Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2016; Corrections, 34909-34913 [2016-12841]
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Federal Register / Vol. 81, No. 105 / Wednesday, June 1, 2016 / Rules and Regulations
amendment corrects technical and
typographic errors in the preamble and
regulation text included in the 2015
EHR Incentive Programs final rule with
comment period. The corrections
contained in this document are
consistent with, and do not make
substantive changes to, the policies that
were adopted subject to notice and
comment procedures in the final rule
with comment period. As a result, the
corrections made through this correcting
amendment are intended to ensure that
the 2015 EHR Incentive Programs final
rule with comment period accurately
reflects the policies adopted in that rule.
In addition, even if this were a
rulemaking to which the notice and
comment procedures and delayed
effective date requirements applied, we
find that there is good cause to waive
such requirements. Undertaking further
notice and comment procedures to
incorporate the corrections in this
document into the final rule with
comment period or delaying the
effective date would be contrary to the
public interest because it is in the
public’s interest for EPs, eligible
hospitals, and critical access hospitals
to be advised, in a timely manner, of the
meaningful use criteria and EHR
reporting periods that they must meet in
order to qualify for Medicare and
Medicaid electronic health record
incentive payments and avoid payment
reductions under Medicare, and to
ensure that the final rule with comment
period accurately reflects our policies as
of the date they take effect and are
applicable. Furthermore, such
procedures would be unnecessary due
to the changes in the law made by the
MACRA, under which the meaningful
use payment adjustment for EPs under
section 1848(a)(7)(A) of the Act will
sunset at the end of CY 2018. The
statements identified above in the
preamble and the regulations text
concerning a payment adjustment in
2019 are moot as a result of those
changes in the law. In addition, such
procedures would be unnecessary, as
we are not altering our policies; rather,
we are simply implementing correctly
the policies that we previously
34909
proposed, received comment on, and
subsequently finalized. This correcting
document is intended solely to ensure
that the 2015 EHR Incentive Programs
final rule with comment period
accurately reflects these policies.
Therefore, we believe we have good
cause to waive the notice and comment
and effective date requirements.
IV. Correction of Errors
In FR Doc. 2015–25595 of October 16,
2015 (80 FR 62762), we are making the
following corrections:
1. On page 62905, first column, first
partial paragraph, lines 7 through 10,
the phrase ‘‘the payment adjustment in
2019 for returning participants and for
the payment adjustment in 2018 for new
participants’’ is corrected to read ‘‘the
payment adjustment in 2018 for new
participants’’.
2. On page 62906, in TABLE 18—EHR
REPORTING PERIODS AND RELATED
PAYMENT ADJUSTMENT YEARS FOR
EPs, the entry for 2017 is corrected to
read as follows:
2017
Applies to avoid a
payment adjustment
in CY 2019
EHR reporting period for a payment
adjustment year
EP new participants (including those
demonstrating Stage 3 under Medicare or Medicaid).
EP returning participants .....................
Applies to avoid a payment
adjustment in CY 2018
Any continuous 90-day period in CY
2017.
Yes, if EP successfully attests by October 1, 2017.
N/A.
N/A .......................................................
N/A .......................................................
N/A.
3. On page 62920, TABLE 21
—BURDEN ESTIMATES STAGE 3, third
column, third full paragraph (Measure
2), lines 8 and 10, the phrase ‘‘an
electronic summary of care document
from a source other than the provider’s
EHR system.’’ is corrected to read ‘‘an
electronic summary of care document.’’.
sradovich on DSK3TPTVN1PROD with RULES
List of Subjects in 42 CFR Part 495
Administrative practice and
procedure, Electronic health records,
Health facilities, Health professions,
Health maintenance organizations
(HMO), Medicaid, Medicare, Penalties,
Privacy, Reporting and recordkeeping
requirements.
As noted in section II.B. of this
correcting amendment, the Centers for
Medicare & Medicaid Services is making
the following correcting amendments to
42 CFR part 495:
PART 495—STANDARDS FOR THE
ELECTRONIC HEALTH RECORD
TECHNOLOGY INCENTIVE PROGRAM
Authority: Secs. 1102 and 1871 of the
Social Security Act (42 U.S.C. 1302 and
1395hh).
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
§ 495.4
Centers for Medicare & Medicaid
Services
[Amended]
2. In § 495.4, paragraph (1)(ii)(C)(2) of
the definition of ‘‘EHR reporting period
for a payment adjustment year’’ is
removed and reserved.
■
[Amended]
3. In § 495.24, paragraph
(d)(7)(ii)(B)(2) is amended by removing
the phrase ‘‘an electronic summary of
care document from a source other than
the provider’s EHR system.’’ and adding
in its place the phrase ‘‘an electronic
summary of care document.’’.
■
Dated: May 25, 2016.
Madhura Valverde,
Executive Secretary to the Department,
Department of Health and Human Services.
[FR Doc. 2016–12853 Filed 5–31–16; 8:45 am]
BILLING CODE 4120–01–P
1. The authority citation for part 495
continues to read as follows:
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■
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42 CFR Part 414
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Medicare Program; Revisions to
Payment Policies Under the Physician
Fee Schedule and Other Revisions to
Part B for CY 2016; Corrections
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Final rule; correcting
amendment.
