Cms-10434 #26 Aqm2018-fua Fum

Centers for Medicare & Medicaid
Services
CMS eXpedited Life Cycle (XLC)

Medicaid and CHIP Program (MACPro)
AQM 2018 – Follow-Up After Emergency
Department Visit for Mental Illness or Alcohol and
Other Drug Abuse or Dependence (FUA/FUM-AD)
Core Measure PRA document
Version 1.0
07/01/2018

Document Number: 354-AMQ 2018 FUA/FUM-AD PRA document-D
Contract Number: HHSM-500-2007-00024I: HHSM-500-T0014

CMS XLC

Table of Contents

Table of Contents
1. FUA/FUM-AD Core Measure Screenshots ............................................................. 1
1.1
1.2
1.3
1.4
1.5
1.6
1.7

Are you reporting on this measure? ................................................................ 1
Measurement Specification – Path 1 ............................................................... 1
Measurement Specification – Path 2 ............................................................... 1
Data Source .................................................................................................... 2
Performance Measure ..................................................................................... 3
Deviations from Measurement Specifications ................................................. 4
Optional Measure Stratification ....................................................................... 7

Appendix A: Acronyms ................................................................................................. 9

List of Figures
Figure 1: Are you reporting on this measure? ................................................................. 1
Figure 2: Measurement Specification – Path 1................................................................ 1
Figure 3: Measurement Specification – Path 2................................................................ 1
Figure 4: Data Source ..................................................................................................... 2
Figure 5: Performance Measure ...................................................................................... 3
Figure 6: Deviations from Measurement Specifications – Screenshot 1 ......................... 4
Figure 7: Deviations from Measurement Specifications – Screenshot 2 ......................... 5
Figure 8: Deviations from Measurement Specifications – Screenshot 3 ......................... 6
Figure 9: Deviations from Measurement Specifications – Screenshot 4 ......................... 6
Figure 10: Optional Measure Stratification – Screenshot 1 ............................................. 7
Figure 11: Optional Measure Stratification – Screenshot 2 ............................................. 8

List of Tables
Table 1: Acronyms .......................................................................................................... 9

AQM 2018 – Follow-Up After Emergency Department Visit for Mental Illness or Alcohol and Other Drug Abuse or Dependence (FUA/FUM-AD)
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CMS XLC

FUA/FUM-AD Core Measure Screenshots

1. FUA/FUM-AD Core Measure Screenshots
1.1

Are you reporting on this measure?

Figure 1: Are you reporting on this measure?

1.2

Measurement Specification – Path 1

Figure 2: Measurement Specification – Path 1

1.3

Measurement Specification – Path 2

Figure 3: Measurement Specification – Path 2

AQM 2018 – Follow-Up After Emergency Department Visit for Mental Illness or Alcohol and Other Drug Abuse or Dependence (FUA/FUM-AD)
Core Measure PRA document Version 1.0
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07/01/2018

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1.4

FUA/FUM-AD Core Measure Screenshots

Data Source

Figure 4: Data Source

AQM 2018 – Follow-Up After Emergency Department Visit for Mental Illness or Alcohol and Other Drug Abuse or Dependence (FUA/FUM-AD)
Core Measure PRA document Version 1.0
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1.5

FUA/FUM-AD Core Measure Screenshots

Performance Measure

Figure 5: Performance Measure

AQM 2018 – Follow-Up After Emergency Department Visit for Mental Illness or Alcohol and Other Drug Abuse or Dependence (FUA/FUM-AD)
Core Measure PRA document Version 1.0
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1.6

FUA/FUM-AD Core Measure Screenshots

Deviations from Measurement Specifications

Figure 6: Deviations from Measurement Specifications – Screenshot 1

AQM 2018 – Follow-Up After Emergency Department Visit for Mental Illness or Alcohol and Other Drug Abuse or Dependence (FUA/FUM-AD)
Core Measure PRA document Version 1.0
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CMS XLC

FUA/FUM-AD Core Measure Screenshots

Figure 7: Deviations from Measurement Specifications – Screenshot 2

AQM 2018 – Follow-Up After Emergency Department Visit for Mental Illness or Alcohol and Other Drug Abuse or Dependence (FUA/FUM-AD)
Core Measure PRA document Version 1.0
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CMS XLC

FUA/FUM-AD Core Measure Screenshots

Figure 8: Deviations from Measurement Specifications – Screenshot 3

Figure 9: Deviations from Measurement Specifications – Screenshot 4

AQM 2018 – Follow-Up After Emergency Department Visit for Mental Illness or Alcohol and Other Drug Abuse or Dependence (FUA/FUM-AD)
Core Measure PRA document Version 1.0
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07/01/2018

CMS XLC

1.7

FUA/FUM-AD Core Measure Screenshots

Optional Measure Stratification

Note: Same N/D/R sets are applicable under each of the stratification

Figure 10: Optional Measure Stratification – Screenshot 1

AQM 2018 – Follow-Up After Emergency Department Visit for Mental Illness or Alcohol and Other Drug Abuse or Dependence (FUA/FUM-AD)
Core Measure PRA document Version 1.0
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07/01/2018

CMS XLC

FUA/FUM-AD Core Measure Screenshots

Figure 11: Optional Measure Stratification – Screenshot 2

AQM 2018 – Follow-Up After Emergency Department Visit for Mental Illness or Alcohol and Other Drug Abuse or Dependence (FUA/FUM-AD)
Core Measure PRA document Version 1.0
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07/01/2018

CMS XLC

FUA/FUM-AD Core Measure Screenshots

Appendix 1: Acronyms
Table 1: Acronyms
Acronym

Definition

AQM

Adult Quality Measures

FUA

Follow-Up After Emergency Department Visit for Mental Illness or Alcohol
and Other Drug Dependence

PRA

Paperwork Reduction Act of 1995

AQM 2018 – Follow-Up After Emergency Department Visit for Mental Illness or Alcohol and Other Drug Abuse or Dependence (FUA/FUM-AD)
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