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Quality Program Reporting Exemptions, COVID-19 Testing Guidance

In a March 27 memo, the Centers for Medicare & Medicaid Services (CMS) released additional guidance about reporting exceptions for hospitals in the quality reporting programs amid the COVID-19 pandemic.

Notably, providers are exempt from data reporting for all chart-abstracted measure for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Survey, Hospital Inpatient Quality Reporting (IQR) Program, Hospital Outpatient Quality Reporting Program, and Health Care–Acquired Condition (HAC) Reduction Program for three discharge periods:

  • Oct. 1–Dec. 31, 2019 (Q4 2019);
  • Jan. 1–March 31, 2020 (Q1 2020); and
  • April 1–June 30, 2020 (Q2 2020).

The memo further clarifies that for the Hospital IQR Program, Hospital Value-based Purchasing Program, HAC Reduction Program, and Hospital Readmissions Reduction Program, qualifying claims will be excluded from the measure calculations for Q1 2020 and Q2 2020 from these measures:

  • claims-based complication;
  • excess days in acute care;
  • Medicare spending per beneficiary;
  • mortality;
  • patient safety indicators;
  • payment measures; and
  • readmission measures.

CMS also released a fact sheet for clinicians in the Merit-based Incentive Payment System (MIPS). The agency extended the 2019 MIPS data submission deadline from March 31 to April 30. For MIPS-eligible clinicians who do not submit their data by the extended deadline of April 30, CMS will automatically identify those clinicians who might be eligible for reweighting of the MIPS performance categories. MIPS-eligible clinicians who are automatically identified will have all four performance categories weighted at zero percent, resulting in a neutral payment adjustment for the 2021 MIPS payment year.

CDC Refreshes Testing, Preparedness Guidelines

The Centers for Disease Control and Prevention on March 24 updated COVID-19 testing guidance to prioritize testing hospitalized patients and symptomatic health care workers. Tests then should be administered to symptomatic patients with underlying conditions and symptomatic patients who are in long-term care facilities, 65 and older, or first responders. As resources allow, CDC encourages health care providers then to test:

  • symptomatic critical infrastructure workers;
  • health care workers and first responders;
  • individuals with mild symptoms in communities experiencing high COVID-19 hospitalizations; and
  • symptomatic individuals who do not meet any of the above categories.

The agency also updated its interim guidelines for collecting, handling, and testing COVID-19 clinical specimens. Under the new guidelines, if nasopharyngeal swabs are unavailable, health care providers may use self- or provider-collected nasal or nasal turbinate swabs. Health care providers can consult CDC’s updated checklists and resources for caring for patients with suspected or confirmed COVID-19.

Visit the America’s Essential Hospitals coronavirus resource page for more information about the outbreak.

Contact Senior Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.

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About the Author

Emily Schweich is a senior communications associate for America's Essential Hospitals.

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