AGENCY:
This document corrects
technical and typographical errors that
appeared in the final rule with comment
period published in the November 16,
2015 Federal Register (80 FR 70886
through 71386) entitled ‘‘Medicare
Program; Revisions to Payment Policies
Under the Physician Fee Schedule and
SUMMARY:
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34910
Federal Register / Vol. 81, No. 105 / Wednesday, June 1, 2016 / Rules and Regulations
Other Revisions to Part B for CY 2016.’’
The effective date for the rule was
January 1, 2016.
DATES:
Effective Date: This correcting
document is effective May 31, 2016.
Applicability Date: The corrections
indicated in this document are
applicable beginning January 1, 2016.
FOR FURTHER INFORMATION CONTACT:
Michelle Peterman (410) 786–2591.
I. Background
In FR Doc. 2015–28005 (80 FR 70886
through 71386), the final rule entitled
‘‘Medicare Program; Revisions to
Payment Policies Under the Physician
Fee Schedule and Other Revisions to
Part B for CY 2016’’ (hereinafter referred
to as the CY 2016 PFS final rule with
comment period), there were a number
of technical and typographical errors
that are identified and corrected in
section IV., the Correction of Errors.
These corrections are applicable as of
January 1, 2016.
II. Summary of Errors
sradovich on DSK3TPTVN1PROD with RULES
A. Summary of Errors in the Preamble
On page 71138, due to typographical
errors, the QualityNet Help Desk email
address, the qualified clinical data
registry (QCDR) data validation
execution report delivery date, and the
email subject are incorrect.
On page 71139, due to typographical
errors, the QualityNet Help Desk email
address, the qualified registry data
validation execution report delivery
date, and the email subject are incorrect.
On pages 71141 and 71145, we
incorrectly stated the Measure
Application Validation (MAV) process
utilized to determine the reporting of
Physician Quality Reporting System
(PQRS) cross-cutting resources.
On page 71147, we inadvertently
omitted language restating the
Consumer Assessment of Healthcare
Providers and Systems (CAHPS)
requirements that apply to groups of 100
or more eligible professionals (EPs) that
register to participate in the Group
Practice Reporting Option (GPRO)
regardless of reporting mechanism.
On pages 71148 through 71150, we
inadvertently omitted language restating
the CAHPS requirement for the QCDR
reporting option in Table 28—Summary
of Requirements for the 2018 PQRS
Payment Adjustment: Group Practice
Reporting Criteria for Satisfactory
Reporting of Quality Measures Data via
the GPRO.
16:11 May 31, 2016
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On page 71380 of the CY 2016 PFS
final rule with comment period, we
inadvertently omitted language in
§ 414.90(k)(5)(i). In this paragraph, we
inadvertently omitted language restating
the CAHPS requirements that apply to
groups of 100 or more EPs that register
to participate in the Group Practice
Reporting Option (GPRO) regardless of
reporting mechanism.
III. Waiver of Proposed Rulemaking
SUPPLEMENTARY INFORMATION:
VerDate Sep<11>2014
B. Summary of Errors in Regulation Text
Under 5 U.S.C. 553(b) of the
Administrative Procedure Act (APA),
the agency is required to publish a
notice of the proposed rule in the
Federal Register before the provisions
of a rule take effect. Similarly, section
1871(b)(1) of the Act requires the
Secretary to provide for notice of the
proposed rule in the Federal Register
and provide a period of not less than 60
days for public comment. In addition,
section 553(d) of the APA, and section
1871(e)(1)(B)(i) of the Act mandate a 30day delay in effective date after issuance
or publication of a rule. Sections
553(b)(B) and 553(d)(3) of the APA
provide for exceptions from the APA
notice and comment, and delay in
effective date requirements; similarly,
sections 1871(b)(2)(C) and
1871(e)(1)(B)(ii) of the Act provide
exceptions from the notice and
comment, and delay in effective date
requirements of the Act. Section
553(b)(B) of the APA and section
1871(b)(2)(C) of the Act authorize an
agency to dispense with normal notice
and comment rulemaking procedures
for good cause if the agency makes a
finding that the notice and comment
process is impracticable, unnecessary,
or contrary to the public interest; and
includes a statement of the finding and
the reasons for it in the notice. In
addition, both section 553(d)(3) of the
APA and section 1871(e)(1)(B)(ii) of the
Act allow the agency to avoid the 30day delay in effective date where such
delay is contrary to the public interest
and the agency includes in the rule a
statement of the finding and the reasons
for it.
In our view, this correcting document
does not constitute a rulemaking that
would be subject to these requirements.
This document merely corrects
typographical and technical errors in
the CY 2016 PFS final rule with
comment period. The corrections
contained in this document are
consistent with, and do not make
substantive changes to, the policies and
payment methodologies that were
adopted subject to notice and comment
procedures in the CY 2016 PFS final
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rule with comment period. As a result,
the corrections made through this
correcting document are intended to
ensure that the CY 2016 PFS final rule
with comment period accurately reflects
the policies adopted in that rule.
Even if this were a rulemaking to
which the notice and comment and
delayed effective date requirements
applied, we find that there is good cause
to waive such requirements.
Undertaking further notice and
comment procedures to incorporate the
corrections in this document into the
CY 2016 PFS final rule with comment
period or delaying the effective date of
the corrections would be contrary to the
public interest because it is in the
public interest to ensure that the CY
2016 PFS final rule with comment
period accurately reflects our final
policies as soon as possible following
the date they take effect. Further, such
procedures would be unnecessary,
because we are not altering the payment
methodologies or policies, but rather,
we are simply correcting the Federal
Register document to reflect the policies
that we previously proposed, received
comment on, and subsequently
finalized. This correcting document is
intended solely to ensure that the CY
2016 PFS final rule with comment
period accurately reflects these policies.
