Secretarial Review and Publication of the Consensus Based Entity Report of 2023 Activities to Congress and the Secretary of the Department of Health and Human Services, 71284-71371 [2024-19479]
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Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
requests for enhanced federal financial
participation for expenditures related to
Medicaid eligibility determination
systems, we will review the submitted
information and documentation to make
an approval determination for the
advanced planning document. Form
Number: CMS–10536 (OMB control
number: 0938–1268); Frequency: Yearly,
once, and occasionally; Affected Public:
State, Local, or Tribal Governments;
Number of Respondents: 56; Total
Annual Responses: 168; Total Annual
Hours: 2,688. (For policy questions
regarding this collection contact Loren
Palestino at 410–786–8842.)
3. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: Medicaid Drug
Use Review (DUR) Program; Use: States
must provide for a review of drug
therapy before each prescription is filled
or delivered to a Medicaid patient. This
review includes screening for potential
drug therapy problems due to
therapeutic duplication, drug-disease
contraindications, drug-drug
interactions, incorrect drug dosage or
duration of drug treatment, drug-allergy
interactions, and clinical abuse/misuse.
Pharmacists must make a reasonable
effort to obtain, record, and maintain
Medicaid patient profiles. These profiles
must reflect at least the patient’s name,
address, telephone number, date of
birth/age, gender, history, e.g., allergies,
drug reactions, list of medications, and
pharmacist’s comments relevant to the
individual’s drug therapy. The State
must conduct retrospective drug use
review which provides for the ongoing
periodic examination of claims data and
other records in order to identify
patterns of fraud, abuse, inappropriate
or medically unnecessary care. Patterns
or trends of drug therapy problems are
identified and reviewed to determine
the need for intervention activity with
pharmacists and/or physicians. States
may conduct interventions via
telephone, correspondence, or face-toface contact. The states and managed
care organizations (MCOs) are provided
the reporting instrument (a survey) by
CMS, and by responding to the survey,
the states generate annual reports which
are submitted to CMS for the purposes
of monitoring compliance and
evaluating the progress of states’ DUR
programs. The survey and the annual
recordkeeping and reporting
requirements under the pertinent
regulations, are completed by
pharmacists employed by, or contracted
with the various state Medicaid
programs and their MCOs. The annual
reports submitted by states are reviewed
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and results are compiled by CMS in a
format intended to provide information,
comparisons and trends related to
states’ experiences with DUR. The states
benefit from the information and may
enhance their programs each year based
on state reported innovative practices
that are compiled by CMS from the
annual reports. A comparison/summary
of the data from the annual reports is
published on Medicaid.gov annually,
and serves as a resource for
stakeholders, including but not limited
to states, manufacturers, researchers,
congress, CMS, the Office of Inspector
General, non-governmental payers and
clinicians on the topic of DUR in state
Medicaid programs. Form Number:
CMS–R–153 (OMB control number:
0938–0659); Frequency: Yearly,
quarterly, and occasionally; Affected
Public: State, Local, or Tribal
Governments; Number of Respondents:
52; Total Annual Responses: 676; Total
Annual Hours: 41,860. (For policy
questions regarding this collection
contact Mike Forman at 410–786–2666.)
William N. Parham, III,
Director, Division of Information Collections
and Regulatory Impacts, Office of Strategic
Operations and Regulatory Affairs.
[FR Doc. 2024–19733 Filed 8–30–24; 8:45 am]
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–3447–N]
Secretarial Review and Publication of
the Consensus Based Entity Report of
2023 Activities to Congress and the
Secretary of the Department of Health
and Human Services
Office of the Secretary of
Health and Human Services, HHS.
AGENCY:
ACTION:
Notice.
This notice acknowledges
receipt and review by the Secretary of
the Department of Health and Human
Services (the Secretary) of the 2023
Consensus Based Entity Annual Report
to Congress as mandated by section
1890(b)(5) of the Social Security Act
(the Act). The Secretary has reviewed
and is publishing the report in the
Federal Register together with the
Secretary’s comments on the report.
SUMMARY:
FOR FURTHER INFORMATION CONTACT:
Charlayne Van, (410) 786–8659.
SUPPLEMENTARY INFORMATION:
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I. Background
The United States (U.S.) Department
of Health and Human Services (HHS)
has long recognized that a high
functioning health care system that
provides higher quality care requires
accurate, valid, and reliable
measurement of quality and efficiency.
The Medicare Improvements for
Patients and Providers Act of 2008 (Pub.
L. 110–275) added section 1890 of the
Social Security Act (the Act), which
requires the Secretary of HHS (the
Secretary) to contract with a consensusbased entity (CBE) to help improve
performance measurement. Section
3014 of the Patient Protection and
Affordable Care Act (the Affordable Care
Act) (Pub. L. 111–148) expanded the
duties of the CBE to include the
identification of gaps in available
measures and to improve the selection
of measures used in health care
programs. The Secretary extends his
appreciation to the CBE in their
partnership for the fulfillment of these
statutory requirements.
Section 1890(b) of the Act requires the
following:
Priority Setting Process: Formulation
of a National Strategy and Priorities for
Health Care Performance Measurement.
The CBE must synthesize evidence and
convene key stakeholders to make
recommendations on an integrated
national strategy and priorities for
health care performance measurement
in all applicable settings. In doing so,
the CBE must give priority to measures
that: (1) address the health care
provided to patients with prevalent,
high-cost chronic diseases; (2) have the
greatest potential for improving quality,
efficiency, and patient-centered health
care; and (3) may be implemented
rapidly due to existing evidence,
standards of care, or other reasons.
Additionally, the CBE must take into
account measures that: (1) may assist
consumers and patients in making
informed health care decisions; (2)
address health disparities across groups
and areas; and (3) address the
continuum of care furnished by
multiple providers or practitioners
across multiple settings.
Endorsement of Measures. The CBE
must provide for the endorsement of
standardized health care performance
measures. This process must consider
whether measures are evidence-based,
reliable, valid, verifiable, relevant to
enhanced health outcomes, actionable at
the caregiver level, feasible to collect
and report, responsive to variations in
patient characteristics such as health
status, language capabilities, race or
ethnicity, and income level and are
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consistent across types of health care
providers, including hospitals and
physicians.
Maintenance of CBE Endorsed
Measures. The CBE is required to
establish and implement a process to
ensure that endorsed measures are
updated (or retired if obsolete) as new
evidence is developed.
Removal of Measures. Section 102(c)
of Division CC of the Consolidated
Appropriations Act, 2021 (Pub. L. 116–
260) amended section 1890(b) of the Act
to permit the CBE to provide input to
the Secretary on measures that may be
considered for removal.
Convening Multi-Stakeholder Groups.
The CBE must convene
multistakeholder groups to provide
input on: (1) the selection of certain
categories of quality and efficiency
measures, from among such measures
that have been endorsed by the entity
and from among such measures that
have not been considered for
endorsement by such entity but are used
or proposed to be used by the Secretary
for the collection or reporting of quality
and efficiency measures; and (2)
national priorities for improvement in
population health and in the delivery of
health care services for consideration
under the national strategy. The CBE
provides input on measures for use in
certain specific Medicare programs, for
use in programs that report performance
information to the public, and for use in
health care programs that are not
included under the Act. The multistakeholder groups provide input on
quality and efficiency measures for
various federal health care quality
reporting and quality improvement
programs including those that address
certain Medicare services provided
through hospices, ambulatory surgical
centers, hospital inpatient and
outpatient facilities, physician offices,
cancer hospitals, end stage renal disease
(ESRD) facilities, inpatient
rehabilitation facilities, long-term care
hospitals, psychiatric hospitals, and
home health care programs.
Transmission of Multi-Stakeholder
Input. Not later than February 1 of each
year, the CBE must transmit to the
Secretary the input of multi-stakeholder
groups.
Annual Report to Congress and the
Secretary. Not later than March 1 of
each year, the CBE is required to submit
to Congress and the Secretary an annual
report. The report is to describe:
• The implementation of quality and
efficiency measurement initiatives and
the coordination of such initiatives with
quality and efficiency initiatives
implemented by other payers;
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• Recommendations on an integrated
national strategy and priorities for
health care performance measurement;
• Performance of the CBE’s duties
required under its contract with the
Secretary;
• Gaps in endorsed quality and
efficiency measures, including measures
that are within priority areas identified
by the Secretary under the national
strategy established under section
399HH of the Public Health Service Act
(National Quality Strategy), and where
quality and efficiency measures are
unavailable or inadequate to identify or
address such gaps;
• Areas in which evidence is
insufficient to support endorsement of
quality and efficiency measures in
priority areas identified by the Secretary
under the National Quality Strategy, and
where targeted research may address
such gaps; and
• The convening of multi-stakeholder
groups to provide input on: (1) the
selection of quality and efficiency
measures from among such measures
that have been endorsed by the CBE and
such measures that have not been
considered for endorsement by the CBE
but are used or proposed to be used by
the Secretary for the collection or
reporting of quality and efficiency
measures; and (2) national priorities for
improvement in population health and
the delivery of health care services for
consideration under the National
Quality Strategy.
