Inpatient Rehabilitation Facility (IRF) Quality Reporting Program (QRP) Public Reporting

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Background:

Section 3004(b) of the Affordable Care Act established the IRF QRP. In addition, the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act) requires the reporting of standardized patient assessment data on quality, resource use, and other measures by Post-Acute Care (PAC) providers, including skilled nursing facilities, home health agencies, IRFs, and long-term care hospitals.

Care Compare

Care Compare formats the reported data to be readily used by the public, which provides a snapshot of the quality of care for each IRF. This tool helps families compare some key quality metrics, such as pressure ulcers and readmissions, for over 1,100 IRFs across the nation.

Procedures for Requesting CMS Review of an IRF’s Measure Data:

The Centers for Medicare & Medicaid Services (CMS) encourages IRFs to review their data as provided in the preview reports. If an IRF disagrees with performance data (numerator, denominator, or quality metric) contained within their preview report, they will have an opportunity to request review of that data by CMS. To make such a request, IRF providers must adhere to the process outlined below:

  • Requests for CMS review of data may be submitted to CMS beginning on the day the IRF Provider Preview Reports are available in the IRF Internet Quality Improvement and Evaluation System (iQIES) folders through 11:59:59 p.m. PST on day 30 of the preview period.
  • CMS will not accept any requests for review of data that are submitted after the posted deadline, which falls on the last day of the preview period.
  • IRFs are required to submit their request to CMS via email with the subject line: “IRF Public Reporting Request for Review of Data” and include the IRF CMS Certification Number (CCN) (e.g., IRF Public Reporting Request for Review of Data, XXXXXX). The request must be sent to the following email address: IRFPRquestions@cms.hhs.gov.
  • The email request must include the following information:
    • IRF CMS CCN
    • IRF Business Name
    • IRF Business Address
    • CEO or CEO-designated representative contact information including: name, email address, telephone number, and physical mailing address, i.e. not a post office box
    • Information supporting the IRF’s belief that the data contained within the IRF’s Provider Preview Report is erroneous including, but not limited to, the following: quality measures affected, and aspects of quality measures affected (numerator, denominator, quality metric)
  • After submitting a request, IRFs will receive an email confirming receipt of their request and may be asked to provide additional information to allow CMS to fully evaluate the request. Such requests from CMS will be sent to the contact person named above.
  • CMS will review all requests and provide a response outlining the decision via email. Please note that IRF-identified errors in data resulting from inaccurate data submissions that an IRF failed to correct will not be corrected. Also, CMS will not consider correcting quality measure calculations that providers find to be inaccurate due to missing data that was submitted beyond the applicable quarterly data submission deadline.
  • Data that CMS decides/agrees to correct will be corrected and displayed during the subsequent quarterly release of IRF quality data on Care Compare.

Please note: The only method for submitting a request to CMS for review of your preview report data is via email. Requests submitted by any other means will not be reviewed. CMS will not review any requests that include protected health information (PHI) or other Health Insurance Portability and Accountability Act (HIPAA) violations in the request being submitted to CMS for review.

To view updated quality data, please visit Care Compare.

IRF Quality Reporting Program Archives

Page Last Modified:
07/07/2021 09:56 AM