For these reasons, we believe there is
good cause to waive the requirements
for notice and comment and delay in
effective date.
IV. Correction of Errors
In FR Doc. 2015–28005 of November
16, 2015 (80 FR 70886), make the
following corrections:
A. Correction of Errors in the Preamble
1. On page 71138, second column,
second paragraph, lines 8 through 12,
the phrase and sentence ‘‘Desk at
Qnetsupport@sdps.org by 5:00 p.m.
e.s.t. on June 30, 2016. The email
subject should be ‘‘PY2015 Qualified
Registry Data Validation Execution
Report.’’ ’’ are corrected to read ‘‘Desk at
Qnetsupport@hcqis.org by 5:00 p.m.
e.s.t. on June 30, 2017. The email
subject should be ‘‘PY2016 Qualified
Registry Data Validation Execution
Report.’’ ’’.
2. On page 71139, third column, fifth
full paragraph, lines 8 through 14, the
phrase and sentence ‘‘Desk at
Qnetsupport@sdps.org by 5:00 p.m. ET
on June 30 of the year in which the
reporting period occurs (that is, June 30,
2016 for reporting periods occurring in
2016). The email subject should be
‘‘PY2015 Qualified Registry Data
Validation Execution Report.’’ ’’ are
corrected to read ‘‘Desk at Qnetsupport@
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Federal Register / Vol. 81, No. 105 / Wednesday, June 1, 2016 / Rules and Regulations
hcqis.org by 5:00 p.m. ET on June 30
following the year in which the
reporting period occurs (that is, June 30,
2017 for the reporting periods occurring
in 2016). The email subject should be
‘‘PY2016 Qualified Registry Data
Validation Execution Report.’’ ’’.
3. On page 71141, first column, first
partial paragraph, lines 5 through 9, the
sentence ‘‘In addition, the MAV process
will also allow us to determine whether
an EP should have reported on any of
the PQRS cross-cutting measures.’’ is
corrected to read ‘‘Please note, the MAV
process is not utilized to determine
whether an EP should have reported on
any of the PQRS cross-cutting measures.
This analysis occurs prior to the EP
being subject to MAV.’’.
4. On page 71145, third column, first
partial paragraph, lines 4 through 8, the
sentence ‘‘However, please note that the
MAV process for the 2018 PQRS
Reporting
period
payment adjustment will now allow us
to determine whether a group practice
should have reported on at least 1 crosscutting measure.’’ is corrected to read
‘‘Please note, the MAV process is not
utilized to determine whether an EP
should have reported on any of the
PQRS cross-cutting measures. This
analysis occurs prior to the EP being
subject to MAV.’’.
5. On page 71147, the third column is
corrected by adding the following
paragraph after the first partial
paragraph:
‘‘For group practices of 100 or more EPs
registered to participate in the GPRO via
QCDR for the 2018 PQRS payment
adjustment: The administration of the
CAHPS for PQRS survey is REQUIRED.
Therefore, if reporting via QCDR, these group
practices must meet the following criterion
for satisfactory reporting for the 2018 PQRS
payment adjustment: For the 12-month
34911
reporting period for the 2018 PQRS payment
adjustment, report all CAHPS for PQRS
survey measures via a certified survey
vendor, and report at least 6 measures
available for reporting under a QCDR
covering at least 2 of the NQS domains, AND
report each measure for at least 50 percent of
the group practice’s patients. Of the nonCAHPS for PQRS measures, the group
practice would report on at least 2 outcome
measures, OR, if 2 outcomes measures are not
available, report on at least 1 outcome
measures and at least 1 of the following types
of measures—resource use, patient
experience of care, efficiency/appropriate
use, or patient safety.’’
6. On page 71148 through 71150,
Table 28—Summary of Requirements
for the 2018 PQRS Payment Adjustment:
Group Practice Reporting Criteria for
Satisfactory Reporting of Quality
Measures Data via the GPRO is
corrected to read as follows:
Measure type
Reporting mechanism
Satisfactory reporting criteria
12-month (Jan 1–Dec
31, 2016).
25–99 EPs;
100+ EPs (if CAHPS
for PQRS does not
apply).
Individual GPRO
Measures in the
Web Interface.
Web Interface ............
12-month (Jan 1–Dec
31, 2016).
sradovich on DSK3TPTVN1PROD with RULES
Group practice size
25–99 EPs that elect
CAHPS for PQRS;.
100+ EPs (if CAHPS
for PQRS applies).
Individual GPRO
Measures in the
Web Interface +
CAHPS for PQRS.
Web Interface + CMSCertified Survey
Vendor.
Report on all measures included in the web
interface; AND populate data fields for the
first 248 consecutively ranked and assigned beneficiaries in the order in which
they appear in the group’s sample for
each module or preventive care measure.
If the pool of eligible assigned beneficiaries is less than 248, then the group
practice must report on 100 percent of assigned beneficiaries. In other words, we
understand that, in some instances, the
sampling methodology we provide will not
be able to assign at least 248 patients on
which a group practice may report, particularly those group practices on the smaller
end of the range of 25–99 EPs. If the
group practice is assigned less than 248
Medicare beneficiaries, then the group
practice must report on 100 percent of its
assigned beneficiaries. A group practice
must report on at least 1 measure for
which there is Medicare patient data.
