior. AHA also commented on the agency’s quality measures proposals and a CMS request for information on health equity and digital quality measurement.&nbsp;</p> </div> <div class="field_topics"> <div><a href="/topics/prospective-payment-systems-pps" class="topic" hreflang="en">Prospective Payment Systems (PPS)</a></div> <div><a href="/topics/quality-measures" hreflang="en">Quality Measures</a></div> <div><a href="/topics/home-health" hreflang="en">Home Health</a></div> </div> <div class="field_type">Headline</div> Fri, 27 Aug 2021 18:53:49 +0000 tjordan_drupal 679257 at https://www.aha.org AHA Comments on CMS’ Home Health Proposed CY22 Rule https://www.aha.org/lettercomment/2021-08-27-aha-comments-cms-home-health-proposed-cy22-rule <span class="title">AHA Comments on CMS’ Home Health Proposed CY22 Rule</span> <span class="uid"><span>dsamuels_drupal</span></span> <span class="created">Aug 27, 2021 - 11:20 AM</span> <div class="body"><p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:&quot;Arial&quot;,sans-serif">On behalf of our nearly 5,000 member hospitals, health systems and other health care organizations, including 900 hospital-based home health agencies, the American Hospital Association appreciates the opportunity to comment on the Centers for Medicare &amp; Medicaid Services’ calendar year 2022 proposed rule for the HH prospective payment system. Specifically, our letter focuses on the field’s behavioral response to the CY 2020 implementation of the new HH PPS case-mix system, the <span style="background:white">Patient Driven Grouping Model (PDGM), as well as the proposed quality reporting provisions.</span>&nbsp; </span></span></span></p> <p><span style="font-size:11pt"><span style="text-autospace:none"><span style="font-family:Calibri,sans-serif"><b><span style="font-family:&quot;Arial&quot;,sans-serif">We continue to support the PDGM objective of increasing HH PPS payment accuracy. However, we remain concerned that the sizeable behavioral adjustment prospectively implemented in the payment system’s first year did not advance this goal. In fact, the field’s evaluation identified several specific elements of the adjustment that were erroneously projected, highlighting the historic difficulty CMS has had in aligning prospective adjustments with actual provider behavior. </span></b></span></span></span></p> <p><span style="font-size:11pt"><span style="text-autospace:none"><span style="font-family:Calibri,sans-serif"><b><span style="font-family:&quot;Arial&quot;,sans-serif">These analyses show that several key CMS behavioral assumptions were inaccurate, as discussed below. </span></b><span style="font-family:&quot;Arial&quot;,sans-serif">In fact, the COVID-19 public health emergency (PHE), which of course could not have been anticipated, underscores the risks inherent in making prospective behavioral offsets.<b> As such, with regard to any adjustments to the CY 2020 4.36% behavioral offset, we agree with and appreciate CMS’ decision to defer action in CY 2022 and ask the agency to hold until the conclusion of the PHE. Until then, closer analyses of the gap between projected and actual provider behavior is warranted. </b>In addition, we are interested in better understanding the actual behavioral adjustments made by hospital-based HH agencies, given their unique role, including critical contributions toward pandemic response.&nbsp; &nbsp;</span></span></span></span></p> <p><span style="font-size:11pt"><span style="text-autospace:none"><span style="font-family:Calibri,sans-serif"><span style="font-family:&quot;Arial&quot;,sans-serif">See the letter below for our complete comments.</span></span></span></span></p> </div> <div class="field_topics"> <div><a href="/topics/home-health" class="topic" hreflang="en">Home Health</a></div> <div><a href="/topics/quality-measures" hreflang="en">Quality Measures</a></div> <div><a href="/topics/health-equity" hreflang="en">Health Equity</a></div> </div> <div class="field_type"> <div>Type</div> <div><a href="/taxonomy/term/113" hreflang="en">Letter/Comment</a></div> </div> <div class="field_access_level"> <div>Access Level</div> <div><a href="/taxonomy/term/278" hreflang="en">Public</a></div> </div> <div class="field_paragraphs_text_with_heade"> <div> <div class="paragraph paragraph--type--paragraphs-text-with-headers- paragraph--view-mode--default"> </div> </div> </div> <div class="field_lead"><p>August 27, 2021</p> </div> <div class="field_search_promotion"> <div>Search Promotion</div> <div>Not Promoted</div> </div> <h4 class="page-header">Key Resources</h4> <div class="field_related_files file file--mime-application-pdf file--application-pdf"> <div> <article> <div class="field_media_file"><span class="file file--mime-application-pdf file--application-pdf"><a href="https://www.aha.org/system/files/media/file/2021/08/aha-comments-on-cms-home-health-proposed-cy22-rule-letter-8-27-21.pdf" type="application/pdf; length=563600" title="Letter: AHA Comments on CMS’ Home Health Proposed CY22 Rule">AHA Comments on CMS’ Home Health Proposed CY22 Rule</a></span> </div> </article> </div> </div> <div class="field_archived"> <div>Archived</div> <div>Off</div> </div> Fri, 27 Aug 2021 16:20:16 +0000 dsamuels_drupal 679245 at https://www.aha.org AHA Statement on FY 2022 Final IPPS Rule https://www.aha.org/press-releases/2021-08-02-aha-statement-fy-2022-final-ipps-rule <span class="title">AHA Statement on FY 2022 Final IPPS Rule</span> <span class="uid"><span>tjordan_drupal</span></span> <span class="created">Aug 02, 2021 - 05:46 PM</span> <div class="body"><p class="text-align-center"><strong>Stacey Hughes<br /> Executive Vice President<br /> American Hospital Association</strong></p> <p class="text-align-center"><strong>August 2, 2021</strong></p> <p>The AHA appreciates CMS listening to our concerns by repealing the requirement that hospitals and health systems disclose privately negotiated contract terms with payers on the Medicare cost report. This policy was originally adopted for the stated purpose of better aligning fee-for-service Medicare payments with market rates. However, privately negotiated rates take into account a number of unique circumstances between a private payer and a hospital and are not an appropriate benchmark for fee-for-service Medicare payments.</p> <p>In addition, we appreciate that CMS is continuing to review comments on its organ acquisition proposed policies. We continue to urge the agency to engage with stakeholders, including providers, in developing any modifications. We also appreciate that CMS is continuing to review comments on proposed changes related to Medicare-funded residency slots and we look forward to working with them to develop a workable policy to help ease current physician shortages and strengthen the health care delivery system.</p> <p>Further, we are pleased that the agency recognizes that the COVID-19 pandemic has resulted in non-representative performance in its hospital quality measurement and value programs, requiring temporary policy adjustments. We also thank CMS for extending the add-on payment for new COVID-19 treatments through the year in which the current public health emergency ends. This will help ensure hospitals and health systems have the resources to treat COVID-19 patients.</p> <p>Lastly, the AHA strongly supports COVID-19 vaccinations of both health care workers and the communities they serve. We have worked closely with the hospital field and the federal government to encourage vaccination to help protect both our patients and health care workforce from the virus. While CMS’s new quality measure on the rate of health care personnel COVID-19 vaccination likely needs further refinement to ensure it accurately reflects hospitals’ progress in vaccinating their workforce, we will work with CMS, CDC and hospitals to facilitate the reporting of the measure starting on October 1.</p> <p class="text-align-center">###</p> <p>Contact: &nbsp; &nbsp; Colin Milligan, <a href="mailto:cmilligan@aha.org">cmilligan@aha.org</a>, (202) 638-5491<br /> &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;Sean Barry, <a href="mailto:sbarry@aha.org">sbarry@aha.org</a>, (202) 626-2306<br /> &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;&nbsp;<br /> &nbsp;</p> </div> <div class="field_topics"> <div><a href="/topics/advocacy-public-policy" class="topic" hreflang="en">Advocacy &amp; Public Policy</a></div> <div><a href="/topics/covid-19-vaccines-and-therapeutics" hreflang="en">COVID-19: Vaccines and Therapeutics</a></div> <div><a href="/topics/quality-measures" hreflang="en">Quality Measures</a></div> <div><a href="/topics/workforce" hreflang="en">Workforce</a></div> </div> <div class="field_type"> <div>Type</div> <div><a href="/press-release" hreflang="en">Press Releases</a></div> </div> <div class="field_access_level"> <div>Access Level</div> <div><a href="/taxonomy/term/278" hreflang="en">Public</a></div> </div> <div class="field_paragraphs_text_with_heade"> <div> <div class="paragraph paragraph--type--paragraphs-text-with-headers- paragraph--view-mode--default"> </div> </div> </div> <div class="field_search_promotion"> <div>Search Promotion</div> <div>Not Promoted</div> </div> <div class="field_archived"> <div>Archived</div> <div>Off</div> </div> Mon, 02 Aug 2021 22:46:23 +0000 tjordan_drupal 678754 at https://www.aha.org AHA Comments on Inpatient PPS Proposed Rule for FY 2022 https://www.aha.org/lettercomment/2021-06-28-aha-comments-inpatient-pps-proposed-rule-fy-2022 <span class="title">AHA Comments on Inpatient PPS Proposed Rule for FY 2022</span> <span class="uid"><span>dsamuels_drupal</span></span> <span class="created">Jun 28, 2021 - 11:40 AM</span> <div class="body"><p><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-family:&quot;Arial&quot;,sans-serif">On behalf of our nearly 5,000 member hospitals, health systems and other health care organizations, our clinician partners—including more than 270,000 affiliated physicians, 2 million nurses and other caregivers—and the 43,000 health care leaders who belong to our professional membership groups, the American Hospital Association appreciates the opportunity to comment on the Centers for Medicare &amp; Medicaid Services’ (CMS) hospital inpatient prospective payment system (PPS) proposed rule for fiscal year (FY) 2022. We are submitting separate comments on the agency’s proposed changes to the long-term care hospital PPS.