Section 50206(c)(1) of the Bipartisan
Budget Act of 2018 (Pub. L. 115–123)
amended section 1890(b)(5)(A) of the
Act to require the CBE’s annual report
to Congress to include the following: (1)
an itemization of financial information
for the previous fiscal year ending
September 30th, including annual
revenues of the entity, annual expenses
of the entity, and a breakdown of the
amount awarded per contracted task
order and the specific projects funded in
each task order assigned to the entity;
and (2) any updates or modifications to
internal policies and procedures of the
entity as they relate to the duties of the
CBE including specifically identifying
any modifications to the disclosure of
interests and conflicts of interests for
committees, work groups, task forces,
and advisory panels of the entity, and
information on external stakeholder
participation in the duties of the entity.
The statutory requirements for the
CBE to annually report to Congress and
the Secretary also specify that the
Secretary must review and publish the
CBE’s annual report in the Federal
Register, together with any comments of
the Secretary on the report, not later
than 6 months after receiving it.
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This Federal Register notice
implements the statutory requirement
for Secretarial review and publication of
the CBE’s annual report. The CBE
submitted a report on its 2023 activities
to Congress and the Secretary on
February 26, 2024. The Secretary’s
Comments on this report are presented
in section II of this notice, and the CBE’s
2023 Activities Report to Congress and
the Secretary is provided, as submitted
to HHS, in the addendum to this
Federal Register notice in section IV.
II. Secretarial Comments on the CBE’s
(Battelle Memorial Institute) 2023
Activities: Report to Congress and the
Secretary of the Department of Health
and Human Services
As part of its core mission, HHS seeks
to stabilize and improve the quality of
health care throughout the country. In
response to recent public health crises
and to prudently prepare for imminent
threats in the future, HHS must
continue to focus on advancing equity
and inclusion, strengthening public
trust, and building meaningful
engagement and learning across the
health care system. By embedding the
cross-cutting principles 1 of equity,
public trust and collaboration into its
diverse programs and initiatives, HHS is
working to improve the health and wellbeing of individuals and families. The
following comments are regarding the
2023 activities performed within the
Partnership for Quality Measurement
(PQM) forum, created by Battelle in its
capacity as the CBE.
Over the past year, the CBE has
supported HHS’ commitment to
promoting a resilient, high value, and
safe health care system for all
Americans. In 2023, HHS supported the
work conducted by the CBE to identify
health care quality measurement
priorities and to provide consensusbased recommendations about measures
to use for assessing and improving
quality. As the new CBE beginning in
2023, Battelle established the PQM and
continued the use of rigorous standards
to review measures for quality measure
endorsement and maintain highly
reliable and scientifically sound
measures across priority health care
topic areas.
The PQM is comprised of diverse
representatives in health care that
engage with the health care quality
improvement community. Members of
the PQM help shape the future of health
care by taking an active role in the
quality measurement process, using
1 HHS Strategic Cross-Cutting Principles available
at https://www.hhs.gov/about/strategic-plan/20222026/overview/.
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their health care experiences and/or
professional expertise to review and
provide feedback on quality measures
HHS is considering for use in Medicare
programs. The CBE’s processes have
evolved with a renewed focus on
advancing measurement science,
ensuring transparency, and increasing
diversity in engagement of interested
parties as evidenced by its Annual
Report and feedback received by the
Centers for Medicare & Medicaid
Services (CMS). This focus has resulted
in increased engagement from patients,
patient advocacy groups, and clinicians,
as well as a shared sense of ownership.
The CBE focused on four key
initiatives, including Endorsement &
Maintenance (E&M) of clinical quality
measures, Pre-Rulemaking Measure
Review, Measure Set Review and Core
Quality Measures Collaborative
(CQMC). In 2023, the CBE completed
three endorsement cycles. A combined
81 measures were submitted for
endorsement consideration in the first
two cycles (Fall 2022 and Spring 2023)
that were started under the previous
CBE. The third cycle (Fall 2023) which
launched the revised process, began in
October 2023 and was completed in
March 2024.
Over the past year, the CBE expanded
committee and public engagement by
creating five new project committees
that are focused on a patient’s journey
through the health care system. A
description of these five new
committees can be found on the CBE’s
website at https://p4qm.org/EM/
projects. The committee structure is not
based solely on a health care condition
or disease state but by the type of
function the health care system is
performing (for example, prevention/
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screening, advanced illness, and postacute care), including the type of
evidence submitted in support of that
function (for example, screening results
in a referral). The focus areas of the
committees include primary prevention;
initial recognition and management;
management of acute events, chronic
disease, surgery and behavioral health;
advanced illness and post-acute care
and cost and efficiency.
HHS recognizes that, concurrent with
the CBE’s efforts to engage the quality
measurement community on enhancing
the E&M process, the CBE engaged the
same community on ways to create a
more transparent and impactful measure
review process to support quality
reporting and value-based purchasing
programs as evidenced in the CBE’s
Annual Report and feedback received by
CMS. Like E&M, enhancements were
centered around increasing efficiency in
the process while expanding committee
and public engagement. HHS believes
that these process enhancements
resulted in increased quantity and
quality of the feedback CMS received on
quality measures.
The CBE convened the CQMC Full
Collaborative in late 2023 to set
priorities for the upcoming year. The
goal of the meeting was to explore the
CQMC’s role in three key areas,
including health equity measurement,
movement to digital measures and
alignment around measurement models.
In addition, the CQMC discussed the
leading barriers to adoption of measures
within the core sets and achieving the
desired impact of the core sets and how
these can be overcome. The CQMC also
began to develop a vision and strategy
for the next phases of work.
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HHS and the CBE both recognize the
importance of clinical quality and cost/
resource use measures in improving
U.S. health care. Maintaining these
measures through transparent, periodic,
and consensus-based reviews is critical
for ensuring health care quality
performance can not only be measured
but can also be improved upon. HHS
and the CBE recognize that a true
consensus process must be transparent,
reliable, and equitable. The CBE is
building relationships within the health
care quality community, including
patients and clinicians, necessary to
advancing the national goal of attaining
the highest level of health and wellness
for the widest range of individuals
possible as evidenced by its Annual
Report and feedback received by CMS.
III. Collection of Information
Requirements
This document does not impose
information collection requirements,
that is, reporting, recordkeeping, or
third-party disclosure requirements.
Consequently, there is no need for
review by the Office of Management and
Budget under the authority of the
Paperwork Reduction Act of 1995 (44
U.S.C. 3501 et seq.).
IV. Addendum
In this Addendum, we are publishing
the CBE Report on 2023 Activities to
Congress and the Secretary of the
Department of Health and Human
Services, as submitted to HHS.
Xavier Becerra,
Secretary, Department of Health and Human
Services.
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CONSENSUS-BASED ENTITY 20:23
Annual Report to Congress and
the Secretary of Health and
Human Services
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FINAL REPORT
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11:tl~l!il: ~i1;1r,:\,!jil~l\ls•li~IEE!it! ili!;Jiil!tJ/' lil!W!~i~111t:11i1il ~~l\ffil I'$! &ll!!il1!:1l•i ~Ille~ i!'lill'!I /!l~R!i!~il~l!' ~r; fl!Mlffiffi l!!11/21 !il!t1mil\ltri ~tJ&\'~i!!
a r£ i?•.·11 c1Emt:e-tla:se1:1,
!S1)11nd, r.,,fe,
1L<;f!
HUl'ir>CDf¾".Y,IDILNHSJnlU
i£I
;,ind dfl:'ctive, meaning
,;f the m<".'l,;me 1•1ill lnrrr;ise
tl·1,:- Iikelihm:id of desi1 <:Cl he,1 Ith
\•1ill ,r,;.:,t inctt:'l.lc,e thi2!
Ii kel iho\",d of
adverse
is consi stl;'c11t
Remm me ndatton Group.