The group practice must have all CAHPS for
PQRS survey measures reported on its
behalf via a CMS-certified survey vendor.
In addition, the group practice must report
on all measures included in the Web Interface; AND populate data fields for the first
248 consecutively ranked and assigned
beneficiaries in the order in which they appear in the group’s sample for each module or preventive care measure. If the pool
of eligible assigned beneficiaries is less
than 248, then the group practice must report on 100 percent of assigned beneficiaries. A group practice will be required
to report on at least 1 measure for which
there is Medicare patient data.
Please note that, if the CAHPS for PQRS
survey is applicable to a group practice
who reports quality measures via the Web
Interface, the group practice must administer the CAHPS for PQRS survey in addition to reporting the Web Interface measures.
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Reporting
period
Group practice size
Measure type
Reporting mechanism
Qualified Registry ......
2–99 EPs;
100+ EPs (if CAHPS
for PQRS does not
apply).
Individual Measures ...
12-month (Jan 1–Dec
31, 2016).
2–99 EPs that elect
CAHPS for PQRS;
100+ EPs (if CAHPS
for PQRS applies).
Individual Measures +
CAHPS for PQRS.
12-month (Jan 1–Dec
31, 2016).
2–99 EPs;
100+ EPs (if CAHPS
for PQRS does not
apply).
Individual Measures ...
12-month (Jan 1–Dec
31, 2016).
sradovich on DSK3TPTVN1PROD with RULES
12-month (Jan 1–Dec
31, 2016).
2–99 EPs that elect
CAHPS for PQRS;
100+ EPs (if CAHPS
for PQRS applies).
Individual Measures +
CAHPS for PQRS.
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Satisfactory reporting criteria
Report at least 9 measures, covering at least
3 of the NQS domains. Of these measures, if a group practice sees at least 1
Medicare patient in a face-to-face encounter, the group practice would report on at
least 1 measure in the PQRS cross-cutting
measure set. If less than 9 measures covering at least 3 NQS domains apply to the
group practice, the group practice would
report on each measure that is applicable
to the group practice, AND report each
measure for at least 50 percent of the
group’s Medicare Part B FFS patients
seen during the reporting period to which
the measure applies. Measures with a 0
percent performance rate would not be
counted.
Qualified Registry +
The group practice must have all CAHPS for
CMS-Certified SurPQRS survey measures reported on its
vey Vendor.
behalf via a CMS-certified survey vendor,
and report at least 6 additional measures,
outside of the CAHPS for PQRS survey,
covering at least 2 of the NQS domains
using the qualified registry. If less than 6
measures apply to the group practice, the
group practice must report on each measure that is applicable to the group practice.
Of the additional measures that must be
reported in conjunction with reporting the
CAHPS for PQRS survey measures, if any
EP in the group practice sees at least 1
Medicare patient in a face-to-face encounter, the group practice must report on at
least 1 measure in the PQRS cross-cutting
measure set.
Direct EHR Product or Report 9 measures covering at least 3 doEHR Data Submismains. If the group practice’s direct EHR
sion Vendor Product.
product or EHR data submission vendor
product does not contain patient data for
at least 9 measures covering at least 3 domains, then the group practice must report
all of the measures for which there is
Medicare patient data. A group practice
must report on at least 1 measure for
which there is Medicare patient data.
Direct EHR Product or The group practice must have all CAHPS for
EHR Data SubmisPQRS survey measures reported on its
sion Vendor Product
behalf via a CMS-certified survey vendor,
+ CMS-Certified
and report at least 6 additional measures,
Survey Vendor.
outside of CAHPS for PQRS, covering at
least 2 of the NQS domains using the direct EHR product or EHR data submission
vendor product. If less than 6 measures
apply to the group practice, the group
practice must report all of the measures
for which there is Medicare patient data.
Of the additional 6 measures that must be
reported in conjunction with reporting the
CAHPS for PQRS survey measures, a
group practice would be required to report
on at least 1 measure for which there is
Medicare patient data.
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Reporting
period
Group practice size
Measure type
Reporting mechanism
Satisfactory reporting criteria
Report at least 9 measures available for reporting under a QCDR covering at least 3
of the NQS domains, AND report each
measure for at least 50 percent of the
group practice’s patients. Of these measures, the group practice would report on at
least 2 outcome measures, OR, if 2 outcomes measures are not available, report
on at least 1 outcome measures and at
least 1 of the following types of measures—resource use, patient experience of
care, efficiency/appropriate use, or patient
safety.
The group practice must have all CAHPS for
PQRS survey measures reported on its
behalf via a CMS-certified survey vendor,
and report at least 6 additional measures,
outside of the CAHPS for PQRS survey,
covering at least 2 of the NQS domains
using the QCDR AND report each measure for at least 50 percent of the group
practice’s patients. Of these non-CAHPS
measures, the group practice would report
on at least 2 outcome measures, OR, if 2
outcomes measures are not available, report on at least 1 outcome measures and
at least 1 of the following types of measures—resource use, patient experience of
care, efficiency/appropriate use, or patient
safety.
12-month (Jan 1–Dec
31, 2016).
2–99 EPs;
100+ EPs (if CAHPS
for PQRS does not
apply).
Individual PQRS
measures and/or
non-PQRS measures reportable via
a QCDR.
