Section 10322 of the Affordable Care Act (ACA) authorizes the establishment of a new quality reporting program for Inpatient Psychiatric Facilities (IPFs). The program began with an initial set of 6 measures for FY 2014 and FY 2015 and currently includes 18 measures. For FY 2020 we propose adding one measure calculated from administrative claims. IPFs that fail to comply with the program’s requirements will receive a 2% reduction in their Annual Payment Update (APU). To minimize burden and maximize efficiency, CMS has leveraged existing systems within CMS to collect aggregated data and calculated measure rates from the IPFs, in a form, manner and time as specified by CMS, via a secure portal known as the QualityNet Web site. CMS will use the FY 2014 procedural requirements designed to align with current quality reporting programs. These procedural requirements involve submitting necessary forms (e.g., Notice of Participation Form, Reconsideration Request Form) to comply with the program and align with current CMS reporting requirements for other hospital quality reporting programs. When adding new measures, the law requires CMS, where “feasible and practical”, to select measures put forward by “one or more national consensus building entities”. Section 3013 of the ACA requires CMS to perform a gap analysis for needed quality measures every three years. Section 3014 of the ACA requires CMS to develop quality and efficiency measures through a “consensus-based entity”. Consequently, the Measure Applications Partnership (MAP), convened by the National Quality Forum (NQF), was formed to develop measures consistent with these requirements. CMS reviewed the MAP’s formal recommendations prior to identifying IPFQR measures for the FY 2018 IPPS/LTCH PPS rule.
The latest form for Inpatient Psychiatric Facility Quality Reporting Program (CMS-10432) expires 2022-11-30 and can be found here.