M,emoers
Grm.iµ
vidi? !"t'Gomm;?ndaUon::
tr,
Thc::sc inp1Jts
li!nsurli! that a
immber
,,nd post ,Kutt: care, a1H:I cost .~nd
Witl1 liH! F-i.lll 2JJB
tL'iitl,E:il
J nd Nomi na I Group.~ tech-
nique fc,r measure e11dc-r:Seme11.t
1011), fhis.
!J.io;;d
with ,:,,rnmlt~e
and Ml lx<>r,m1m:i~e discw;si Ml to
support b'i!'tl121 p,:,;llcy o!Jk•::imi:t!L
Tm; pu rpo.'w. of this uarr11 ,,rn.,,,
of voir.:!'!'.5 ro ntn !::nt~ k, thi?
,:,;:,11:,ensu:~-builclin~ process,
a rnea:c;ure for endor!i;;,mPnt. In
re:spo rise,
.~ll
of our work
iliK Iude multip,le
fo,t·
B.afu:-lle re--c1f'"L"rnf'fl
:st1b1nitted to tlie !)!l::ViOUS CBE
:mn,md
or
<:i::1uld 1,1~ i11fl.uer1tlJil in di::ci •
SlOII
th,: proc,:ss, while inc1easingthe
l.irnc:f! of publk w tmnent .lil 1d
en13a13Pmrnl:: d1iratk11.
FJatte!le
,.,. ,, "', "''"'" for e11-
dOt'S.ement ,:onsiderati,)n The rail
octcbe:r
In
,;;ndor,;ems'nt
. .,
:w
d
CFIF, ;mrl the third (F,,;II JO.B;
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Th1ec ne:•!i comm itlt(,e strnctu re is
not ba!,Cd solely .c,n.;:, i1'2c11th rnri::
cc,nditlml! m disea:,e state, but b;·
71294
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
i'f,ii-RU !!!!'maid I'll Mt-afl:1.11'\i! R,evh,!'i!i {?li!MR}: llnttolLe
mnveriesM;ikelmld;,r;,.
thf' purp,:isf' of
recommenck,tiorn ,::,11 the selection
,30:,,rd.Jno:· 'Nith ."rection ;§)
th,:- f'r<t··Rulern;)idng:
c-~1t1tunent with om effurb!J to i:,ng.;,ge the
a ..,•., c.,n,·, "·~
Hw lft,MJ
r&nmmf'ndatiom;
the in,:lusion ,)t n11;,.:,:,;ure.s under com,kleratiot, for
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"'·"nnrn1, 0; co11~.;n:o;1i:e;
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
71295
R"'ll~tl:~•~11±Sfillili!lla!;ellil in'tlt.i ii!!Zii:t'll •l!li1.\!'II file~llli ltiti!~~!ttl9,.E,~:tm ;in~ :tffi;:;; !lie~i'lei~nf ,$If; l\l!l~ltl!i a%11ii 141'1111\\ll!il'l ~Sl!if'~'>'
'
•
y
r;;
.c1,,1;;,xi ated •r1ith i rn pe:rt.:iln(e, s6entifi,r
• Dat;; ;:;;;.,,,,:;ribing ':h>i? .;;ppr,:.,.::ric1ten.,;ifrvf th,;, n,;,as•;f';? I,:,r
e','ii!IUuti:19 Mi?u,Ur,;RJ 9rltHi<?S
merits of
tar,15et
of the progr.arn imder <::on:sider.ati-:i n:
• ::I,t.a derrr;:,mtr?ti :1~J
the
,::; :,;;1t1 ve impe1i:: ts in
! onq
Time t11 valu&1 l'ii!~ll1M:!om Io
does rn 11 cnt ,,, . i:u,,·"·,··
t'1E
:,wr2eted P'-''Plelc'U,:n
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tkelley on LAP7H3WLY3PROD with NOTICES2
im provem 1mtl
71296
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
11,ce
I r.>1,f,-;l\i/'int:r
Vi!i" 1A' (l-F"O~:!;/; Wiic5- tn i!llCF!i"ilfis: thP, nn,inr·n\i
fe'l:•(liJ,, CIK 'CMS (t) llki
1"1:!•
qu.;ili~y
e;,,;p-e,:t to rer::e:ive on e:.,,:h
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tkelley on LAP7H3WLY3PROD with NOTICES2
process; ~ttdk-
71297
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
MSR ce11ter:;or1
ti?rf'S.1I•d pasty revi,c,ws of m,e;.:i,~u rf's a crn:,s vari OIL'>
CMS
~ser
)0:\SS
End-St,~ge Reni~l Dt5'f"JS<=
mifiiSlll"f;
(ESRD
meeting mi?mb'f:rs cr,;-,1t''"'"'Ha:.u,;;;· v,iith CMS
1.:11,c,v,,1 re(<;,m men<iati •)ns. f.'.(•m mittees re,:om ·
me.
basi!d
fl1<o"'1Sll
infr,rn,ati
man<:eiJ
rem,:wal
r1ct;:.ntior
IYillcJl5'U t"t'S Wl":r-e
l:S.fWQIP,
d@titms
buil.ds1.:m1s.ensus amund m,,a5urn ,,,,,.,,., •. '""i''-'
in the val·
~ocia I determ i na
in
meJtsure spie<:ilfcation t,)"
p1N$.·8l1,0lilt!d rnedidni'..!,
rne..;is:uH! eNdusions. 'llnit
re~l-world
n,l rios. consideration {,f the unique ne-ed,; of ru rJil
c;:,mmlm itles, J 11d ,c•xpl,;r"'tio1t ,,f
in<:t •::<C1Se
rmia\;urli.!
pi.!Lkml, :and rllt!i£1;;Wii!d +2ntlLies.
am:l timl! to vi'llm! realization, the three MS!R
domain;;.;;ire:
(U11ie1:111 d~!£trHm,,:
datJ
b,:>e11
Measure
id<"'nti lied .~ !ld
Patientjour11ey: rh!i! m•~~tHi! is imµlermmled
iHTass the patient jmi
•
•
•
10
to
patient uukomes.
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tf
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EN03SE24.011</GPH>
tkelley on LAP7H3WLY3PROD with NOTICES2
71298
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
71299
Department of Hl.'ratth an cl Hu man
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'~
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.:
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03SEN1
EN03SE24.012</GPH>
tkelley on LAP7H3WLY3PROD with NOTICES2
~
71300
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
11-1f.i! ~liii!!ffi~!fll•Eiffiml§ it!l~\ii!il illi'Ji!! rnrc,u.:d ~Ill;! m ;:;,z.~~i; iilflii'l ii!~ ~~liii!Jm~ illf l\lil~!ll:t '11!'\ml l!ll1am,;in ik,Ji:I,~
'
'
'
Subsequf!11Hy, IJ<1tt.elle workf!d ;:.losely
initia1i'""'"
Qua Iit~, MeJsU I'<:tt1ent
to e1.'a luate QIJ3 Iity llH:\l sures ~ubmittl::'d tr:,r encl,,r;e•
Meiii!ili.llrl!! leview jPRMRj:
BJ:ttelle convE11es P'QM .,.,.,,,,,",n"'"' mtcmbEr.s to
mc·,,-sm ,_.~
su bmittecl to CMS os pn 11 of tr1e
Cl:lmmiltee members
p.:i 1111ers Vii!:11 CMS 21nd
A met I ti:l ll
Health lnsuram:e P<1rinersl11p (/1.tllP),
,-h~,~•~hi,~ ta.,;,k,:d
quality me.:is.u1es .:icn:iss p,3yers to reduce burden on
cli11id.:itl!i.
H@•comi,:i~na•~~~nto
add meactuTe to program
ld~r:.omm,u1datJon to
rem 1:>ve me.;Jilunl' from
pro91,1m
• "[~l',Jl:4,lf\,'.,,)IA
. o:,timizati::,n"
n1;,cess<1r:v''
be:nofit)
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tkelley on LAP7H3WLY3PROD with NOTICES2
to ln½rtlduction I 14
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
71301
1.4
he<1I
.St€W,'lrti5,
1,,m1:ali<,,1•-s ami me,;l.~,!Jff!
r,ss:f',a1ri'.lh"1r<:
impleme11~1'", ,\nd l1ie<1IU1 infornHtion
tr.~nspi'lr>?nt aUainablr,
~
,_
::lded meas.u res whose be 1l!efits
ililies,
pn:;.ce&~. To·
parti dpc1ti ng in cons em; 1.15• b.;ised
m,:ml)er:,Hp, in PQM th:ce (,f c~t
m-lens;,1
, .