</span></span></span></p> <p><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><b><span style="font-family:&quot;Arial&quot;,sans-serif">We first thank CMS for its ongoing support for our nation’s hospitals, providers and patients during the COVID-19 public health pandemic. The AHA appreciates the continued support, assistance and flexibility that CMS is providing to our members so that they are best positioned to care for their patients and communities. We look forward to continuing to work with you to protect the health of our nation.</span></b></span></span></p> <p><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><b><span style="font-family:&quot;Arial&quot;,sans-serif">We support a number of the inpatient PPS proposed rule’s provisions, including the repeal of market-based Medicare severity diagnosis related group (MS-DRG) data collection and the use of FY 2019 data in rate-setting. At the same time, we have concerns with other proposals. In particular, we are concerned about proposals for organ acquisition payments and urge CMS not to finalize them. We also strongly urge CMS to modify its proposals in distributing residency slots as part of the graduate medical education (GME) program. Finally, we have concerns about several of the agency’s proposed new measures for the inpatient quality reporting program. </span></b><span style="font-family:&quot;Arial&quot;,sans-serif">A summary of our key recommendations follows.</span></span></span></p> <p><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><b><span style="font-family:&quot;Arial&quot;,sans-serif">“Market-based” MS-DRG Data Collection and Weight Calculation </span></b></span></span></p> <p><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-family:&quot;Arial&quot;,sans-serif">CMS proposes to repeal the requirements that hospitals include on their Medicare cost report what the agency calls “market-based payment rate information.” Specifically, hospitals would no longer be required to report, by MS-DRG, the median payer-specific negotiated charge for Medicare Advantage (MA) organizations. The agency also proposes to repeal the requirement that the information be used to calculate new market-based MS-DRG relative weights. <b>We strongly support repealing <span style="color:black">these requirements and thank the agency for its actions. </span></b></span></span></span></p> <p><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><b><span style="font-family:&quot;Arial&quot;,sans-serif">Organ Acquisition Payments</span></b></span></span></p> <p class="CxSpMiddle" style="margin-bottom:11px"><span style="font-family:&quot;Arial&quot;,sans-serif">The Medicare program reimburses transplant hospitals for organ acquisition costs, the transplant surgery, inpatient and post-transplant costs for Medicare recipients. CMS proposes to clarify, modify and codify into regulation the activities related to organ acquisition payments, in addition to proposing new requirements. <b>The AHA is concerned with CMS’ proposals related to Medicare usable organs and organ acquisition payments. </b>Specifically, organ tracking capabilities simply do not exist to the degree necessary to obtain the information CMS would require. As such, if enacted, this proposed policy could severely limit patient access to organ transplantations. <b>Thus, we strongly urge CMS to withdraw its proposal and instead engage with stakeholders in developing any modifications to organ acquisition payment methodologies. </b></span></p> <p class="CxSpMiddle" style="margin-bottom:11px"><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><b><span style="font-family:&quot;Arial&quot;,sans-serif">Graduate Medical Education Program</span></b></span></span></p> <p><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="border:none windowtext 1.0pt; font-family:&quot;Arial&quot;,sans-serif; padding:0in"><span style="color:#231f20">CMS proposes to implement several provisions of the Consolidated Appropriations Act of 2021 that affect Medicare direct GME and indirect medical education (IME) payments to teaching hospitals.</span></span><span style="font-family:&quot;Arial&quot;,sans-serif"> <b>The AHA is very concerned about CMS’ proposed method to award a maximum of one full-time equivalent (FTE) residency slot per hospital per year and its proposal to prioritize slot distribution by health professional shortage area (HPSA) scores. </b>Such a limitation is unworkable and unproductive and such a prioritization method reflects neither statutory intent nor the reality of teaching hospital service areas. Instead, we urge CMS to provide sufficient FTE slots as appropriate for the length of a residency program and to<b> </b>implement an alternative method for prioritization, which reflects statutory intent in a streamlined and simplified manner. We also have concerns with other proposals, including the criteria to determine hospitals that serve HPSAs. </span></span></span></p> <p><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><b><span style="font-family:&quot;Arial&quot;,sans-serif">Hospital Quality and Value-based Programs</span></b></span></span></p> <p><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><b><span style="font-family:&quot;Arial&quot;,sans-serif">The AHA applauds CMS for recognizing the unprecedented impact of the COVID-19 public health emergency (PHE) on its hospital quality measurement and value programs. We support CMS’ proposed measure suppression policy and most of the proposed program-specific measure suppressions for FYs 2022 and 2023.