Summary of Updates on HIQR Collection Forms

FY 2020 Inpatient Prospective Payment System Rule: Summary of Updates on Hospital Inpatient Quality Reporting Information Collection Forms

Form	Notes on Updates
Hospital Inpatient Quality Reporting Notice of Participation	Form resubmitted with streamlined content and conforming edits to the regulations at 42 CFR 412.140.
Hospital Quality Reporting Data Accuracy and Completeness Acknowledgement (DACA)	Form resubmitted with streamlined content and improved readability.
Hospital Compare Request Form for Withholding/Footnoting Data for Public Reporting	Form resubmitted with minor clarifying edits and reorganizing of Measures for Footnoting table.
Centers for Medicare & Medicaid Services (CMS) Inpatient Prospective Payment System (IPPS) Quality Reporting Programs Measure Exception Form for PC and HAI Data Submission	Form resubmitted to remove references to ED measures, which have been finalized for removal from the program beginning with calendar year 2020 discharges.
CMS Quality Reporting Program APU Reconsideration Request Form	Form resubmitted with the addition of Title to clarify who is filling out the form, and addition of sub-headings for eCQM Validation and Chart-Abstracted Validation.
CMS Hospital IQR Program Validation Review for Reconsideration Request Form	Form resubmitted to clarify instructions for submitting form electronically since it is no longer required to be submitted by mail.
Validation Templates for CLABSI, CAUTI, MRSA, and CDI measures	Templates resubmitted to reflect the annual changes in fiscal year, as well as new CDC pathogen lists.
Centers for Medicare & Medicaid Services (CMS) Quality Program Extraordinary Circumstances Exceptions (ECE) Request Form	Form resubmitted with conforming edits to the regulations at 42 CFR 412.140 and to list CrownWeb and non-measure related requirement(s) to the Data Requirement(s) Affected section.

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