U.S. (.ong;rts?.5-.'l, '"'""''"c.~,,..
HHS, .:ind other g:01J1ernment off'kia!;:;, S,:,:1)nclc1ry
p.11 ll e!i In tere~,t"''l.! in h,2;:i!ih
es, sud, a, nr,r,,.,, d~'"'·
-
•
,_,
-
on qu.~lit:y me<1sures thclt HHS ls ci:,nsidering t,::ir use
"'""'"""'r•prog1.:ims, M,imbi::1:s a,njoin
.,
w
r:nrnrnitt.,r•s th;, t f!Va IUilte whether mE'.asL1res show ld
be em:lomE>d
on the.it' stipp·Grtin;g E'11ide,11ce, the,ir
s.ci1:·t1tifi( rigor suth 1·Lc1iJbility· ,:md
their
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tkelley on LAP7H3WLY3PROD with NOTICES2
foo:,,ii.;ilily, Hii!ir
klni.:,1 ll:,
dii1kian:,,,
urnJ whel11f!r th~ [ll(c'aSLires lhiHllSf!l~•~•!>·••::it
1H!<<t•
rmmt;;.
,..r,,,,,.,,,;,.,·"·~
;;asured-;,n;,,,;.;:,f,, anrl
71302
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
1.S
Hi~ .<:;;,cr>?cti r.'i of HHS: bt M;,r.::h
in.::atrd.
Table 1. Contents oHlle 202! Anm.1al Repon to C,::m~ress ancl tile Secretar:r of !elf.Iii>
:ELEMENT
SE:CTIONI
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03SEN1
EN03SE24.015</GPH>
tkelley on LAP7H3WLY3PROD with NOTICES2
cind
71303
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
.
B.attelle
.
-
,,1s t,; l,1 unch th,;
1:>JiU rement
((BE :Strat<?gy). Tl1e go.al orn1e CBE Strnt,:,gy is to:
the Cl.IL
mf:'il:':llr~me
rnhE:rent me
sur
•
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03SEN1
EN03SE24.016</GPH>
tkelley on LAP7H3WLY3PROD with NOTICES2
111
71304
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
, 11-1:.li f~iil'!ifill!nl!llli'ia11:!ad IS)n!blt~ l~i ~1:11ti111al Ellltili1 l\t:i ~itt\lTiii!iJ~i;y; .in\\\l ifll!13 :il!!!llt!,i!~ill~l!l !l11'! ITI!eia!tffi •ti l#'lt1m!liim
'
'
~~ .zm
'
lmp10Vi!mer
interf!~
S:i!S'i
ift
introduce tl7E' B;~U,elleCBE ream
for HS>l!',n•,t,"m,·,f"
in CBE rn,•·,na••"'"~
consultation with CMS,
[l1.1ri1lg thE> M":iR meeting, ,<:l1nmitt<:e m,:m·
IB.,ttelle sele,t,;,d the CMS
.
~1.i1
L
fFSRIH1,thf!
r(;•r
bet !i .:l~!JI e,:SC{.I
!'P.vi,;in1:, ami i1nr10vin3
n,P;;sLm'!s.
'.Nhi l,e th;;;s-e re.com menchl:i om;; '~"·:11w,r111·o1
M;,di,:;ire program.
r,e.,,i 1cw ES f< Ci 01 Pmeast1re-s under
tt1e first
B.i lh,lle
lhi!
th" MSR C,,mmi~. Th,,, pu rp,,si:- c4the meetini!: was to revi-ew m"".asures
lt1 the CMS
R:<im,I Di ~~use QUt1H ty
it.mil per:,p--,ctives. pill1"111td1c-ke,
,::if
teill
wo1ld
~mb~d
eqw ily
~'ilffli
2.2J Ernbed
id•~ring thit bf.'~ ways
w.iys to p.ik
tkelley on LAP7H3WLY3PROD with NOTICES2
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erlm:;ition with mf!a;,;ur,;,m..
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
71305
1m~I!'#:{i,;n~1111,11!l!i1ci/ilii~'!il!tlf lliln:!l:~'!1' :l:!~lii ~!ilHilil •!ll'!itll ~:e:. ,':!.tlnf¾ll'lll!!!i! ltl!'!liil ltl!i!! ~!11!!1~!~~• mfi fll!§t\t! 11\111~ l\ilefflsn ~~ iill!i!!
'
'
'
lives
{:c,nsiderttie unique ch-llteflges exp,;,;rienced rn rnr,,I cocnmlmities
mid
1/{•t)t"/",r•<em>f;Sfl'<,,\(,<.
I urn I
c;,re ,,C(,c.S!;. g;itpc5 ;,nd mov'e pr,:,grl3/5s on he;ilth
d>:•\r,:,lo~~ers to,) i:,mside r how 11.:,ti(,n.:>I
tl1r12shulJsc<in<l ti:1;!<. adiLl!,lrnenl r1H.1d;2ls rt!I.Jlai?
trndllion.i!l~•
ill
e◊ tmn it bee enc,:,m';)g.,,d
s,;;enarb,~ and puU,mt-le•lel fadors
mt'!Jce;ure reviews it1dudi?d
im;:re,ts,,,;
di.<;D.issions about the use of n1o:;,,"\!HJre exdu.siom;
Jddress 1v,M,·,n1,r-t,, dc,tJ ,rnd <:onfouncling concerns.
' ·,,11 rr · h,1 R8tO!Tll •
• '·
•• • •
,p • ,·
r,.'
the
c•
. ·
··nr~ .. -.
-ong lSRLl pt,tl0nts. tl1f! (.'.,J
• •
- c:mnn1itteefeltil was
tkelley on LAP7H3WLY3PROD with NOTICES2
,md other
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fill
•
71306
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
o.f act ion. S11,1 ilarly, for .:i nu1i\'IISU 1·111 tel-ilted to thi:i llt.'lndardti:i!!d fl:stu l.i! nlltfo, the cor11mltt111e
i'!!o:presi;;ed c:nnc:em tl'iat p;itient ;::hpi C:·f! \l/;11$ not adequ atel;:t r:.iff(;.r.l:f!d. TI-if! c:m'nrn iff P.e r.i ted ;'J
gerwra.l la,:k of pati~nt,edut~tfonand engagii,11:'lP.tn.t:. in d,e-ci:$.l cm-m,iking., and eilnpM.1:i:ed the
im portante of,t'Qnsi d1:ri11; a 1Mtie!lt'.$ persm1al ~•..i!s \~ 11id ~viS:hes f\lr q~a Iity of life,
~..J M•tiiliilre.Priorltii:ratlon
l.n 202.%, th0:C8f hi:fd tl'l~.cop;;u:tty to 1evit:~I/ all n1e-.;11:si.m:ruub1nltkd l'i>r t:&M. PRM~, ..-,nd MSR.
In atc:mdam:e ,vitil the SSA, the C:BE i.'.> t;;.i •prtoritlte 11'1ea,1;1J1e,s, d101.1kl thi/.re• be Htriited ts~
:1':0tm:e:~all'-li Iable .to review .~ ll. l'.lleasu r,es submitted in a .t)ICle. Tabt~ 2: p1·c,,1i.des a summar1 i:"Jf
11~eai1oure,s. re~rii~We<f fit:l:i ngwl thi11 the c,ategorieS- listed wifihiti \1$¢:l'ti¢ it 1.(/; Wiiile Pl iorttl.:atiM ••
o:f'.r.liOOSIWti.>.!l, W1:IS r,\ot, t'tet¼l!.lll!ry, sot11(li ~.\I dii!11gii!:S i:!t\~U re W.i c.or1U t\.lill\l lti t1ave l:hlil !.l.bill t:v to
rl;'\lbi'!W all ,meat::u Ii?:!> iil1d opti mitli!' thoi!pr{l-\~f1-'>-'i- for E;-ffid i'!'llj:;y i'l 11d;;!~r.tive11e!\..;., l(n. thf! !iiP.ctltit'l!';
t;.ekiw, vi'€' p1·.ovide add!ition.a l de't-1 ii. on th"' d.a n.ge,.i;, m-ide b!:.'tween Batte lie•~ and Ute prior
tsl:'s prool:lss"s .,mdi 1,'11 oc~urcs for l:&M, P'RM RC, 01.1d MSlt
•
",o\il;;,-~J_lf41 ~i:ll•ri:•.f ,>l;ts'l.<.t t~,':,,;,;,
<i,w.~ llt,1111,~t .~;1,IHil/,!)i: ~:«ii'1!'1i'""·
of t~,;im.6.-r .$/. :.l02J, O"I/IJ. ,'1'1~,f(,'~' ,Y1 ,li"I~ S~M 1-'~I• 202,1 ;Mt<';f Spreig 2CU.!! (:1/:!s'«i f/i,,if b~" j'\O•
l'l't:H>¾:!t;/, :r:tie S&1"1 F,i.o~ ;:0.2!(; ~v~-i~· ,'l'il!\\l',U,lt!.~. (i'li'C-:.,:'ll) rt.1J,'ie<:e(l,·e en,:lorse.,:,:,...,-.1• d«i'S/1:;,'"1$ NI ~D((iiJi"J' :to24,.