</span></b><span style="font-family:&quot;Arial&quot;,sans-serif"> The AHA also shares CMS’ commitment to advancing health equity and values the opportunity to respond to the agency’s requests for information (RFIs) on this vitally important priority. However, we have concerns about several of the agency’s proposed new measures for the inpatient quality reporting program and recommend that CMS reconsider their adoption.</span></span></span></p> <p><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-family:&quot;Arial&quot;,sans-serif">We appreciate your consideration of these issues. Our detailed comments are attached.</span></span></span></p> </div> <div class="field_topics"> <div><a href="/topics/medicare" class="topic" hreflang="en">Medicare</a></div> <div><a href="/topics/disparitiesequity-care" hreflang="en">Disparities/Equity of Care</a></div> <div><a href="/topics/quality-measures" hreflang="en">Quality Measures</a></div> <div><a href="/topics/medical-educationteaching-hospitals" hreflang="en">Medical Education/Teaching Hospitals</a></div> <div><a href="/topics/icd-10-cm-and-icd-10-pcs-codes-and-coding" hreflang="en">ICD-10-CM and ICD-10-PCS Codes and Coding</a></div> </div> <div class="field_type"> <div>Type</div> <div><a href="/taxonomy/term/113" hreflang="en">Letter/Comment</a></div> </div> <div class="field_access_level"> <div>Access Level</div> <div><a href="/taxonomy/term/278" hreflang="en">Public</a></div> </div> <div class="field_paragraphs_text_with_heade"> <div> <div class="paragraph paragraph--type--paragraphs-text-with-headers- paragraph--view-mode--default"> </div> </div> </div> <div class="field_lead"><p>June 28, 2021</p> </div> <div class="field_search_promotion"> <div>Search Promotion</div> <div>Not Promoted</div> </div> <h4 class="page-header">Key Resources</h4> <div class="field_related_files file file--mime-application-pdf file--application-pdf"> <div> <article> <div class="field_media_file"><span class="file file--mime-application-pdf file--application-pdf"><a href="https://www.aha.org/system/files/media/file/2021/06/aha-comments-on-inpatient-pps-proposed-rule-for-fy-2022-june-28-2021.pdf" type="application/pdf; length=874644" title="AHA Comments on Inpatient PPS Proposed Rule for FY 2022 - June 28, 2021">AHA Comments on Inpatient PPS Proposed Rule for FY 2022</a></span> </div> </article> </div> </div> <div class="field_archived"> <div>Archived</div> <div>Off</div> </div> Mon, 28 Jun 2021 16:40:53 +0000 dsamuels_drupal 678160 at https://www.aha.org FDA approves new Alzheimer’s drug https://www.aha.org/news/headline/2021-06-07-fda-approves-new-alzheimers-drug <span class="title">FDA approves new Alzheimer’s drug</span> <span class="uid"><span>tjordan_drupal</span></span> <span class="created">Jun 7, 2021</span> <div class="field_media_featured_image"><article> <div class="field_media_image"> <img src="/sites/default/files/styles/900x400/public/2018-04/FDA%20product%20update.jpg?itok=fxs3OT8L" width="900" height="400" alt="FDA product update" /> </div> </article> </div> <div class="body"><p>The Food and Drug Administration today <a href="https://www.fda.gov/news-events/press-announcements/fda-grants-accelerated-approval-alzheimers-drug">approved</a> Biogen’s Aduhelm to treat Alzheimer’s disease, the first new treatment approved for the disease since 2003. The drug was approved using the accelerated approval pathway, which is typically used when a drug for a serious or life-threatening illness is found to have a meaningful therapeutic advantage over existing treatments.</p> <p>Aduhelm represents a first-of-its-kind treatment approved for Alzheimer’s disease in that it is the first therapy that targets the disease’s fundamental pathophysiology. As part of the accelerated approval provisions, which enables Alzheimer’s patients’ earlier access to treatment, FDA is requiring Biogen to conduct a new randomized, controlled clinical trial to verify the drug’s clinical benefit. In the event the trial fails to verify the drug’s clinical benefit, FDA may withdraw its approval.</p> </div> <div class="field_topics"> <div><a href="/topics/quality-measures" class="topic" hreflang="en">Quality Measures</a></div> </div> <div class="field_type">Headline</div> Mon, 07 Jun 2021 18:29:37 +0000 tjordan_drupal 677856 at https://www.aha.org Regulatory Advisory: Hospital Inpatient PPS Proposed Rule for FY 2022 https://www.aha.org/advisory/2021-05-20-regulatory-advisory-hospital-inpatient-pps-proposed-rule-fy-2022 <span class="title">Regulatory Advisory: Hospital Inpatient PPS Proposed Rule for FY 2022</span> <span class="uid"><span>Matthew Diener</span></span> <span class="created">May 20, 2021 - 06:00 AM</span> <div class="body"><div class="container"> <div class="row"> <div class="col-md-8"> <h2>At a Glance</h2> <h3>At Issue</h3> <p>The Centers for Medicare &amp; Medicaid Services (CMS) April 27 issued its hospital <a href="https://public-inspection.federalregister.gov/2021-08888.pdf">inpatient prospective payment system (PPS) and long-term care hospital (LTCH) PPS proposed rule for fiscal year (FY) 2022</a>. The rule affects inpatient PPS hospitals, critical access hospitals (CAHs), LTCHs and PPS-exempt cancer hospitals. A summary of the proposals related to inpatient PPS hospitals, CAHs and PPS-exempt cancer hospitals is attached. Look for a separate AHA advisory on the LTCH PPS-related proposals soon. Comments on the proposed rule are due to CMS by June 28. The final rule will be published on or around Aug. 1 and take effect Oct. 1.