Appendix I: Vendor Participation Crosswalk

CAHPS for MIPS Vendor Participation Survey
2018 Proposed vs. 2018 Finalized
NOTE: There may be slight wording changes made to some questions in the 2018 CAHPS for MIPS survey. The final version of the CAHPS for MIPS survey will be
posted to the QPP website or CMS website.
Form Name

The Consumer
Assessment of
Healthcare Providers
and Systems
(CAHPS) for the
Merit-based Incentive
Payment System
(MIPS) Survey 2018
Survey
Administration
Renewal Participation
Form for Survey
Vendors
The Consumer
Assessment of
Healthcare Providers
and Systems
(CAHPS) for the
Merit-based Incentive
Payment System
(MIPS) Survey

Form Title – Proposed Rule 2018

Form Title – Final Rule 2018
(Note: underlined text indicates
new language)

The Consumer Assessment of
Healthcare Providers and Systems
(CAHPS) for the Merit-based
Incentive Payment System (MIPS)
Survey 2018 Survey Administration
Renewal Participation Form for
Survey Vendors

The Consumer Assessment of
Healthcare Providers and Systems
(CAHPS) for the Merit-based
Incentive Payment System (MIPS)
Survey

Reason for Change

Consolidating renewal
form and new participation
form together.

Participation Form for Survey
Vendors

Page 1: Note: Organizations must
also adhere to the Rules of
Participation

Narrative added to stress
importance of adhering to
the Rules of Participation.

Participation Form
for Survey Vendors

1

Form Name

Form Title – Proposed Rule 2018

Form Title – Final Rule 2018
(Note: underlined text indicates
new language)

The Consumer
Assessment of
Healthcare Providers
and Systems
(CAHPS) for the
Merit-based Incentive
Payment System
(MIPS) Survey

Page 2: If Yes, please provide the
name of the survey(s) for which you
have been approved as a vendor in the
table 2.1.b below.

Text deleted.

Check here to add up to 3 more
subcontractors Include additional
subcontractor information in a
separate document.

Include additional subcontractor
information in a separate document.

Reason for Change

Question no longer necessary

Participation Form
for Survey Vendors
The Consumer
Assessment of
Healthcare Providers
and Systems
(CAHPS) for the
Merit-based Incentive
Payment System
(MIPS) Survey

Form will be posted as
PDF file, therefore check
boxes can not be used.

Participation Form
for Survey Vendors

2

Form Name

The Consumer
Assessment of
Healthcare Providers
and Systems
(CAHPS) for the
Merit-based Incentive
Payment System
(MIPS) Survey

Form Title – Proposed Rule 2018

Form Title – Final Rule 2018
(Note: underlined text indicates
new language)

Reason for Change

5.1. Please email CVs for all of your
key project staff and key
subcontractor’s staff via the CAHPS
for MIPS Survey Technical
Assistance email at [TBD].

5.1. Please email CVs for all of your
key project staff listed in Table 3.1.a.
List of Key Project Staff via the
CAHPS for MIPS Survey Technical
Assistance email at [TBD].

Edited for Clarity

Your organization’s Project Manager,
Mail Survey Supervisor and
Telephone Survey Supervisor must
attend training for your organization.
Your organization’s
Programmer/Developer or the
Programmer/Developer’s Supervisor
is strongly encouraged to attend
training. Your organization’s
subcontractors that have key roles in
administering the CAHPS for MIPS
Survey are required to attend training.

In addition to the Project Manager,
we require the following staff to
attend training, as applicable: Mail
Survey Supervisor; Telephone
Survey Supervisor; Information
Systems Specialist and Computer
Programmer/Developer; Data
Administrator; and Back-up Data
Administrator. Your organization’s
subcontractors that have key roles in
administering the CAHPS for MIPS
Survey are also required to attend
training.

Edited for clarity and to
address the need for
certain staff members to
only attend specific
training sessions that are
germane to their particular
role.

Participation Form
for Survey Vendors
The Consumer
Assessment of
Healthcare Providers
and Systems
(CAHPS) for the
Merit-based Incentive
Payment System
(MIPS) Survey
Participation Form
for Survey Vendors

3

Form Name

The Consumer
Assessment of
Healthcare Providers
and Systems
(CAHPS) for the
Merit-based Incentive
Payment System
(MIPS) Survey

Form Title – Proposed Rule 2018

Form Title – Final Rule 2018
(Note: underlined text indicates
new language)

Reason for Change

Acknowledge that review of and
agreement with the Rules of
Participation is necessary for
participation and public reporting of
results by CMS’ Medicare Compare
Website.

Acknowledge that review of, and
agreement with, the Rules of
Participation is necessary for
participation and public reporting of
results by CMS’ Medicare Compare
Website.

Corrected Punctuation

Applicant organization qualification
and acceptance

Applicant Organization Qualification
and Acceptance

Letter capitalization

Participation Form
for Survey Vendors
The Consumer
Assessment of
Healthcare Providers
and Systems
(CAHPS) for the
Merit-based Incentive
Payment System
(MIPS) Survey
Participation Form
for Survey Vendors

4

The Consumer
Assessment of
Healthcare Providers
and Systems
(CAHPS) for the
Merit-based Incentive
Payment System
(MIPS) Survey
Participation Form
for Survey Vendors

According to the Paperwork
Reduction Act of 1995, no persons
are required to respond to a collection
of information unless it displays a
valid OMB control number. The valid
OMB control number for this
information collection is 0938-1222.
The time required to complete this
information collection is estimated to
average 10 hours per response,
including the time to review
instructions, search existing data
resources, gather the data needed, and
complete and review the information
collection. If you have comments
concerning the accuracy of the time
estimate(s) or suggestions for
improving this form, please write to:
CMS, 7500 Security Boulevard, Attn:
PRA Reports Clearance Officer, Mail
Stop C4-26-05, Baltimore, Maryland
21244-1850.

According to the Paperwork
Reduction Act of 1995, no persons
are required to respond to a
collection of information unless it
displays a valid OMB control
number. The valid OMB control
number for this information
collection is 0938-1222 (Expiration
date: XX/XX/XXXX). The time
required to complete this information
collection is estimated to average 10
hours per response, including the
time to review instructions, search
existing data resources, gather the
data needed, and complete and
review the information collection. If
you have comments concerning the
accuracy of the time estimate(s) or
suggestions for improving this form,
please write to: CMS, 7500 Security
Boulevard, Attn: PRA Reports
Clearance Officer, Mail Stop C4-2605, Baltimore, Maryland 212441850. ****CMS Disclosure****
Please do not send applications,
claims, payments, medical records or
any documents containing sensitive
information to the PRA Reports
Clearance Office. Please note that
any correspondence not pertaining to
the information collection burden
approved under the associated OMB
control number listed on this form
will not be reviewed, forwarded, or
retained. If you have questions or
concerns regarding where to submit

Edited to be in agreement
with other CAHPS for
MIPS PRA Appendices.

5

Form Name

Form Title – Proposed Rule 2018

Form Title – Final Rule 2018
(Note: underlined text indicates
new language)
your documents, please contact
[email protected]

Reason for Change

6