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EN03SE24.019</GPH>
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''At>
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03SEN1
71307
EN03SE24.020</GPH>
tkelley on LAP7H3WLY3PROD with NOTICES2
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
71308
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
In this ;;ection
CM\
3.1 Endorsemi.lnl: and Malnt&nanee
eff,::<b'v,e, m,~,"lning IJSE' of th<c n"1<':'c1:;urce
in·
cteosfl ll1ii! lik<i'lih,:.H.<-J of ucsir'-!J hl!c1ltll c-ul,.mnl!s;
wi 11 m;I:- i m::r;,a.~ the Iike-!ihrmd nf un intif!.nrted,
ad•.•erse h,;alfh mJb::i:,mes; ,md is o:im;istenh•Jith
rm ,r,,,,.,.l<"1n:a 1<170\\•1"°""1'71> .. [)IJ!"iflg i'J<tcfl
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0
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m;,nt.
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with conditio1,~. ,'?ndor:s,12111ent ren1(1ved (m;i,ir1-·
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tkelley on LAP7H3WLY3PROD with NOTICES2
• Use
71309
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
'
..
.m'!Lttlliltiili
0
'
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m,·I ~,-,___,,,,.
a,ddition.:il guidsino: on the inte1pretati!)tt ,:md ,~pplication ,:,f
PQM
Ev,,luation Rubric
~
first sl.ep in ,mul,1m,s1 nl~I
<1nd
.,1t,,...,.,"." m i'!ll!iliJ l"<'m>;'nt i nitiati\•?.<; """!'i fc,
with
the qu,~!ity me,~s1.11·ementcomrnunity (i.i:-,, me,1surl':
•'·"""'''"""' meln bui:s, p0 tier.ts mid
irt rnmmifu:e
by
Starn.Jar ds AP!-•lt>Vc!l Com mttlc."-!
R-ctrred 14 existing E&M prc,je--i::tcommitb:es more
f•Au l>idU
di ni t:c1I sUb:!i1::ie,:hiliti,i;
fivf'
171"'U prn_jfft c-:-i mmi fuc.Pa:;; ma P? refl,,,:-tivf' of
th,e ~rson !1ie,,ltl1 CJ!'!: j,';!urno:y:
barriers J-o
me,~-'HJr-e <:-ndor.5,;,ment P<:-rceived barriers
the
,::,f ti me (;.f th,:: -c 11<.i,xscfment pt or:i::ss,
.s.
!his r~€>db,H.:k,
Noi.•el l!Jfbrkl Detplli and Numim1 l
:i;em~t1t ptt}Llcl!is ii1cridci~•-
C.rn!lf:t~. fNHDtJG;•
cnmm itf?e and
of,JII rnmmittiee memtJe1s ,1nd strucbul)':: measme
IC\'h::-w '··" 1m;u1,u, to build N"""'''""'
to inrre1.l5!'!:f'l11:,il£:@rmmt
3.2.1 I 11Gre.€1sed
pi
imary bi, rder iclidnli fled b}•
i11 Leresl!c'd p;,i rlies
me,;su Ne ,endor.,.l?ment w.~,,;. the
emh::,n:;eml':'nt pr<:i<:<:ss
the
,,,,.,,,n,11>11 arid 10s-::iur-c.es
:nf'E<ied
a m e-a.,;urf' and put
,endor,se,ment proc;;,,,s.
'
~
"'"'
..:.
.•
th;, f,-,,11
,lnd spring
st.:i 11:it·d uncler tl1e previou '>
pm,;p;s;,5 prio riti ~;; tr,ar;.5pa r@nc:,· and """~ ''""""·~·,H<-~,n
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the io,,.,,,.,,,"" p(•~-sible pi:, pu !atio n (•f ini::t:cres1:s:·d pc~rties.
71310
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
Previous
ilil!!pllf~ S;::llell/l~'f!l,::
ll'aiiii,I:
Tu t:11J<J.'..i ll~iciL h' i.t1'- 001 ir;<.i 00~.,1,,,m I·· i.Bnl tu Subm;l and cr.cTI •0 1iU-aie n,is•i;,•t,·, ,,;l.L!i'f ·,,ith ,;;,;[erri;~,'iiJ
measure :;::ience ·and me1hcd:ilcgic;il k~owledge •,,ii r~mal !y ccinc n:rt initia soientif ,c acceptabiliti
r,:v~;.\,;;. to inf,mn oomr-:i:tee m\,1c:w.
Co11e1.1rre-nt Public Ccr1mi.ent= A le 0 gthie' pa blic ccm:11e-nt period will occur in t;,'O sessians:
1) ("O:'.O.JIHiill Will\ i: !"11t1,1I i,~:;gtJIJril- <J(CG'-'1[)"1bilil;· 1"'1"'1l'W to
2:) afte, endorseme•t cecsic,'1 •as :,een p:.sted
0
,l]fjllrl en!JOl,,,,,,lf113ril
d.iui;,iut1 rrml<in9 <md
De!plil,i imd Nominal Groops 'rl!cl"mi,qtH!: To miH;iate 1he cemnv;il
aM C.."Ji\C:,
□Fthe
to addfe$$ pm•.,,,1.lslv stat,-xl ¢<:ll'C8m~. i"lt.(lst conE<IE,tc,ncv a<:,'l">;;;,-, o:,rnmitt,~'Ei.
SMP
t10
NHDt\:G l.>8c.1r.iq1s ·,,•Hb,dld c;msen~us mnong n:,vie•tf p<1nelislE, .am:; le·>B.'aiiJe experiilncel:i ,nd
tra l~ ed fa::;ililarors
l!lle!.1111.:Mi 1\1111 lti•i;:t21kehold-!!r groups; M21, nm ining fe•.'ler committee:; ,,Jith more gent1rn'
i::nvere;ie -,,,ill :ena bl!:! each i::ommilte<' tr! i::omrm,n: .:in a .,,,.,k:ler ra r.ge ::if "1"8asi.;res_
r:,n,i~;1:m,on: ,::ir a
group ,;,,~ch ,:::..11clc1
!he CSllC! Fli•nimit n;;i t~<" "ruhn,,,r s:i'l "'1p"' i,lep pr.,;,;i.:iu5lt w\--er;;,;;,en b~• 111.; CS:AC v,11
•Mc1 r dan C-18S tr1(l fX"(>C«.Y;$, ;.111!(:W!rl;,;l <~lld(>f~limnt (lG::.1;;1ons ti;• Sti:UICI•' Q
c □ nmi'.tees ro st; nc un e:;s apoealed.
S(l'el?• trno ano
1"ir!:Nl:~s11,: :nfuwation at::o.Jtthe apP!1als prcce:.s ',\i I :;,e im;luded relevant
,,nd CMS in order t.:i i 1c:r<";JE,e
"""""''"u;""' r,,atNiA!E- $b'"l<1 red ·,,,.ith 1n,,,8~.1Jrs; dt,V<•l~p;,rs, raom1nitte<":;;.
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buy-in.
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
71311
p1co,:eS-s, (O mmi l:tees
focu~-ed on ,1 healtl1 c,,re comliticm
of h1<:rJSUr'r::! ,i:J!-a Sl!-en
J.
2:.
Pr11e11en,Or>11•pr,,,,-,,ntion, an,i scr,;.-ning
ritl.,tecl to l.eJ ltll stattis ancl/or health ries-1,,
tlchovi;:,.rn t I 11:a Ith and Su bsta nc:-c:
4, C11'd iov~,srnlar
2.
s.
3.
Pefi11c1:t.JI ,md '.Vomen·.s
Prev'l?nth,n ,3r1d
n.
