Summary of Updates on HIQR Collection Forms

FNY 2024 Inpatient Prospective Payment System Rule: Summary of Updates on Hospital Quality Reporting Information
Collection Forms
Form
1. Hospital Inpatient Quality Reporting Notice of
Participation
2. Hospital Quality Reporting Data Accuracy and
Completeness Acknowledgement (DACA)
3. Care Compare Request Form for
Withholding/Footnoting Data for Public
Reporting
4. CMS Quality Reporting Program APU
Reconsideration Request Form
5. CMS Hospital IQR Program Validation Review
for Reconsideration Request Form
6. Centers for Medicare & Medicaid Services
(CMS) Quality Program Extraordinary
Circumstances Exceptions (ECE) Request Form

Notes on Updates

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No changes.

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Added a bullet for “Electronic health record data elements for hybrid measures.”

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Added electronic clinical quality measures (eCQMs) to Table 1.
Added Foreign Object Retained After Surgery, Blood Incompatibility, Air Embolism, and Falls and
Trauma to Table 2.
No changes made.

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No changes made.

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7. Hospital Value-Based Purchasing (VBP) Program
Review and Corrections Request Form
8. Hospital Value-Based Purchasing (VBP) Program
Appeal Request Form
9. Hospital Value-Based Purchasing (VBP) Program
Independent CMS Review Request Form
10. Maternal Morbidity Structural Measure

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In the introduction, added language to clarify the ECE submission deadlines.
Under the IQR Program, added “Hybrid Measures.”
Removed SNF VBP Program.
Removed “Claims-based measures” throughout and changed “Non-measure related requirements” to
“Other.”
No changes made.

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No changes made.

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No changes made.

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11. Population and Sampling
12. CMS Quality Reporting Validation Educational
Review Form
13. eCQM Denominator Declaration

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Under Note, added verbiage that the IPPS Measure Exception Form, for PC-01, cannot be used for this
measure.
No changes made.
No changes made.

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This is new to the PRA Package.
Replicates the data entry form that is within the Hospital Quality Reporting Secure Portal.

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