</p> <h3>AHA Take</h3> <p>We applaud CMS’ proposal to repeal the requirement that hospitals and health systems disclose privately negotiated contract terms with payers on the Medicare cost report. We have long said that privately negotiated rates take into account any number of unique circumstances between a private payer and a hospital and their disclosure will not further CMS' goal of paying market rates that reflect the cost of delivering care. We once again urge the agency to focus on transparency efforts that help patients access their specific financial information based on their coverage and care.</p> <h3>What You Can Do</h3> <ul> <li><strong>Participate in an AHA members-only webinar May 24</strong> at 1:30 ET to share your questions about and feedback on this regulation for AHA’s comment letter to CMS. To register for this 60-minute webinar, <a href="https://aha.adobeconnect.com/e6h4eryl6vqy/event/registration.html">visit here</a>.</li> <li><strong>Share this advisory with your senior management team</strong> and ask your chief financial officer to examine the impact of the proposed payment changes on your Medicare revenue for FY 2022. Hospitals may assess the impact of these provisions on their organizations by using AHA’s calculators on readmissions, value-based purchasing and Medicare DSH: <a href="https://www.aha.org/inpatient-pps">https://www.aha.org/inpatient-pps</a>.</li> <li><strong>Verify CMS’ <a href="https://www.cms.gov/medicare/acute-inpatient-pps/fy-2022-ipps-proposed-rule-home-page">table</a> listing the factor used to calculate uncompensated care payments for Medicare Disproportionate Share Hospitals (DSH).</strong> Hospitals have until June 28 to review this table and notify CMS in writing of any inaccuracies.</li> <li><strong>Verify that you have attested to meaningful use.</strong> Attestation status can be determined through <a href="http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/RegistrationandAttestation.html">CMS’ website</a>.</li> <li><strong>If applicable, apply for low-volume hospital status</strong> by written request to your Medicare Administrative Contractor (MAC) by Sept. 1 in order to receive the low-volume adjustment beginning Oct. 1.</li> <li><strong>Share this advisory with your billing, medical records, quality improvement and compliance departments, as well as your clinical leadership team</strong> – including the quality improvement committee and infection control officer – to apprise them of the proposals around the diagnosis-related groups and quality measurement requirements.</li> <li><strong>Submit comments to CMS with your specific concerns by June 28 at <a href="http://www.regulations.gov/">www.regulations.gov</a>.</strong> The final rule will be published on or around Aug.1 and take effect Oct. 1.</li> </ul> <h3>Further Questions</h3> <p>Please contact Shannon Wu, AHA senior associate director of policy, at <a href="tel:1-202-626-2963">202-626-2963</a> or <a href="mailto:swu@aha.org?subject=Question on Hospital Inpatient PPS Proposed Rule for FY 2022">swu@aha.org</a> if you have further questions.</p> <hr /> <h2>Hospital Inpatient PPS Proposed Rule for FY 2022</h2> <h3>Table of Contents</h3> <p><a href="/system/files/media/file/2021/05/2021-05-20-ADV-IPPS-Proposed-Rule-FY2022.pdf#page=4">Inpatient PPS Payment Update</a></p> <p><a href="/system/files/media/file/2021/05/2021-05-20-ADV-IPPS-Proposed-Rule-FY2022.pdf#page=6">“Market-based” MS-DRG Data Collection and Weight Calculation</a></p> <p><a href="/system/files/media/file/2021/05/2021-05-20-ADV-IPPS-Proposed-Rule-FY2022.pdf#page=7">Disproportionate Share Hospital (DSH) Payment Changes</a></p> <p><a href="/system/files/media/file/2021/05/2021-05-20-ADV-IPPS-Proposed-Rule-FY2022.pdf#page=9">Chimeric Antigen T-Cell (CAR-T) Therapy</a></p> <p><a href="/system/files/media/file/2021/05/2021-05-20-ADV-IPPS-Proposed-Rule-FY2022.pdf#page=10">New Technology Add-on Payments (NTAPs)</a></p> <p><a href="/system/files/media/file/2021/05/2021-05-20-ADV-IPPS-Proposed-Rule-FY2022.pdf#page=11">New COVID-19 Treatments Add-on Payments (NCTAPs)</a></p> <p><a href="/system/files/media/file/2021/05/2021-05-20-ADV-IPPS-Proposed-Rule-FY2022.pdf#page=11">Area Wage Index Modifications</a></p> <p><a href="/system/files/media/file/2021/05/2021-05-20-ADV-IPPS-Proposed-Rule-FY2022.pdf#page=14">Graduate Medical Education (GME)</a></p> <p><a href="/system/files/media/file/2021/05/2021-05-20-ADV-IPPS-Proposed-Rule-FY2022.pdf#page=17">Organ Acquisition Payment</a></p> <p><a href="/system/files/media/file/2021/05/2021-05-20-ADV-IPPS-Proposed-Rule-FY2022.pdf#page=17">Medicaid Enrollment of Medicare Providers</a></p> <p><a href="/system/files/media/file/2021/05/2021-05-20-ADV-IPPS-Proposed-Rule-FY2022.pdf#page=18">Counting Days Associated with Section 1115 Demonstration Projects in the Medicaid raction</a></p> <p><a href="/system/files/media/file/2021/05/2021-05-20-ADV-IPPS-Proposed-Rule-FY2022.pdf#page=18">Rural Provisions</a></p> <p><a href="/system/files/media/file/2021/05/2021-05-20-ADV-IPPS-Proposed-Rule-FY2022.pdf#page=19">Key Coding and MS-DRG Changes</a></p> <p><a href="/system/files/media/file/2021/05/2021-05-20-ADV-IPPS-Proposed-Rule-FY2022.pdf#page=28">Medicare Shared Savings Program</a></p> <p><a href="/system/files/media/file/2021/05/2021-05-20-ADV-IPPS-Proposed-Rule-FY2022.pdf#page=30">Promoting Interoperability Programs</a></p> <p><a href="/system/files/media/file/2021/05/2021-05-20-ADV-IPPS-Proposed-Rule-FY2022.pdf#page=33">Hospital Quality Reporting and Value Programs</a></p> <p><a href="/system/files/media/file/2021/05/2021-05-20-ADV-IPPS-Proposed-Rule-FY2022.pdf#page=46">Next Steps</a></p> <p><a href="/system/files/media/file/2021/05/2021-05-20-ADV-IPPS-Proposed-Rule-FY2022.pdf#page=46">Further Questions</a></p> <hr /> <p><em>Click on the PDF link below to read the full Regulatory Advisory.