CMS has proposed a new rule that modifies the QIP for PY2019-21. Comments on the rule will be accepted until August 28, 2017. The proposed rule includes updates to reimbursement rates, the ESRD QIP Extraordinary Circumstances Exception Policy (ECE), PSC, NHSN dialysis event data validation sampling methodology, and quality measures. The rule also requests comments on how to include individuals with AKI in the ESRD QIP, and on the feasibility and appropriateness of accounting for social risk factors in the program. Find an advance copy of the proposed rule at https://s3.amazonaws.com/public-inspection.federalregister.gov/2017-13908.pdf . The proposed rule is scheduled for the July 5, 2017 Federal Register. A copy of the CMS press release on the proposed rule can be found at https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2017-Press-releases-items/2017-06-29.html .
A CMS Fact Sheet summarizes the various changes and proposals in the rule, and also introduces a planned CMS RFI that will welcome continued feedback on the Medicare program with the aim of increasing efficiency, transparency, flexibility, program simplicity, and innovation. Find the Fact Sheet at https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2017-Fact-Sheet-items/2017-06-29.html .
Prepare for ESRD QIP PY 2017 Reporting Documents by Updating your Account
More than 200 outpatient dialysis facilities have not designated a Facility Point of Contact (FPOC) in the ESRD QIP system. Facilities should maintain their accounts and make sure that FPOCs have access to reporting documents. CMS is preparing ESRD QIP end-of-year documents for release in December, including the Payment Year 2017 Final Performance Score Reports and the Performance Score Certificate, which facilities are required to post for public review. For help with the ESRD QIP system, including reviving a deactivated account, contact the QualityNet Help Desk at email@example.com or 866-288-8912.
CMS has published a 5-page Frequently-Answered-Questions brochure that covers PSC posting, ICH CAHPS eligibility and exemption attestation, Depression Screening, and Pain Assessment. Find a copy at http://mycrownweb.org/wp-content/uploads/2016/01/CROWNWeb-and-the-ESRD-QIP-QA.pdf .
We’ve also put a summary of QIP and CROWNWeb (CW) deadlines and events on the Network 16 website at https://www.nwrn.org/files/DataBulletin0116.pdf. They include:
- New CW Data Management Guidelines took effect on January 1, 2016
- CW 4.9 was released on January 5, 2016
- Post your 2015 PSC in your facility by January 22, 2016
- New: CROWNWeb call on “System Progression and Things to Come,” January 28, 2016; register at http://mycrownweb.org/pcw_community_events/crownweb-system-progression-and-things-to-come/ .
- Enter ICH CAHPS attestations for QIP exemptions into CW by January 31, 2016
- Close your facility’s November clinical data in CW before January 31, 2016
- Generate your facility’s CMS-2744 for review and cleanup before February 15, 2016
- Submit your facility’s balanced CMS-2744, with comments, to your Network before April 1, 2016
The summary also includes links to general 2744 and CW resources, and national phone numbers for when you need help. If you need help from your Network, in Southern California call 888-268-1539, and in the Northwest or Alaska call 206-935-3994.
Keep up with ongoing CROWNWeb events at http://mycrownweb.org/events/ .
PY 2016 Performance Score Reports (PSR) and Certificates (PSC) were released on December 30, 2015. Since facilities are required to post their PSCs in a prominent patient area within 15 business days of their release, your facility’s PSC must be posted on or before January 22, 2016. Your PSR is a backup report that you don’t need to post, but which will help educate your staff so they can answer any questions that patients may have about your posted PSC. To find step-by-step instructions for logging onto the QualityNet website and downloading your PSR and PSC, review the PY 2016 Preview Period National Provider Call slides, which are available on the CMS website at https://www.cms.gov/Outreach-and-Education/Outreach/NPC/Downloads/2015-12-09-ESRD-Presentation.pdf. An audio recording and written transcript of the Call are also available under December 9, 2015 at https://www.cms.gov/Outreach-and-Education/Outreach/NPC/National-Provider-Calls-and-Events.html.
The December edition of the Network’s facility newsletter, Network 16 News, has been published and distributed. You can find a copy online at https://www.nwrn.org/providers-and-professional-staff/nw16n.html. This issue features an article on Network 16’s merger with the HealthInsight Quality Improvement Organization to form the HealthInsight ESRD Alliance, and the subsequent granting to the Alliance of new five-year contracts for the five traditional Network 16 states, and for Network 18’s Southern California service area.
It also includes notes on reporting requirements for Involuntary Discharge, and on PSC availability, and announcement of four continuing education opportunities:
Immediately following the NRAA Annual Conference, on October 9-10, the NRAA and Renal Physicians Association will jointly sponsor their Medical Directors Dialysis Facility Symposium. Topics include integrated care, roles and responsibilities, home therapy, PSCs, safety, leadership challenges, supportive care, and patient engagement and satisfaction. See http://www.nraa.org/index.php/meetings/medical-directors-symposium for details.
CMS has announced that as of December 17, 2014 the Final Performance Score Reports (PSRs) and Performance Score Certificates (PSCs) for PY2015 are available at http://www.DialysisReports.org . Facilities are required to download their PY2015 PSC from this website and have it posted in their unit on or before January 2, 2015.
Whether you received a Total Performance Score or not, all facilities are required to print and display their PY2015 PSC, in both English and Spanish, for the entire year, in plain view in a public area where it will be easily visible for all patients and their representatives. The Facility Medical Director must sign both versions.
Beginning January 15, 2015, all QIP operations on http://www.DialysisReports.org will cease. After that date you will no longer be able to access information from this website. Before the January 15 shutdown, please save an electronic copy of your final PY2015 PSR/PSC for your records. These functions will be transitioned to a new website, and details announced, in the future.