Qualified Clinical Data
Registry (QCDR).
12-month (Jan 1–Dec
31, 2016).
2–99 EPs that elect
CAHPS for PQRS;
100+ EPs (if CAHPS
for PQRS applies).
Individual PQRS
measures and/or
non-PQRS measures reportable via
a QCDR + CAHPS
for PQRS.
Qualified Clinical Data
Registry (QCDR) +
CMS-Certified Survey Vendor.
List of Subjects in 42 CFR Part 414
Administrative practices and
procedure, Health facilities, Health
professions, Kidney diseases, Medicare,
Reporting and recordkeeping
requirements.
Accordingly, 42 CFR chapter IV is
corrected by making the following
correcting amendments to part 414:
1. The authority citation for part 414
continues to read as follows:
outcome measures, or, if 3 outcomes
measures are not available, report on at
least 2 outcome measures and at least 1
of the following types of measures—
resource use, patient experience of care,
efficiency/appropriate use, or patient
safety. If a group practice reports the
CAHPS for PQRS survey measures,
apply reduced criteria as follows: 6
QCDR measures covering 2 NQS
domains; and, of the non-CAHPS for
PQRS measures, 2 outcome measures or
1 outcome and 1 other specified type of
measure, as applicable.
*
*
*
*
*
Authority: Secs. 1102, 1871, and 1881(b)(l)
of the Social Security Act (42 U.S.C. 1302,
1395hh, and 1395rr(b)(l)).
Dated: May 25, 2016.
Madhura Valverde,
Executive Secretary to the Department.
2. Section 414.90 is amended by
revising paragraph (k)(5)(i) to read as
follows:
[FR Doc. 2016–12841 Filed 5–31–16; 8:45 am]
PART 414—PAYMENT FOR PART B
MEDICAL AND OTHER HEALTH
SERVICES
■
■
BILLING CODE 4120–01–P
§ 414.90 Physician Quality Reporting
System (PQRS).
sradovich on DSK3TPTVN1PROD with RULES
*
*
*
*
*
(k) * * *
(5) * * *
(i) If a group practice does not report
the CAHPS for PQRS survey measures,
report at least 9 measures available for
reporting under a QCDR covering at
least 3 of the NQS domains, and report
each measure for at least 50 percent of
the eligible professional’s patients. Of
these measures, report on at least 3
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34913
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DEPARTMENT OF COMMERCE
National Telecommunications and
Information Administration
47 CFR Part 300
[Docket Number: 160523450–6450–01]
RIN 0660–AA32
Revision to the Manual of Regulations
and Procedures for Federal Radio
Frequency Management
National Telecommunications
and Information Administration, U.S.
Department of Commerce.
ACTION: Final rule.
AGENCY:
The National
Telecommunications and Information
Administration (NTIA) is making
certain changes to its regulations
relating to the public availability of the
Manual of Regulations and Procedures
for Federal Radio Frequency
Management (NTIA Manual).
Specifically, NTIA is releasing an
update to the current edition of the
NTIA Manual, with which federal
agencies must comply when requesting
use of radio frequency spectrum. NTIA
is also making changes to the regulatory
text to comply with the Incorporation by
Reference formatting structure.
DATES: This regulation is effective on
June 1, 2016. The incorporation by
SUMMARY:
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]]>Agencies
[Federal Register Volume 81, Number 105 (Wednesday, June 1, 2016)]
[Rules and Regulations]
[Pages 34909-34913]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-12841]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Part 414
[CMS-1631-F3]
RIN 0938-AS40
Medicare Program; Revisions to Payment Policies Under the
Physician Fee Schedule and Other Revisions to Part B for CY 2016;
Corrections
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Final rule; correcting amendment.
-----------------------------------------------------------------------
SUMMARY: This document corrects technical and typographical errors that
appeared in the final rule with comment period published in the
November 16, 2015 Federal Register (80 FR 70886 through 71386) entitled
``Medicare Program; Revisions to Payment Policies Under the Physician
Fee Schedule and
[[Page 34910]]
Other Revisions to Part B for CY 2016.'' The effective date for the
rule was January 1, 2016.
DATES:
Effective Date: This correcting document is effective May 31, 2016.
Applicability Date: The corrections indicated in this document are
applicable beginning January 1, 2016.
FOR FURTHER INFORMATION CONTACT: Michelle Peterman (410) 786-2591.
SUPPLEMENTARY INFORMATION:
I. Background
In FR Doc. 2015-28005 (80 FR 70886 through 71386), the final rule
entitled ``Medicare Program; Revisions to Payment Policies Under the
Physician Fee Schedule and Other Revisions to Part B for CY 2016''
(hereinafter referred to as the CY 2016 PFS final rule with comment
period), there were a number of technical and typographical errors that
are identified and corrected in section IV., the Correction of Errors.
These corrections are applicable as of January 1, 2016.
II. Summary of Errors
A. Summary of Errors in the Preamble
On page 71138, due to typographical errors, the QualityNet Help
Desk email address, the qualified clinical data registry (QCDR) data
validation execution report delivery date, and the email subject are
incorrect.
On page 71139, due to typographical errors, the QualityNet Help
Desk email address, the qualified registry data validation execution
report delivery date, and the email subject are incorrect.
On pages 71141 and 71145, we incorrectly stated the Measure
Application Validation (MAV) process utilized to determine the
reporting of Physician Quality Reporting System (PQRS) cross-cutting
resources.