</em></p> </div> <div class="col-md-4"> <center> <div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/system/files/media/file/2021/05/2021-05-20-ADV-IPPS-Proposed-Rule-FY2022.pdf" target="_blank" title="Click here to download the Regulatory Advisory PDF.">Download the PDF</a></div> </center> </div> <div class="col-md-4"> <div style="border: black solid 1px; padding: 10px;"> <center> <h3 style="color: #9d2235;">Key Takeaways</h3> </center> <p>CMS proposes to:</p> <ul> <li>Increase inpatient PPS payments by 2.8% in FY 2022.</li> <li>Repeal the requirement to report the median payer-specific negotiated rates for inpatient services, by Medicare Severity-Diagnosis-related Group (MS-DRG), for Medicare Advantage organizations.</li> <li>Use data from Worksheet S-10 in the FY 2018 cost report to determine the distribution of FY 2022 DSH uncompensated care payments.</li> <li>Extend New COVID-19 Treatments Add-on Payments for eligible COVID-19 products through the end of the fiscal year in which the public health emergency (PHE) ends.</li> <li>Implement changes to the GME program and related payments, as required in the Consolidated Appropriations Act, 2021.</li> <li>Modify the Promoting Interoperability Program, including by requiring a 180-day reporting period for CY 2024 and increasing the minimum required score to be considered a meaningful EHR user.</li> <li>Modify the Promoting Interoperability Program, including by requiring a 180-day reporting period for CY 2024 and increasing the minimum required score to be considered a meaningful EHR user.</li> <li>Suppress certain measures in hospital quality reporting and value programs, applying neutral payment adjustments under hospital value-based purchasing (VBP) for FY 2022, to account for the impact of the COVID-19 PHE.</li> <li>Add five new measures for the inpatient quality reporting (IQR) program.</li> </ul> </div> </div> </div> </div> </div> <div class="field_media_featured_image"><article> <div class="field_media_image"> <img src="/sites/default/files/2021-05/Page-1-2021-05-20-ADV-IPPS-Proposed-Rule-FY2022.jpg" width="1159" height="1500" alt="Regulatory Advisory: Hospital Inpatient PPS Proposed Rule for FY 2022 page 1. May 20, 2021." /> </div> </article> </div> <div class="field_topics"> <div><a href="/topics/regulatory" class="topic" hreflang="en">Regulatory</a></div> <div><a href="/topics/inpatient-pps" hreflang="en">Inpatient PPS</a></div> <div><a href="/topics/medicare" hreflang="en">Medicare</a></div> <div><a href="/topics/quality-measures" hreflang="en">Quality Measures</a></div> </div> <div class="field_type"> <div>Type</div> <div><a href="/advisories" hreflang="en">Advisory</a></div> </div> <div class="field_paragraphs_text_with_heade"> <div> <div class="paragraph paragraph--type--paragraphs-text-with-headers- paragraph--view-mode--default"> </div> </div> </div> <div class="field_lead"><p>May 20, 2021</p> </div> <div class="field_search_promotion"> <div>Search Promotion</div> <div>Not Promoted</div> </div> <h4 class="page-header">Key Resources</h4> <div class="field_related_files file file--mime-application-pdf file--application-pdf"> <div> <article> <div class="field_media_file"><span class="file file--mime-application-pdf file--application-pdf"><a href="https://www.aha.org/system/files/media/file/2021/05/2021-05-20-ADV-IPPS-Proposed-Rule-FY2022.pdf" type="application/pdf; length=975915" title="Regulatory Advisory: Hospital Inpatient PPS Proposed Rule for FY 2022">Regulatory Advisory: Hospital Inpatient PPS Proposed Rule for FY 2022 PDF</a></span> </div> </article> </div> </div> <div class="field_archived"> <div>Archived</div> <div>Off</div> </div> Thu, 20 May 2021 11:00:00 +0000 Matthew Diener 677438 at https://www.aha.org CMS proposes to increase SNF payments in FY 2022 https://www.aha.org/news/headline/2021-04-08-cms-proposes-increase-snf-payments-fy-2022 <span class="title">CMS proposes to increase SNF payments in FY 2022</span> <span class="uid"><span>tjordan_drupal</span></span> <span class="created">Apr 8, 2021</span> <div class="field_media_featured_image"><article> <div class="field_media_image"> <img src="/sites/default/files/styles/900x400/public/2018-08/CMS-rule-proposed-blue-gradient-bkgd.jpg?itok=TyiqLXwA" width="900" height="400" alt="CMS-rule-proposed-blue-gradient-bkgd" /> </div> </article> </div> <div class="body"><p>The Centers for Medicare &amp; Medicaid Services late today issued a <a href="https://www.federalregister.gov/public-inspection/2021-07556/medicare-program-prospective-payment-system-and-consolidated-billing-for-skilled-nursing-facilities">proposed rule </a>to update skilled nursing facility payment rates for fiscal year 2022. The rule would update payments by a net 1.3% relative to FY 2021 ($444 million), which includes a 2.3% market basket, a 0.2 percentage point productivity reduction and a forecast error adjustment to account for prior overpayment. CMS also would update the diagnosis code mappings used in the case-mix system implemented in FY 2021, and rebase and revise the SNF market basket.