H-e.:ilth
Primary Carn ,.md C.lmmi,· lllne£S
13, Renal
14.
a11d/,:ir .-nd-',iil• ~e
man11,gem ent, p11!liilfr•le and hos•
pie-!:' care, pc,st-acute care, ;.,nd
tar,c,
ah2<1IU1
Ji't:i-
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1d/
71312
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
th!'! mi mb?r d i nte;rP.stRi parti.P.'>
i r, th!c
pro(<:~5 .and to <=llSlliH!
v,.,i te (foes not dominate
f.or rmiasure ~ndo1smnent 1011fews
has.cl rnmmitlee
ofan
decision.
that nn.e
rn mmi ttflic ·s ,:•ndor scm;2nt
Rr,u rt!
ha., bet.,•E;f!n
45 ,md 0() D,1·11n11m,.,., members. E,J ch committee
.
comprise
••
nm,l 11;,allh ;,:,:perl5,
,md othe1 l11tere~t.c•ill par tics.
.
function.,
rnf!v.Su f'e<£ up
pu rp0se of th
~!CrAde '!'$tt;•lt:J'=,;,::,·-nrr~,erts ,~,n :'T!e~S:lif~s prior tw
endo rS£ff'''1~,,.1t
f--1t'
At:,,;;n ~' th@ Mdor'lerr:.1nt Fr,eeti 1g ':::-- listen
tt-'i: Re~omm~'ld,;;1l-on,; f:wn:::i,..p ~~!-;..;1..-s~ion-;;.
ill
A.tt.;in ;,:;
.. n,circ,•s·.c;n-•"'1r"t me@t1 ng t.:di ;~g<<?'?rn-.'1'1: '<'.,
•oh::9.1\><'ns,,s) id,;,ntiti;;,d fr'")m che
10•·,;,!i,-,,1,,,ae,,,,
~ne~":;l.0r-?
-~~tkrgs fp::.rn be-ti
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~ AJJVi\i:i)f~1 ~00::1 Fl~:!(fF ffi~rt•'.:i:il!Cf'l OHA.lr:·EJ pfr>•~1(:i,~ f°)(ii\,111l-~I IH~lmifl8:f'f '¥!:!,.(ifflf.'S ir 9(:V~fl•~ 1>-t ::'f!,):)f';r~'"1l>;i•)t r,,~'f!fl~
R<!!corrmeru:i3':f:r ::;ro:up meels kl r~vie>-.'l,'' 2nd di?SOJss ar:!:l!-s. -:if ncrr-.:o,,s!!r1J.Js l::;a•s::!!C •:::!F'i iode-3!!1"'.de-n~ p:relim· t3r)' "'l:'?\• e.i."5- ard p:ublJO cc-mnerti
.. 51.>lt' Of{)IJp;,i v,>te 1>f"\ t111sJ 1:1:110<1f$-$f!'hrnt :!~1:>i:::ri
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
71313
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3.3 CBE Meuure Portfolio
71314
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
3.4 An nu al
Endorsement Resu Its
Sim:!! the Fall 2023 en-
dorsement meeti11.g;'i •;.·i 11 110!:
the
E(1: ({1 mmi l:t:€es
tc r1;view ;md
'lend ors,; ment decisi<1 r,;;
on qua lit-; .:md;'or i:ost,I 1~<1t11r:f:
use mlU;:i:;;u1e:s submltt,~d to the
Fall
to
,md v;,:I id m,:asi.m~s th3t have
i:m1\,fous CBE
,, nd Spring 202:>.
(fall
or
EIE1tt":'lh:• (Fall 2(123 C~'clt') for
a nrl 1!l rm, i11trri;i11,:;, mf'.i'l:vUff•!'i.
en,cfor ~'i!mi!rlt ct:•nslJ121@tlon
ric.Moclr.,...,,.T;,,fao·.,e»·,ll<
th<:
f-'..::rk,tl Ufthc
•uithd re·,v
SMP
8111n~a.s.urie.~., SJ. 1t,elf?suhrnit-
ti;d t:r tl.e Fall
a11d Spri 11g
of th,:
2{12'3 cydce1;,
me:.sure,:;;
records;md
tim1,ed int,erest i11 rric1intaitling
"''n{lor:,.,;rrnmt
11H1<1sLI1!!S t~i!il
endor.-;f'd rnnr"' than S )lr,m;
,~g,:,.
1:ontim1ing activftie'S
will f<l.;:iliti.it£
ie•;i l!\'Jl!d by
F&M Cnmrni~,;s, whilf' H
measures were ,\•itl,d r:n,;n
due L!llfa\'01 abl·C ,;,'1iN•,till.r
Mrt:hi:v.l, P,anel ,;.SMr:,
:Fall
rne,%ures tin tuttm: i:vcle,.
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lhe mea!>Llri! ·s endon,e!ml!nt no
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
71315
u
4
4
4
8
i:ndor,,;,d: 5
7
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tkelley on LAP7H3WLY3PROD with NOTICES2
0
71316
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
14 m ea.<;1ir!'.~ Wl'I"€'- .~uhmi~&cl,
11;,w m,;,;;;s~ir,;cs ;iml t 1•.l{"J rn, int;,n,, nr:P rne.;l!wi th<:lr€W
1ne,1su res ,~:,; tliey no longer intend eel h:, [)I.I l"'>-IJ<? "nnn,s.s•ni,om
4),
for
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tkelley on LAP7H3WLY3PROD with NOTICES2
12
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
For
71317
new n1e.'iS1Jrf's ,;nd
rnaintl"nafN'.f' me;i1:;,e rsencl1:crecl by U11:: five E&M proje<:tcmnmittees; in
sun:;s IJJl)l,e 5), Endors,em":nt ch:cisions
l-,:.cbtl.li.lry2024,
Uic:;.s::
will be
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11
71318
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
l,itll!IDI t(;,1:1m\!l;tl/;U'i~~i,!ili, il'ltill•' li$1:!!illi ~'Tin!t,!11! ~'f/N/;l!l!~ ~ i:il<€!.t!3)'~Wi iiil\\lli lzl:ti'i, l1/e:~1fm(cl,' llli fl!!fit~lil !lltl\\l fl\,illl(l\)1l;M lir!1},11;1"1l!I
'
3.5 ,,.,,,,,.,,n, Measurem'9nt
Areas and lnsuf'fldent Evidence
ctnd <:nh,1 n,: I:'·
E&M proc~s,,;; noted
"'""""'".v' frnrn l:ls,M
cif ffll,!,\!_!,U fii!S
m,it '"''"'''"'
€!\'idf!tlCI:'
rnN::m re: ,md it;, <cvalu atfon
to 5ll pp,ort the
l.a<:k <if evi·
d>::vebp
(Cm.: 1/3 .[29). ,, '' '"'" u,'h the comm itt;zc
pas.,; these measures d lli" to a lar:k af
,md ll,al t\101e mec1surerrl-!!HL i~ needed
111
;~rea,
2:01:! cvd,2, Ull! P"ali.!nt S<1fety Comrnilte~
!"\•.i IirntP.d
"
a,,,-~11.,,,,,,r~ lilf'il.
((BE HJ746), Committef:' m1tml:n~r:s
,0Jm:::atk.1,11
how these rlifii!lsmes,
"hould be r'.'\•iE'"1ted for ma)(imllm ,ilp·
propriJtene;:6 ,21ncl scientific rigor.
t!\.',Jlr.ti!tirm in ronjun(ti 011 with d inica I
measure.'.. This ,';,mt.<l<ivis<e ,md to ue,,te i.,oti::ntiJ l
10c,H,1mN)1'.lal:1,;,·,;;
that ,i:,ou Id be
cornm ittef>
Cormnitiee
m.,,,3SU r'"'s that focused
tkelley on LAP7H3WLY3PROD with NOTICES2
the nit.':,. of obsePtild O'.'N
rate;,;
for
i:,:,gnitiv,~ impai1·
VerDate Sep<11>2014
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er.celtel'l!I::+! le) ad•,ise and t,:i tr+1atie po'ien-
hial e:u10,1m:e ,:,ndh,rrec.0111mce11d.atio11;<,;
U·1at (◊Uld l.:ie inte;J;r.~ted il1D')
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03SEN1
EN03SE24.031</GPH>
Geriatrk:,,,rid P;11llafr.•e
reo:.,m me11ded <:'<:J n.•ening .a group
e:.:pelts in
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EN03SE24.032</GPH>
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Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
71320
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
prm:li!l-iS¼lli ,HM ~imHar in
and
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tkelley on LAP7H3WLY3PROD with NOTICES2
Tl,c
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
71321
GOAL
FOCUS
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tkelley on LAP7H3WLY3PROD with NOTICES2
E\!ALUATIC.'.IN
CRITERIA.