On page 71147, we inadvertently omitted language restating the
Consumer Assessment of Healthcare Providers and Systems (CAHPS)
requirements that apply to groups of 100 or more eligible professionals
(EPs) that register to participate in the Group Practice Reporting
Option (GPRO) regardless of reporting mechanism.
On pages 71148 through 71150, we inadvertently omitted language
restating the CAHPS requirement for the QCDR reporting option in Table
28--Summary of Requirements for the 2018 PQRS Payment Adjustment: Group
Practice Reporting Criteria for Satisfactory Reporting of Quality
Measures Data via the GPRO.
B. Summary of Errors in Regulation Text
On page 71380 of the CY 2016 PFS final rule with comment period, we
inadvertently omitted language in Sec. 414.90(k)(5)(i). In this
paragraph, we inadvertently omitted language restating the CAHPS
requirements that apply to groups of 100 or more EPs that register to
participate in the Group Practice Reporting Option (GPRO) regardless of
reporting mechanism.
III. Waiver of Proposed Rulemaking
Under 5 U.S.C. 553(b) of the Administrative Procedure Act (APA),
the agency is required to publish a notice of the proposed rule in the
Federal Register before the provisions of a rule take effect.
Similarly, section 1871(b)(1) of the Act requires the Secretary to
provide for notice of the proposed rule in the Federal Register and
provide a period of not less than 60 days for public comment. In
addition, section 553(d) of the APA, and section 1871(e)(1)(B)(i) of
the Act mandate a 30-day delay in effective date after issuance or
publication of a rule. Sections 553(b)(B) and 553(d)(3) of the APA
provide for exceptions from the APA notice and comment, and delay in
effective date requirements; similarly, sections 1871(b)(2)(C) and
1871(e)(1)(B)(ii) of the Act provide exceptions from the notice and
comment, and delay in effective date requirements of the Act. Section
553(b)(B) of the APA and section 1871(b)(2)(C) of the Act authorize an
agency to dispense with normal notice and comment rulemaking procedures
for good cause if the agency makes a finding that the notice and
comment process is impracticable, unnecessary, or contrary to the
public interest; and includes a statement of the finding and the
reasons for it in the notice. In addition, both section 553(d)(3) of
the APA and section 1871(e)(1)(B)(ii) of the Act allow the agency to
avoid the 30-day delay in effective date where such delay is contrary
to the public interest and the agency includes in the rule a statement
of the finding and the reasons for it.
In our view, this correcting document does not constitute a
rulemaking that would be subject to these requirements. This document
merely corrects typographical and technical errors in the CY 2016 PFS
final rule with comment period. The corrections contained in this
document are consistent with, and do not make substantive changes to,
the policies and payment methodologies that were adopted subject to
notice and comment procedures in the CY 2016 PFS final rule with
comment period. As a result, the corrections made through this
correcting document are intended to ensure that the CY 2016 PFS final
rule with comment period accurately reflects the policies adopted in
that rule.
Even if this were a rulemaking to which the notice and comment and
delayed effective date requirements applied, we find that there is good
cause to waive such requirements. Undertaking further notice and
comment procedures to incorporate the corrections in this document into
the CY 2016 PFS final rule with comment period or delaying the
effective date of the corrections would be contrary to the public
interest because it is in the public interest to ensure that the CY
2016 PFS final rule with comment period accurately reflects our final
policies as soon as possible following the date they take effect.
Further, such procedures would be unnecessary, because we are not
altering the payment methodologies or policies, but rather, we are
simply correcting the Federal Register document to reflect the policies
that we previously proposed, received comment on, and subsequently
finalized. This correcting document is intended solely to ensure that
the CY 2016 PFS final rule with comment period accurately reflects
these policies. For these reasons, we believe there is good cause to
waive the requirements for notice and comment and delay in effective
date.
IV. Correction of Errors
In FR Doc. 2015-28005 of November 16, 2015 (80 FR 70886), make the
following corrections:
A. Correction of Errors in the Preamble
1. On page 71138, second column, second paragraph, lines 8 through
12, the phrase and sentence ``Desk at Qnetsupport@sdps.org by 5:00 p.m.
e.s.t. on June 30, 2016. The email subject should be ``PY2015 Qualified
Registry Data Validation Execution Report.'' '' are corrected to read
``Desk at Qnetsupport@hcqis.org by 5:00 p.m. e.s.t. on June 30, 2017.
The email subject should be ``PY2016 Qualified Registry Data Validation
Execution Report.'' ''.
2. On page 71139, third column, fifth full paragraph, lines 8
through 14, the phrase and sentence ``Desk at Qnetsupport@sdps.org by
5:00 p.m. ET on June 30 of the year in which the reporting period
occurs (that is, June 30, 2016 for reporting periods occurring in
2016). The email subject should be ``PY2015 Qualified Registry Data
Validation Execution Report.'' '' are corrected to read ``Desk at
Qnetsupport@
[[Page 34911]]
hcqis.org by 5:00 p.m. ET on June 30 following the year in which the
reporting period occurs (that is, June 30, 2017 for the reporting
periods occurring in 2016). The email subject should be ``PY2016
Qualified Registry Data Validation Execution Report.'' ''.