&nbsp;</p> <p>CMS also proposes to adopt two new quality measures beginning in FY 2023. One would assess the rate of COVID-19 vaccination among health care personnel, and the other would calculate healthcare-associated infections acquired in SNFs based on claims for subsequent hospitalizations. For the SNF Value-based Purchasing program, CMS proposes to suppress data for the single measure used in that program due to the impact of the COVID-19 pandemic, and instead will issue a uniform 1.2% payback percentage to participating SNFs with sufficient case volume rather than determining payment adjustments based on performance.</p> <p>Comments on this rule are due to CMS by June 7.<br /> &nbsp;</p> </div> <div class="field_topics"> <div><a href="/topics/current-emerging-payment-models" class="topic" hreflang="en">Current &amp; Emerging Payment Models</a></div> <div><a href="/topics/quality-measures" hreflang="en">Quality Measures</a></div> </div> <div class="field_type">Headline</div> Thu, 08 Apr 2021 19:33:47 +0000 tjordan_drupal 676702 at https://www.aha.org Reminder: April 1 deadline to submit certain Medicare quality data, attest to interoperability https://www.aha.org/news/headline/2021-03-30-reminder-april-1-deadline-submit-certain-medicare-quality-data-attest <span class="title">Reminder: April 1 deadline to submit certain Medicare quality data, attest to interoperability</span> <span class="uid"><span>tjordan_drupal</span></span> <span class="created">Mar 30, 2021</span> <div class="field_media_featured_image"><article> <div class="field_media_image"> <img src="/sites/default/files/styles/900x400/public/2019-12/CMSlogo.jpg?itok=uFgSPen5" width="900" height="400" alt="CMS logo" /> </div> </article> </div> <div class="body"><p>The Centers for Medicare &amp; Medicaid Services last month extended to April 1 the deadline for eligible hospitals to submit calendar year 2020 electronic clinical quality measures to the Hospital Inpatient Quality Reporting Program and Medicare Promoting Interoperability Program.</p> <p>The agency also extended to April 1 the deadline to attest to the interoperability program’s other four objectives — health information exchange, provider to patient exchange, public health and clinical data exchange.</p> <p>AHA <a href="https://www.aha.org/lettercomment/2021-01-27-cms-urged-extend-deadline-submit-2020-interoperability-program-data">requested</a>&nbsp;the deadline extension in January, citing problems with the system used to submit the data.</p> </div> <div class="field_topics"> <div><a href="/topics/quality-measures" class="topic" hreflang="en">Quality Measures</a></div> </div> <div class="field_type">Headline</div> Tue, 30 Mar 2021 19:46:40 +0000 tjordan_drupal 676505 at https://www.aha.org Revised Hospital Star Ratings Coming in April 2021 https://www.aha.org/special-bulletin/2021-01-27-revised-hospital-star-ratings-coming-april-2021 <span class="title">Revised Hospital Star Ratings Coming in April 2021</span> <span class="uid"><span>dsamuels_drupal</span></span> <span class="created">Jan 27, 2021 - 03:22 PM</span> <div class="body"><p><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-size:10.5pt"><span style="font-family:&quot;Arial&quot;,sans-serif"><span style="color:#333333">Starting today, hospitals can see the data that will be publicly reported on the Centers for Medicare &amp; Medicaid Services (CMS) <a href="https://www.medicare.gov/care-compare/">Care Compare website</a>&nbsp;in April. This includes an update of Overall Hospital Quality Star Ratings using the revised Star Ratings methodology that CMS finalized in the calendar year (CY) 2021 outpatient payment prospective payment system (OPPS) final rule. For a summary of the changes to this methodology, see the section on Star Ratings in <a data-fontcolor="1" href="https://www.aha.org/advisory/2020-12-15-hospital-oppsasc-final-rule-cy-2021-including-maintenance-340b-cuts" originalsrc="http://send.aha.org/link.cfm?r=-AE84IntlHzsGTD1Z8Pnog~~&amp;pe=60-b8hWoB9o1p_BXrsLgVmdGzn30cCjBjXpTFB4GlKvZJQEiS_Qrovj6AK0MNtApr1q3BnIdZzO2W1AHlIchJA~~&amp;t=8hJ2kVn2KHINRTO4bu1dig~~" shash="TbAEo3BljZRMUFUp9kbcQ94S1OJyjo4ZFAQ3jrVXevGBoRALz87ciUhQBmSEoFnZurX9HhxmhPMEFixU9SD66P9almXqaKobo+S0UaZeqtMmrbqXLxvYJ3408stem8Ke2Aas5ltRJIe3t6Ra1+Cw3OLvOV8JmcxH+A2ltjhP/2k=" style="color:#00539c; text-decoration:underline" target="_blank">AHA’s Regulatory Advisory</a>&nbsp;on the OPPS final rule. The Star Ratings displayed in April will reflect measure performance from the October 2020 update of Care Compare.</span></span></span></span></span></p> <p><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif">&nbsp;</span></span><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><strong><span style="font-size:10.5pt"><span style="font-family:&quot;Arial&quot;,sans-serif"><span style="color:#333333">From now through February 26, hospitals are encouraged to thoroughly review their information on the Hospital Quality Reporting page for QualityNet, available on this <a href="https://hqr.cms.gov/hqrng/login">webpage</a>.