71322
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
P'RMR and ti1S Rp1oce:sse!lJ !l<.O 1mnend selectlo n •Cir 1,e1t1ovoi to JddreS!l .nilitiot'liat ho.i IU1 c.;i1 e: pd orltfos, fl ll clltlcal
m~~SiJ N!-l'lumt. E--~P.'>,
and i r1C:l'Efl¼S!! align rnemt: of ITIE'l35llrl¼:!, .;imo t1tg p~,g;rams.
$ed:H.:io 5,!,1 o1 this report:.
•
PRMR
f!'111bllic
cammn1t
•••
I , diS!I
••
I
fi:0111,d 1
Round1
.E\r.!il1111tion
Q&A
Ev.tlwation
Pr~ ·to ; Pr'<ll-vofa to . Sl!!H i,111,
klenlily. •
itler11ify
and Publi1:
tire&UI
areae.ot
CQlfflmimt
.__..,.....,~...
di
r~ MSR proce,:1;::;;l'i di+tail~d fo rtiht-11' in
ctAdditio
.Jlrtll!r\liit<
flierileht _ _ _..,...w,
·•
""'~--:·""')C;;;;:::;~=::¥ -,,.,
ICl;impilh1 all Aliaffllili,mllmlli
• illrb:l;ifti::pi;,rt
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EN03SE24.035</GPH>
tkelley on LAP7H3WLY3PROD with NOTICES2
tlbund 1 l::val U!lti:011 C:::Omp~ed al'illl
Rlliiltrnfil ·&i!l flc!:>Qfflmlllridatio/n .G~p;
.Conitttl'lntary C,;,mpli1nl and Pull:IIMwi:11.
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
71323
(.nnr::111Tenf, with 01.1 r efftlri:$ fo at1gagI1 th~ qu;1I it:y m.-.:i5ml!-m,l'!1itmm1TilH1i tyan -anh.:in<:111g tha F:M11 pm.ca;;:.,.
iP11:!;i.m1ers; plliic~•rtiak.~r.sJon wai)":o to trE!,ite a ri10 r.i
tkelley on LAP7H3WLY3PROD with NOTICES2
ttaTl$parent a11d impactful meMu re r!!'Vi-e-w \proces-:
(Frgu re 6); The 1emlts of ttm:s.e e,11g,lge111e.-11h c.;1111 l.:t<e
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ih $eptember2tl!3-. Like
E&M, c11l1i\t'l(!cmc1nt'!i ce1\tt:red o.ltiund Itlt:h~as.lng ~!fl
dem:y i rt th!! pr~e~ tqhfle eii.pa r\r.!litif:!. ourn milt~ .~md
public; ieng..,gemerit
•
••
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Battelie e11gage,d that community (i.t!:,, mea.;.1.1redevielo pets,. i\)fn11:r MAP Co1nm itb;:ic: mi:it11b..::rs, l)l.)tiimt$ .mci
71324
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
4.2.1 locrfYl;lsed Efficrency
E!attel~ took sever.a I .~fe~ to il1<:t,;,<1!$t;: the ,tt:i•
d(!>ncy .:m.d dle<:.tivlllMs~ t>f the. f!RMR process,
U1e first. 1,;,,as to sbre.,,rn I in"1' the meas;tlr!! l'E!·
VJ,f,'\/1' ~'J;rQ(:eSIS by elimim,t111gd1tplicativesteps,
•ilidtKling; tile MAP Cr:101d1niZ1ibihg to1nrirfittl:'e'S
.1e-i!dl1.tdltall.ot1 oha,o;nrr1~1idatkms iit1d Lh!i1
~ii\'p.'11 i:lte, C-Oi11,1,;IJ/Mllt •.~''tiew!i l:t!,' $pe<:lallz,i:!d
.r.dl.!lsory Wat'kgN:illp.~ i.e.g:.,, rur;llJiealth ;ind
l,ealttl i/q~.111:';), The advit,~r1t1.11-orkgroup.~ werie:
iiitegrated i11to est:lblish;eddi11ki~1~, f~ospitl.\l,
and p1~.sl~acu le c.1:111!!/fo ri,g~l:1mr1. tlil r~ {PAC/i..TC)
(.ornm itl:€es 11 rider thie P'RMR proi::'e,'i-i;, whidt
ensures .:111 ir1ea-.u res recielve tlle ~1tt1=1ltio11 ,of
liUHi [ fM!.ilth .~li-l:i h~,;;1hh eijt.lit),• !!XPli!fb, as wel I
if\.'i iricrl;!ash·,g th ... ii mcn1nt qf tkne. ~Va i11116!!;1- ~r
public i:::omm.en:t
B,)tteUe al5,, streaim li11€'d the '1!-'ll'i:llu,1tio111 foCll5 •
!:lf6lci1 m ea .. t11ie fo th1'ee cloni,,ir1s; to. m1)re:
!mii8hlngfUlly distlngul:sll the f!RMR ptoce1is
fromF.t.:M:
••
• Meii1nlri'1lit1lflfflt Has It biilc!!t1 !:1~111 tm~tr.it!:!d tfiat th!l- n'ie,\'Hl ri:" meeti; .::-ritel'i a·
.associ.ated With importsihl:e, scie1"iuti<
.oi::.ce-pt.abl Uiy; f111dsiblllty, lls..!bliit:,•, :md use
f-0-t the mrg!:it !-'l:!r:ml.;itii.:,1, ..1t1d tt1rtiitie:s
prt1$r"il m under 1:or1si deraU6n1
• Ap Pl'Ol!>l"k,ait:1111u, ohi::.al•: H~,w is im~
pl.cr11{2rrrotitih of tflro n1 r;:a:.;~111 app\lll:'d to;
nptilri it.e, th.! rn'ii!asutt! 11alu e. .ict.o.s;.<;: seg;,
men.ts oft~.tar,getpopulation ,md-e11tities
of .thi:. l)rcigr,"lm u1idef w11si.:t,ir.atio il1
1
••. Time. fo. i.ililil.!Jil' realiz:atiail: To whl'lt axterit
,cfoes cu 11ent i:!ltid!ente sugge:.st a de~t p~th~
'h\"llyfrum me,1:5:ura1'11ertt 00 perfu rm ante
iinµirwemt::r1ti
tl;ased onth€'.,rs;~rtkirl$ made by measlu·e
devl':1l:,opl:'t1iilh the11,e do rna ins, ccirnmiUees
dasslfy l:ihe 1r1er.1 :.Ut!!.s' e~1ii:tl il i:ltlun Cll ted..i 111\:Q
(l(ll;! af tnre~ r:'.iiltE\_gprii:'.S:; !!Vid!!l~te: L'> r:-1;1mple,1.i1
~rnd ,1d-equ.1~; l:lvid-em:-e is, .eittle,r i11«:iri1pl.t:!te
01 i11adi~u ati!: but thet·e is.a· pin u.sif:>lt pill th
fmwiud; or i!•tkler~i.;e i!!l eitJ,er .ir,,ompilet-e of'
i11a,rieq1,1 at!l- ~lid theria is nCl pb ll~ible P,.'ltrt •
kr1wai,:l •
•
f<1lfovling committee. ~vah.-1slitic ni.;; d t$CU$:
!lio11:;, a11<em ,•oles, Ci'.!!~. N:cei!W::s Mt- ofUirl!<i
l'e-r::t.irrirn1mtlc1Hm1s f,01
me.ism I'!:
• Rei:t11:n1Mnd$t The. c£mm.1l1ttai,y rec:om.,
n:\1.n1d!i.f.Ms ,1,dd the m-ilriis~J.ri;- tn t~e
·s~cifi ed pn:igr,mtM prm>!l-r'lbed,.
,. Rt,n::ommilntf1, with <»ndlitloM: the o:.l1t1.tti ii.ii>,;, r.·P.t>!lffll!11 ec:nd"> f.MS add ttif! me1l.!>I)
to th~ sp!!dfi.id rimaram with tfi,e t'.Ql1S1d1:'l':o1tfon of cofl!diticns sud1 as .J dditional
b:.-sti rig. 01 su btl'lissi cm f<:ll1' er1dors1c~me1\t by
re
.iCB.E.
• Doff. not recoriiim IIJ'ltdf Tl1e tomtnittiesl
,1o;es ni::1t R'"lfl'lll\1:.'00CMS t:Jdd the rrtre~
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tkelley on LAP7H3WLY3PROD with NOTICES2
S!,Jr!i.')r1 Lo I.he sp~d ffll!d progi a.m.