3. On page 71141, first column, first partial paragraph, lines 5
through 9, the sentence ``In addition, the MAV process will also allow
us to determine whether an EP should have reported on any of the PQRS
cross-cutting measures.'' is corrected to read ``Please note, the MAV
process is not utilized to determine whether an EP should have reported
on any of the PQRS cross-cutting measures. This analysis occurs prior
to the EP being subject to MAV.''.
4. On page 71145, third column, first partial paragraph, lines 4
through 8, the sentence ``However, please note that the MAV process for
the 2018 PQRS payment adjustment will now allow us to determine whether
a group practice should have reported on at least 1 cross-cutting
measure.'' is corrected to read ``Please note, the MAV process is not
utilized to determine whether an EP should have reported on any of the
PQRS cross-cutting measures. This analysis occurs prior to the EP being
subject to MAV.''.
5. On page 71147, the third column is corrected by adding the
following paragraph after the first partial paragraph:
``For group practices of 100 or more EPs registered to
participate in the GPRO via QCDR for the 2018 PQRS payment
adjustment: The administration of the CAHPS for PQRS survey is
REQUIRED. Therefore, if reporting via QCDR, these group practices
must meet the following criterion for satisfactory reporting for the
2018 PQRS payment adjustment: For the 12-month reporting period for
the 2018 PQRS payment adjustment, report all CAHPS for PQRS survey
measures via a certified survey vendor, and report at least 6
measures available for reporting under a QCDR covering at least 2 of
the NQS domains, AND report each measure for at least 50 percent of
the group practice's patients. Of the non-CAHPS for PQRS measures,
the group practice would report on at least 2 outcome measures, OR,
if 2 outcomes measures are not available, report on at least 1
outcome measures and at least 1 of the following types of measures--
resource use, patient experience of care, efficiency/appropriate
use, or patient safety.''
6. On page 71148 through 71150, Table 28--Summary of Requirements
for the 2018 PQRS Payment Adjustment: Group Practice Reporting Criteria
for Satisfactory Reporting of Quality Measures Data via the GPRO is
corrected to read as follows:
----------------------------------------------------------------------------------------------------------------
Group practice Reporting Satisfactory reporting
Reporting period size Measure type mechanism criteria
----------------------------------------------------------------------------------------------------------------
12-month (Jan 1-Dec 31, 2016).. 25-99 EPs; Individual GPRO Web Interface.... Report on all measures
100+ EPs (if Measures in the included in the web
CAHPS for PQRS Web Interface. interface; AND
does not apply). populate data fields
for the first 248
consecutively ranked
and assigned
beneficiaries in the
order in which they
appear in the group's
sample for each
module or preventive
care measure. If the
pool of eligible
assigned
beneficiaries is less
than 248, then the
group practice must
report on 100 percent
of assigned
beneficiaries. In
other words, we
understand that, in
some instances, the
sampling methodology
we provide will not
be able to assign at
least 248 patients on
which a group
practice may report,
particularly those
group practices on
the smaller end of
the range of 25-99
EPs. If the group
practice is assigned
less than 248
Medicare
beneficiaries, then
the group practice
must report on 100
percent of its
assigned
beneficiaries. A
group practice must
report on at least 1
measure for which
there is Medicare
patient data.
12-month (Jan 1-Dec 31, 2016).. 25-99 EPs that Individual GPRO Web Interface + The group practice
elect CAHPS for Measures in the CMS-Certified must have all CAHPS
PQRS;. Web Interface + Survey Vendor. for PQRS survey
100+ EPs (if CAHPS for PQRS. measures reported on
CAHPS for PQRS its behalf via a CMS-
applies). certified survey
vendor. In addition,
the group practice
must report on all
measures included in
the Web Interface;
AND populate data
fields for the first
248 consecutively
ranked and assigned
beneficiaries in the
order in which they
appear in the group's
sample for each
module or preventive
care measure. If the
pool of eligible
assigned
beneficiaries is less
than 248, then the
group practice must
report on 100 percent
of assigned
beneficiaries. A
group practice will
be required to report
on at least 1 measure
for which there is
Medicare patient
data.
Please note that, if
the CAHPS for PQRS
survey is applicable
to a group practice
who reports quality
measures via the Web
Interface, the group
practice must
administer the CAHPS
for PQRS survey in
addition to reporting
the Web Interface
measures.
[[Page 34912]]
12-month (Jan 1-Dec 31, 2016).. 2-99 EPs; Individual Qualified Report at least 9
100+ EPs (if Measures. Registry. measures, covering at
CAHPS for PQRS least 3 of the NQS
does not apply). domains. Of these
measures, if a group
practice sees at
least 1 Medicare
patient in a face-to-
face encounter, the
group practice would
report on at least 1
measure in the PQRS
cross-cutting measure
set. If less than 9
measures covering at
least 3 NQS domains
apply to the group
practice, the group
practice would report
on each measure that
is applicable to the
group practice, AND
report each measure
for at least 50
percent of the
group's Medicare Part
B FFS patients seen
during the reporting
period to which the
measure applies.
Measures with a 0
percent performance
rate would not be
counted.
12-month (Jan 1-Dec 31, 2016).. 2-99 EPs that Individual Qualified The group practice
elect CAHPS for Measures + CAHPS Registry + CMS- must have all CAHPS
PQRS; for PQRS. Certified Survey for PQRS survey
100+ EPs (if Vendor. measures reported on
CAHPS for PQRS its behalf via a CMS-
applies). certified survey
vendor, and report at
least 6 additional
measures, outside of
the CAHPS for PQRS
survey, covering at
least 2 of the NQS
domains using the
qualified registry.
