(Feb. 2, 2024) – CMS Releases RFI about Medicare Advantage Data Collection and Reporting
The Centers for Medicare & Medicaid Services released a request for information to solicit feedback about how best to enhance Medicare Advantage data capabilities and increase transparency about MA activities. CMS specifically is interested in the following:
- Data-related recommendations related to beneficiary access to care, including provider directories and networks
- Prior authorization and utilization management, including denials of care and beneficiary experience with appeals processes, as well as use and reliance on algorithms
- Cost and utilization of different supplemental benefits
- All aspects of MA marketing and consumer decision-making
- Care quality and outcomes, including value-based care arrangements and health equity
- Healthy competition in the market, including the impact of mergers and acquisitions, high levels of enrollment concentration and the effects of vertical integration, data topics related to MA prescription drug plans
- Special populations, such as individuals dually eligible for Medicare and Medicaid with end-stage renal disease, and other enrollees with complex conditions
Responses to the RFI will be due 120 days after the date of publication in the Federal Register.
CMS Releases April 2024 Public Reporting Hospital Data for Preview
The preview period is now open for hospitals participating in the Inpatient Psychiatric Facility Quality Reporting, Hospital Inpatient Quality Reporting, hospital Outpatient Quality Reporting and Prospective Payment System-Exempt Cancer Hospital Quality Reporting programs to review data that will be publicly reported in April 2024. Additional information is available.
CMS Reminds Hospitals of eCQM Reporting Deadlines
The deadline for hospitals participating in the Hospital Inpatient Quality Reprting and/or Medicare Promoting Interoperability Programs to submit the calendar year 2023 electronic clinical quality measure data is Thursday, Feb. 29. Participating hospitals are required to submit data for at least four eCQMs for two self-selected quarters of CY 2021 data. Each quarter must include at least three self-selected eCQMs, plus the mandatory Safe Use of Opioids-Concurrent Prescribing eCQM. The eCQMs must be the same across quarters. To meet CMS CY 2023 eCQM reporting requirements, report the Safe Use of Opioids-Concurrent Prescribing eCQM, and at least three eCQMs from the CY 2023 Available eCQMs Table, for four quarters using EHR technology certified to the 2015 Edition Cures Update criteria. The Medicare Promoting Interoperability Program requirements and attestation deadline for eligible hospitals and critical access hospitals also is Thursday, Feb. 29.
CMS Releases CART-Outpatient Version 1.24.0
The Centers for Medicare & Medicaid Services released CMS Abstraction and Reporting Tool outpatient version 1.24.0, which supports hospital Outpatient Quality Reporting specifications manual version 17.0a. This CART version must be used for encounter dates Jan. 1 through Dec. 31, 2024. Installation instructions and other resources are available on QualityNet.
MLN Connects Provider eNews Available
The Centers for Medicare & Medicaid Services issued the following updates to MLN Connects Provider eNews:
Before You Go ...
- The National Institutes of Health released a guidance document for implementing evidence-based strategies to address opioid overdoses.