</span></span></span></strong><span style="font-size:10.5pt"><span style="font-family:&quot;Arial&quot;,sans-serif"><span style="color:#333333"> Quick reference and help guides for the data preview are available on <a href="https://qualitynet.cms.gov/inpatient/public-reporting/public-reporting/hospital-compare-preview">QualityNet</a>.&nbsp;</span></span></span></span></span></p> <p><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-size:10.5pt"><span style="font-family:&quot;Arial&quot;,sans-serif"><span style="color:#333333">CMS today also performed its quarterly refresh of selected measure data on Care Compare, and provided final performance information on the fiscal year 2021 Hospital-Acquired Condition (HAC) Reduction Program on the <a href="https://data.cms.gov/provider-data/dataset/yq43-i98g">Provider Data Catalog website</a>.</span></span></span></span></span></p> <p><strong><span style="font-size:10.5pt"><span style="font-family:&quot;Arial&quot;,sans-serif"><span style="color:#333333">Further Questions:</span></span></span></strong><span style="font-size:10.5pt"><span style="font-family:&quot;Arial&quot;,sans-serif"><span style="color:#333333"> If you have further questions, please contact Akin Demehin, AHA director of policy, at <a data-fontcolor="1" href="mailto:ademehin@aha.org?subject=Revised%20Hospital%20Star%20Ratings" style="color:#00539c; text-decoration:underline" target="_blank">ademehin@aha.org</a>, or Caitlin Gillooley, senior associate director of policy, at <a data-fontcolor="1" href="mailto:cgillooley@aha.org?body=Revised%20Hospital%20Star%20Ratings" style="color:#00539c; text-decoration:underline" target="_blank">cgillooley@aha.org</a>.</span></span></span></p> </div> <div class="field_topics"> <div><a href="/topics/star-ratings" class="topic" hreflang="en">Star Ratings</a></div> <div><a href="/topics/quality-measures" hreflang="en">Quality Measures</a></div> </div> <div class="field_type"> <div>Type</div> <div><a href="/bulletins" hreflang="en">Special Bulletin</a></div> </div> <div class="field_access_level"> <div>Access Level</div> <div><a href="/taxonomy/term/279" hreflang="en">Member</a></div> </div> <div class="field_lead"><p>AHA Special Bulletin<br /> January 27, 2021</p> <p><em>Hospitals Can Preview Performance through February 26</em></p> </div> <div class="field_search_promotion"> <div>Search Promotion</div> <div>Not Promoted</div> </div> <div class="field_archived"> <div>Archived</div> <div>Off</div> </div> Wed, 27 Jan 2021 21:22:34 +0000 dsamuels_drupal 675327 at https://www.aha.org MAP begins annual review of quality performance measures for federal programs https://www.aha.org/news/headline/2021-01-04-map-begins-annual-review-quality-performance-measures-federal-programs <span class="title">MAP begins annual review of quality performance measures for federal programs</span> <span class="uid"><span>tjordan_drupal</span></span> <span class="created">Jan 4, 2021</span> <div class="field_media_featured_image"><article> <div class="field_media_image"> <img src="/sites/default/files/styles/900x400/public/2019-12/CMSlogo.jpg?itok=uFgSPen5" width="900" height="400" alt="CMS logo" /> </div> </article> </div> <div class="body"><p class="MsoNoSpacing"><span style="font-size:12pt"><span style="font-family:Arial,sans-serif"><span style="font-size:11.0pt">The National Quality Forum’s Measure Applications Partnership recently initiated its statutorily required annual review of the quality measures that the Centers for Medicare &amp; Medicaid Services is <a href="https://www.cms.gov/newsroom/press-releases/new-measures-under-consideration-mark-milestone-cmss-reimagined-quality-strategy-increase-digital" style="color:#0563c1; text-decoration:underline">considering</a> for use in federal programs. </span></span></span></p> <p class="MsoNoSpacing"><span style="font-size:12pt"><span style="font-family:Arial,sans-serif"><span style="font-size:11.0pt">The MAP provides pre-rulemaking guidance on potential performance measures to the Department of Health and Human Services. This year, the list consists of 20 measures that span across several programs, comprised primarily of digital measures. In response to the public health emergency, the list also includes three measures related to COVID-19 vaccination for patients and health care personnel to be considered for multiple federal quality programs. </span></span></span></p> <p class="MsoNoSpacing"><span style="font-size:12pt"><span style="font-family:Arial,sans-serif"><span style="font-size:11.0pt">MAP will deliver its measure recommendations to CMS by February 2021 and publish its reports in March 2021. </span></span></span></p> <p class="MsoNoSpacing"><span style="font-size:11.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">For more information see the <a href="http://www.qualityforum.org/News_And_Resources/Press_Releases/2020/NQF_Begins_Annual_Review_of_Performance_Measures_for_Federal_Programs.aspx" style="color:#0563c1; text-decoration:underline">NQF news release</a>.</span></span></p> </div> <div class="field_topics"> <div><a href="/topics/quality-measures" class="topic" hreflang="en">Quality Measures</a></div> </div> <div class="field_type">Headline</div> Mon, 04 Jan 2021 20:32:31 +0000 tjordan_drupal 674864 at https://www.aha.org