CMS-10210.Justification for Emergency Processing and Approval

Justification for Emergency Processing and Approval

Additional Quality Measures and Procedures for Hospital Reporting of Quality Data for the FY 2009 IPPS Annual Payment Update (Surgical Care Improvement Project & Mortality Measures)

(0938-1022)

Justification

The Office of Clinical Standards and Quality (OCSQ), Centers for Medicare and Medicaid Services (CMS) is requesting emergency review and approval of its information collection request (ICR) currently approved under OMB control number 0938-1022. This is the resubmission of CMS-10210.

We are requesting emergency processing, review and approval under 5 CFR 1320.13(a)(2)(ii) . We cannot reasonably comply with the normal clearance procedures under this part because and unanticipated event has occurred. Due to unforeseen circumstances, there were severe delays in obtaining OMB approval for the revision of this currently approved information collection.

The approval of this data collection process is essential to meet the requirements of Section 404 of the Medicare Prescription Drug and Modernization Act (MMA) of 2003 and its applicability to the hospital market basket. This section of the MMA requires the Secretary of Health and Human Services to, “… establish a frequency for revising such [market basket] weights including the labor share, in such market basket to reflect the most current data available more frequently than every five years.”

For FY 2008, we propose to add the following categories to the measure set:

• HCAHPS® Survey

  • HCAHPS® is also known as Hospital CAHPS or the CAHPS Hospital Survey.

For FY 2009, the set of measures for the RHQDAPU program will consist of measures previously approved through the PRA process, as well as additional measures identified through this rulemaking.  For FY 2009 the measurement set will therefore include the 27 quality indicators which were identified for FY 2008 and the following additional measures:

• Pneumonia 30-day Mortality (Medicare patients)

• SCIP Infection 4: Cardiac Surgery Patients with Controlled 6AM Postoperative Serum Glucose

• SCIP Infection 6: Surgery Patients with Appropriate Hair Removal

These three measures were recently endorsed by the National Quality Forum (NQF) and will be added to the set.   CMS will propose that data collection for these measures for purposes of RHQDAPU (where needed) would begin in CY 2008.

All of these measures have been approved by the Hospital Quality Alliance (HQA) for inclusion in the national voluntary hospital reporting set, and are fully specified and included in the joint CMS-The Joint Commission Specifications Manual for National Hospital Quality Measures.  The measures offer important additions to our understanding of patient outcomes (mortality) and patient safety efforts, and could help encourage additional systems change in hospitals in the areas of pneumonia care and surgical services.

The information to be collected is not duplicative of similar information collected by the Centers for Medicare & Medicaid Services.  In fact, the purpose of this effort is to reduce the reporting burden for the collection of quality of care information by allowing hospitals to submit electronic data in lieu of submitting paper charts, or to utilize electronic data that they currently report to Joint Commission for accreditation.  As required by statute, CMS is expanding the “starter set” 10 quality measures to include the HQA measures for obtaining the full market basket update under the DRA.  HQA-participating hospitals already collect and submit measures on the expanded set. In addition, these measures are required by the Joint Commission for accreditation.

Proposed Timeline

January 14, 2008 Submit emergency justification to OMB for review and approval

January 25, 20008 Target publication date for 30-day emergency FR notice; start of 30-day comment period

February 25, 2008 End of 30-day comment period (The actual comment period ends on Sunday, 2/24/2008, so we are moving the end of the comment period to the end of the next business day.)

February 29, 2008 Target implementation date for CMS

February 29, 2008 Requested date of OMB approval