Summary of Updates on HIQR Collection Forms

FY 2023 Inpatient Prospective Payment System Rule: Summary of Updates on Hospital Quality Reporting Information Collection Forms

Form	Notes on Updates
Hospital Inpatient Quality Reporting Notice of Participation	Changed radio buttons to bullets and added if the selection is now in a drop down box.
Hospital Quality Reporting Data Accuracy and Completeness Acknowledgement (DACA)	In the requirements section, removed the individual measures to make it more general, e.g. removed “Sepsis” from the chart-abstracted measure. This will make it easier if new measures are added. Both tracked and clean versions are in the zip file.
Care Compare Request Form for Withholding/Footnoting Data for Public Reporting	Added new measures to Table 1 and corrected two Measure ID names. Corrected the MEDCON Measure ID in Table 2. Both tracked and clean versions are in the zip file. Reviewed by Lantana.
Centers for Medicare & Medicaid Services (CMS) Inpatient Prospective Payment System (IPPS) Quality Reporting Programs Measure Exception Form for PC and HAI Data Submission	Made minor verbiage edits to the SSI and CAUTI/CLABSI sections as requested by DPS (HACRP Team). Both tracked and clean versions are in the zip file.
CMS Quality Reporting Program APU Reconsideration Request Form	Made minor verbiage edit in the validation section to encourage sending through Managed File Transfer as requested by the Validation Support Contractor. Both tracked and clean versions are in the zip file.
CMS Hospital IQR Program Validation Review for Reconsideration Request Form	No changes made.
Centers for Medicare & Medicaid Services (CMS) Quality Program Extraordinary Circumstances Exceptions (ECE) Request Form	Clarifyed the deadlines for reporting and performance ECEs. Added the new COVID-19 HCP Vaccination measure where applicable. Added lines to the Non-Measure requirements, where applicable, for the submitter to write in the appropriate requirement. For the SNF VBP program, added the Non-Measure and Other requirements for selection. Both tracked and clean version are in the zip file.
Hospital Value-Based Purchasing (VBP) Program Review and Corrections Request Form	No changes made.
Hospital Value-Based Purchasing (VBP) Program Appeal Request Form	No changes made.
Hospital Value-Based Purchasing (VBP) Program Independent CMS Review Request Form	No changes made.
Maternal Morbidity Structural Measure	This is new for the PRA package. Replicates the data entry form that is within the HQR Secure Portal.
PC-01 Measure	This is new for the PRA package. Replicates the data entry form that is within the HQR Secure Portal.
Population and Sampling	This is new for the PRA package. Replicates the data entry form that is within the HQR Secure Portal.
Validation Templates CAUTI CDI CLABSI MRSA	No changes made. Provided by the Validation Support Contractor.
CMS Quality Reporting Validation Educational Review Form	No changes made. Provided by the Validation Support Contractor.

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