If less than 6
measures apply to the
group practice, the
group practice must
report on each
measure that is
applicable to the
group practice. Of
the additional
measures that must be
reported in
conjunction with
reporting the CAHPS
for PQRS survey
measures, if any EP
in the group practice
sees at least 1
Medicare patient in a
face-to-face
encounter, the group
practice must report
on at least 1 measure
in the PQRS cross-
cutting measure set.
12-month (Jan 1-Dec 31, 2016).. 2-99 EPs; Individual Direct EHR Report 9 measures
100+ EPs (if Measures. Product or EHR covering at least 3
CAHPS for PQRS Data Submission domains. If the group
does not apply). Vendor Product. practice's direct EHR
product or EHR data
submission vendor
product does not
contain patient data
for at least 9
measures covering at
least 3 domains, then
the group practice
must report all of
the measures for
which there is
Medicare patient
data. A group
practice must report
on at least 1 measure
for which there is
Medicare patient
data.
12-month (Jan 1-Dec 31, 2016).. 2-99 EPs that Individual Direct EHR The group practice
elect CAHPS for Measures + CAHPS Product or EHR must have all CAHPS
PQRS; for PQRS. Data Submission for PQRS survey
100+ EPs (if Vendor Product + measures reported on
CAHPS for PQRS CMS-Certified its behalf via a CMS-
applies). Survey Vendor. certified survey
vendor, and report at
least 6 additional
measures, outside of
CAHPS for PQRS,
covering at least 2
of the NQS domains
using the direct EHR
product or EHR data
submission vendor
product. If less than
6 measures apply to
the group practice,
the group practice
must report all of
the measures for
which there is
Medicare patient
data. Of the
additional 6 measures
that must be reported
in conjunction with
reporting the CAHPS
for PQRS survey
measures, a group
practice would be
required to report on
at least 1 measure
for which there is
Medicare patient
data.
[[Page 34913]]
12-month (Jan 1-Dec 31, 2016).. 2-99 EPs; Individual PQRS Qualified Report at least 9
100+ EPs (if measures and/or Clinical Data measures available
CAHPS for PQRS non-PQRS Registry (QCDR). for reporting under a
does not apply). measures QCDR covering at
reportable via a least 3 of the NQS
QCDR. domains, AND report
each measure for at
least 50 percent of
the group practice's
patients. Of these
measures, the group
practice would report
on at least 2 outcome
measures, OR, if 2
outcomes measures are
not available, report
on at least 1 outcome
measures and at least
1 of the following
types of measures--
resource use, patient
experience of care,
efficiency/
appropriate use, or
patient safety.
12-month (Jan 1-Dec 31, 2016).. 2-99 EPs that Individual PQRS Qualified The group practice
elect CAHPS for measures and/or Clinical Data must have all CAHPS
PQRS; non-PQRS Registry (QCDR) for PQRS survey
100+ EPs (if measures + CMS-Certified measures reported on
CAHPS for PQRS reportable via a Survey Vendor. its behalf via a CMS-
applies). QCDR + CAHPS for certified survey
PQRS. vendor, and report at
least 6 additional
measures, outside of
the CAHPS for PQRS
survey, covering at
least 2 of the NQS
domains using the
QCDR AND report each
measure for at least
50 percent of the
group practice's
patients. Of these
non-CAHPS measures,
the group practice
would report on at
least 2 outcome
measures, OR, if 2
outcomes measures are
not available, report
on at least 1 outcome
measures and at least
1 of the following
types of measures--
resource use, patient
experience of care,
efficiency/
appropriate use, or
patient safety.
----------------------------------------------------------------------------------------------------------------
List of Subjects in 42 CFR Part 414
Administrative practices and procedure, Health facilities, Health
professions, Kidney diseases, Medicare, Reporting and recordkeeping
requirements.
Accordingly, 42 CFR chapter IV is corrected by making the following
correcting amendments to part 414:
PART 414--PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES
0
1. The authority citation for part 414 continues to read as follows:
Authority: Secs. 1102, 1871, and 1881(b)(l) of the Social
Security Act (42 U.S.C. 1302, 1395hh, and 1395rr(b)(l)).
0
2. Section 414.90 is amended by revising paragraph (k)(5)(i) to read as
follows:
Sec. 414.90 Physician Quality Reporting System (PQRS).
* * * * *
(k) * * *
(5) * * *
(i) If a group practice does not report the CAHPS for PQRS survey
measures, report at least 9 measures available for reporting under a
QCDR covering at least 3 of the NQS domains, and report each measure
for at least 50 percent of the eligible professional's patients. Of
these measures, report on at least 3 outcome measures, or, if 3
outcomes measures are not available, report on at least 2 outcome
measures and at least 1 of the following types of measures--resource
use, patient experience of care, efficiency/appropriate use, or patient
safety. If a group practice reports the CAHPS for PQRS survey measures,
apply reduced criteria as follows: 6 QCDR measures covering 2 NQS
domains; and, of the non-CAHPS for PQRS measures, 2 outcome measures or
1 outcome and 1 other specified type of measure, as applicable.
* * * * *CMS-1631-F3
Dated: May 25, 2016.
Madhura Valverde,
Executive Secretary to the Department.
[FR Doc. 2016-12841 Filed 5-31-16; 8:45 am]
BILLING CODE 4120-01-P
