Public Comment

Welcome to CMS Quality Measures Public Comment Page

This page serves as the designated site for CMS to solicit public comments on proposed quality measures that are included in the individual project pages. The public comment period provides an opportunity for the widest array of interested parties to provide input on the measures under development and can provide critical suggestions not previously considered by the measure contractor or its technical expert panel (TEP).

1. Appropriate Monitoring of Patients Receiving an Opioid via an IV Patient Controlled Analgesia (PCA) Device

The Centers for Medicare & Medicaid Services (CMS) has contracted with Abt Associates to hold a Public Comment period for Appropriate Monitoring of Patients Receiving an Opioid via an IV Patient Controlled Analgesia (PCA) Device. The Public Comment period was from Decmber 27, 2012 through January 17, 2013. A summary of the responses received are posted in the “Downloads” section below.

2. Develop ICD-10-CM Specifications for Outpatient Imaging Efficiency Measures

The Centers for Medicare & Medicaid Services (CMS) has contracted with Mathematica Policy Research to develop International Classification of Diseases, Clinical Modification (ICD-10-CM) specifications for the Hospital Outpatient Quality Reporting (OQR) Program’s Outpatient Imaging Efficiency (OIE) measures, in preparation for the transition ICD-10 on October 1, 2014.  Currently, the OIE measures, which are calculated using the Medicare Fee-for-Service paid claims data, are defined, or, “specified”, using the ICD-9-CM diagnosis codes. These measures will need to be re-specified into ICD-10-CM in order to maintain continued use of the existing quality measures. 

Specific project objectives:

The translation from ICD-9 to ICD-10 is not a direct, one-to-one mapping of one ICD-9 code to one ICD-10 code. The ICD-10 code set has more than five times the number of codes available in ICD-9.  In addition, ICD-10 includes an expanded code length that allows for a greater level of specificity in each code.  As a result, a single ICD-9 code may map to a single ICD-10 code, to multiple ICD-10 codes, or to a combination of ICD-10 codes. Due to the complexity of translating from ICD-9 to ICD-10, careful consideration of the ICD-10 measure specifications will be required. To solicit feedback on the potential impact of converting the OIE measure specifications into ICD-10, CMS seeks informal public comments on its draft ICD-10 specifications for three of the six currently reported OIE measures.

Instructions for Providing Comments:

Use the link provided below to access the online form and submit comments for the following draft ICD-10 OIE measure specifications for the following measures:

• OP-8, MRI Lumbar Spine for Low Back Pain;
• OP-10, Abdomen CT Use of Contrast Material; and,
• OP-14, Simultaneous Use of Brain CT and Sinus CT.

Provide the following information about yourself or your organization:

• If you are providing comments on behalf of an organization, include the name of your organization and use the drop down menu to identify the organization type (e.g., physician group, hospital, professional association, medical device company, government representative, etc.).
• If you are commenting as an individual, include your specialty.
• Use the drop down menu to select your location by city, state, and country.

Do not include personally identifiable information or personal health information in your comments.

Further information on the ICD classification system can be found at the following link:

http://www.who.int/classifications/icd/en/

To provide informal public comments, please visit the following link:

http://www.oiequalitymeasures.com/ or submit comments to oiequalitymeasures@bah.com

The public comment period will be open until 5 p.m. E.T. on Wednesday, May 29, 2013.

3. 30-Day Hospital Readmission Measure and Anemia Management Measures for ESRD Population

The Centers for Medicare & Medicaid Services (CMS) has contracted with Arbor Research/UM-KECC to develop a 30-day hospital readmission measure and anemia management measures for the ESRD population. The purpose of the project is to develop quality measures that can be used to promote the delivery of high quality care to Medicare beneficiaries with ESRD. The public comment period provides an opportunity for the widest array of interested parties to provide input on the measures under development and can provide important suggestions not previously considered by the measure contractor or its technical expert panels (TEPs).

The following draft measures were developed under this project, and are now posted for public comment:

• Anemia of chronic kidney disease: Patient informed consent for ESA treatment
• Anemia of chronic kidney disease: Dialysis facility ESA management to avoid transfusion
• Anemia of chronic kidney disease: Dialysis facility standardized transfusion ratio
• Anemia management of chronic kidney disease: Hgb > 12 g/dL
• Anemia of chronic kidney disease: Hgb < 10 g/dl
• Standardized 30-day readmission ratio for dialysis facilities

Specific project objectives: The goal of this project is to develop and implement measures that will be used to assess and improve the quality of care for Americans with ESRD.

Instructions for Providing Comments:

• If you are providing comments on behalf of an organization, include the organization’s name and your contact information.
• If you are commenting as an individual, submit identifying or contact information.
• Please identify the measures for which you are providing comments. You may submit general comments on the entire set of measures or you may provide comments specific to individual measures.
• Email your comments to: ESRD_Quality_Measures@ArborResearch.org.

Comments are due by close of business April 18, 2013. 

4. Antipsychotic Medication use Quality Measures Call for Public Comment

Centers for Medicare & Medicaid Services (CMS) has contracted with RTI International to develop antipsychotic medication use quality measures (AP QMs) in nursing homes. The purpose of the project is to develop quality measures that can be used to provide quality care to Medicare beneficiaries. The public comment period provides an opportunity for the widest array of interested parties to provide input on the measures under development and can provide critical suggestions not previously considered by the measure contractor or its technical expert panel (TEP).

Specific project objectives: The goal of this task is to develop nursing home quality measures for antipsychotic medication use with the following parameters: 1) The quality measures are MDS 3.0 based; 2) The quality measures focus on both long-stay and short-stay residents (i.e., one for long-stay and one for short-stay); 3) The quality measures take into account that antipsychotic medication use may be appropriate under certain conditions; and 4) measures should be submitted for NQF endorsement with as few exclusions at possible. The developed AP QMs should be appropriate for public reporting. To achieve these objectives, RTI solicits public comments on two AP QMs: Percent of Long-Stay Residents Who Receive an Antipsychotic Medication and Percent of Short-Stay Residents Who Newly Received an Antipsychotic Medication.

Instructions for Providing Comments:

1. If you are providing comments on behalf of an organization, include the organization’s name and your contact information.
2. If you are commenting as an individual, submit identifying or contact information.
3. Please indicate which measures you are providing comments on. You may submit general comments on the entire set of measures or you may provide comments specific to individual measures.
4. At the end of the public comment period, all public comments will be posted on the CMS Web site

Email your comments to: APQMPublicComments@cms.hhs.gov. Comments are due by close of business April 1, 2013. Please note that the original due date of March 15^th has been extended to April 1^st.

Instructions/Information:

• To be notified of when the next Public Comment Period is scheduled, please see the "CMS Related Links" (below) to sign up on the Mailing List.