What’s happening: The Centers for Medicare & Medicaid Services (CMS) is granting exceptions for certain measures in Medicare quality reporting and value-based programs to hospitals, psychiatric hospitals, and post-acute providers in designated areas affected by the California Wildfires and Straight-line Winds public health emergency in Los Angeles.
What else to know: If providers voluntarily report data where exceptions are allowed, CMS notes that the data will be used for public reporting and applying scoring methodologies under value-based programs.
Hospitals located within these designated affected areas should be aware of the potential subsequent impact to the Hospital Value-Based Purchasing Program and Hospital-Acquired Condition (HAC) Reduction Program minimum case threshold counts for inclusion in these programs and which measures have enough data for scoring.
For example, hospitals that do not submit data during the excepted periods for the Centers for Disease Control and Prevention’s health care-associated infection may not meet case minimums and will subsequently be scored only on the HAC Reduction Program’s claims-based CMS Patient Safety and Adverse Events Composite (CMS PSI- 90).
Providers and facilities located in the designated areas may request additional reporting requirement exceptions using the applicable extraordinary circumstance exception (ECE) request process for the respective programs. Providers not located in the designated areas can also make ECE requests. These requests will be determined on a case-by-case basis.
