Application and Re-application processes

Application and Triennial Re-application to Be a Qualified Entity to Receive Medicare Data for Performance Measurement (ACA Section 10332) (CMS-10394)

6_Reapplicaiton Requiremetns List

Application and Re-application processes

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QECP REAPPLICATION REQUIREMENTS LIST
The time required to complete this information collection is estimated to average 20 hours per
response, including the time to review instructions, search existing data resources, gather the needed
data, and complete and review the information collection.
QECP Minimum Requirements Review: Reapplication QE Program Requirements
Element 1.1: Identify changes to the QE’s organization (if applicable)
•

If your organization plans to work with new/additional contractors, vendors, partners,
subsidiaries or member organizations, complete the QECP Letter of Commitment, including
Appendix B: Contractual Relationship Attestation, which includes an attestation to breach of
contract liability between parties, with potential to collect damages for failure to perform.

Element 1.4: Identify changes to the QE’s ability to obtain claims data from at least one other source to
combine with the QE Medicare data
•
•
•

If the geographic area has changed, submit a new QECP Data Source Attestation.
If the amount of other-payer claims data received by your organization has increased, submit a
new QECP Data Source Attestation.
If the amount of other-payer claims data received by your organization has decreased, submit a
new QECP Data Source Attestation. In addition, provide an explanation, by data supplier name,
of the reason why the data source is no longer available to your organization, or the reason why
the amount of data received by the supplier has decreased. Submit documentation that
demonstrates that the remaining claims data from other sources are sufficient to address
methodological concerns regarding sample size and reliability.

Element 2.1: Identify significant changes to the QE’s data security and privacy policies and procedures
•
•

If your organization has experienced a change to its security environment through which QE
Medicare data flows, submit an updated, annotated QE data flow diagram.
If your organization has experienced a change to its data security environment or practices,
provide an explanation of the changes, including the date when each change occurred.

Elements 2.3 & 2.4: Identify changes to the corrections and appeals process; identify any changes
related to the secure transmission of beneficiary data
•

•

If your organization plans to:
o change level of reporting (provider-identified vs regional) prior to the next reporting
cycle for either public or non-public reports.
o to make a change to their corrections and appeals process prior to the next reporting
cycle. This includes any changes to your organization’s privacy and security protections
for the release of beneficiary identifiers and/or claims data to providers.
Please provide:
o a corrections and appeals process including the process that would allow an entity to
securely transmit beneficiary claims to providers.

•
•

an explanation of the masking methodology that would prevent providers from being reidentified.
an explanation describing the changes. These changes must be reflected in the QE data flow
diagram provided under Statement 3. Changes related to contractual relationships with data
analytics/warehousing vendors are subject to the requirements of Statements 1and 3.

Element 3.1: Identify changes to the standard measures the QE intends to report in its next public
reporting cycle
•

If your organization plans to change the standard measures that have previously been publicly
reported, provide an explanation of the standard measures that will be added or removed in
your organization’s next public reporting cycle. For measures that will be added, submit a
revised QECP Measure Information Workbook, accompanied by the required supporting
documentation for Element 3.1.

Element 3.2: Identify changes to alternative measures the QE intends to report in its next public
reporting cycle
•

If your organization plans to change the alternative measures that have previously been publicly
reported, provide an explanation of the alternative measures that will be added or removed in
your organization’s next public reporting cycle. For measures that will be added, submit a
revised QECP Measure Information Workbook, accompanied by the required supporting
documentation for Element 3.2.

Element 3.3: Identify changes in the design of reports for providers and the public
•

•

If your organization plans to make changes to the content or appearance of provider and/or
public reports, provide an explanation of the changes, and submit the revised provider and/or
public report prototype.
If your organization plans to make changes to the dissemination plan, provide an explanation of
the changes.

Prior to a reapplication being submitted as final, the contents of the reapplication must be accompanied
with a completed attestation from an individual at the entity authorized to attest to its accuracy and
completion.
End of QECP Reapplication Requirements List


File Typeapplication/pdf
File TitleQECP Reapplication Requirement List
AuthorCMS OEDA
File Modified2021-12-29
File Created2021-12-29

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