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
4.2.2 E'i<pandlt)g Cotn1111ttee arid Public
Efrgagemet,t
• ••
71325
NE: W: Aci11 lc!iio nr (;rcmp v~.
i::i ... eommli!nci1tl,:rn Gn:mi:,
The d1:ifir1g pto·po.se behind (lur e11olvi11g n1ea~u ,-e re·
view pr6csess, wci:stt; it1c1ea~the qu.;mtily arid q11..)lity
i::,Hfai r~Ei'dba.i:k Ct.tS i::tn.1kl expe,cLlo r~t:eive.t)tleach
m™lire. TT1erefure1 Eklttelle impler,:,ented a new mmmi tree ~tr~icture aTitl 1!1ae.-.se-d tilt:': .'lt11oui1tof ~nie. and
C:ppo1 tm1m:es 161 pu bli.c i.:i:mm1Qt1L
COMMITTEE STRUCTiJr;tE.
like.th~~ E&.M. pr,)c,~s .. l'lafu::1 le beg.rn using" N•)Veil
Hjlbrid b,elphhlr,d fllorn.\lnal Gt1.rups.li!t:h11lque. ki, .
p1·a-n1lem.ilki11ff,.me;11!.ure. ,revil'!W!5 (D.;i,vil.'i; ~t, ~I ..WJl).
Each PRMT~ t<Qmr11ittee co l)Sists of an Advisory (:belptl il
• Batlellef;P~M11 ~ndtilSP.
fti111rrillt'l":i~'.,1~r\'!J·~~r1;dµred
• iri to ~ii A.d~:i Sl:lt>y. Groo.o ~rill. .•
•••~· rieci::ll'!'lmend;ition G~oup:
·. Menibeirsdf the 11!:lvr~ ry • .
,::;;•aup revi~\! and p1'CiidQ!ii ~-•
• prnn.i<!'rii:l~rj<,il'l:ll<lil .:11e"1~~:1,
•pi{1.11i .lxl ~~itiirr,~nci ,'!lf~r\
<fa: up r,;~t,,~gs. tryel!i input~
il,ri~tJll!i·d1iit ,l l~.t~l'.fllllTlt'.l\"!I': .
.1,fv<lltQ~•CtY1l:!ibut.;i to th0.eon:
.. ~¾~~~t:ttiild;ng pr1:10!!!iS;
.Girou p ond :a.1Mcom.melldatitm (Nomi na ll Group.
Eilch gro1,1p has a specific role .iu1drui1dmri wlth
j,et,pect t:o ev.:i:I uati 11g; ~nd voting.oh meast11e:s; Due
to ~tl.'ltt1t❖t,' tlme ccinsbro irnt:s, both the Advi~•~ry alld
Ri"1:i:i,rrirr1~ritfati6r1 Gt¢UP' rm!rribers t"'~•le',\1s;tlt1tlE,"(,•;;iluate, mea:!lu fills, 011'ly too me1r1beHtof ROC:citmt1e-J'1datli:m ·
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tkelley on LAP7H3WLY3PROD with NOTICES2
nmu p,; 11cih/. 011 nuia~IJ l"#s.
71326
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
nw.i purpose oftf1ls fa<::hnlque i:s fo slg.raln<.:ant~ .ini::°";n;e- H1e nuri16.;+r d ii.·,teresh!,d po1 rtJii+.5-partid p.ati ng
in thie <:onsem,us-buil<ling ~'.lr«e~s am.1 to i.msure
•tl1~t one-·11oiite ~-s. not dom,i mite the i::omrri iij~s'
dedsiot1•1n~ki11gp1«.ess. Ass~e11 ill Figure 7, oe,1~h
co1r1111ltLeia> hils betwe-i:!n 4S iii nid oo 1t1 em bt!t i;. Ei:!d.\
.eo~nii t.ti>E;- compri!5i'!1'i r,\i'iitii'll'.Tts, diok:i,111il, fa t.tl itiie:5,,.
pu1·chase1-s, t~ral he\1ltli ,e::,;p,ert;s, heaith!:'ql.lify ;expel'ts.,
1......s1.111':iad)!i!rs, :,mi:! ot.het iiritQ1 .....sh.><l pt1rtlell.
.
. ..
.
. i=,Rt.lR
.
. .
•• ~1$01'y' E\11Q ll~Ci:tnnwndallCfl ~~~ p.xr,i'dll< •iffltt~l'l 1'eoiil~ck
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tkelley on LAP7H3WLY3PROD with NOTICES2
•, 11:l~ci:rrrn.ordati<:fl t..-aui:, ,,,_.1., ~ re1o1~· ;in,f r<1ci:rnm,md
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
71327
PIUSI.U:: ENGAGIMENT'
In a:i:tdiUim tn recl1Jdng the 11wim ber a ri::6111mi trees reviewi1'1g the ill,;!MU rce.,;;,.1'l'hi ch ••
:Stteamlihe.s th:: m.ea&il.im· re~~ii:'w p1oces51
Battel.l~ 1rnwed a1mu.1iT Pi;:MRn1~m•!lJ!i frorr\
if!!te,mb"'r to .laritia,1:y; ihii:,e, cha n~i. allow
for a I6r,rger wim:kr~t for p1J blk l:."d tTWrierit. a11d
c:ommi~ revie:w.~. 111 202J there \,reore. three
cppmtunifi-es fu1 publk cc,mrnenh:m M1UC
meii!lsuras:
• Writttt1 mmm411nts-: thll! p1.1~i'c hl.lls hm
O!!cii1.rnbet· t la !Jecemli,;,r ,.:i to pro~•ide
wril:te.11,:;omments -on.each mea:iiure.
conunehts appear 011 tht publ.ic PQIM.
,~,u
• .Vemail.mmmentiu &tb.!lle pttw1des lhi!
opp¢rfllnityforveirl:Nii commints.'Jia listening.sessi,1 l\"5, Tiie ~ l)li;::, in~y register b,
rni.i,k~ a crL1tr11r1llltrl In a~lwo1 r'1til or i:>n tb(l> duy
ii-hh~ m'l!~tlng.. ii ri.11g:tti,$ ti on.,, :th~ p~iblk
a.rid corn:tn 11:tl:!e- ri,ern;bers may also a!i:k
CMS qiu estiori,;; al:i,ttl.ltsp-ei;;!f,k. mea,1,ure'i, on
n
the. MUC Li st
• Post rec:ammemlatJon mm,menb
f:'olli:i~11ing tin-'! recomrri,end.atio,il1,, t'11e
put/lit:: ma~1 pn:ividi~ writt,e1i tlD rriment:s for
CMS'sfurtfMlr consideratiori,.
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tkelley on LAP7H3WLY3PROD with NOTICES2
\,i~silll'.
71328
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
1111 :1m.1,.1:1.~&t11iled a,bove, Silttecll,e r.o,tiplet-l'!d twQ• murrl~ o-f
pt1blir. cmrim!!nt related fo thf!.;lf!23 MUC List: ai -.vritl:en p,uhlk.
cti triment. period from Dt-qem bet 1thro1.1gh December 22 aind
tlH\t'C -s¢tti ng•.s.peidfk l istt::r,ing :.csii,;:,rni f0:r wrbal p11.J bli<: com••
m!-!•l~- for tti'.! 2(123 l'RMR tyd:.?, a.aHelle·re:.~i~'e-d '195 w(ilt~ri
ai mme1ntt; from 141 profo:';!$iQnl'l i or~ r,irati<em; :;1,r1d 49 patientr./ •
1:i..dient 11:e. pre-;ent.,tives:, me Iisbe11i. hg ses:sir:ms h<lld 1obust atti.md..;m::~. from the: ptiblk: 196 atlelld41liii!. (l lcisplt:ll se.ssl r:.m),
J.SB att.;;111di!-!iis.{C.I in id.iin.sessiM), 21nd JM.aitl:~rirl~-'i {l"A~:/I J"C:
se.~sion). Du ting these li.~t!iming ses:si 011-~, over 7r, ~tt-endee-s
wi~d i::on1 mc~rl::l or q uu!ltio1llil, ~ngJgiing with oot11 CM$ ,md
PQM l,eild~rs:hip obi:i1..1tth~~ m~·asut'~s 11.mder ,01,s1t1~rt1ti1:m, Public
W lmmitl IS ai!ii av~ ilabl.i),,•ia lhe PQ~I i;,.ebsite .and ,.,,;m il>e lr1dui:.kitl
i11 th,e 1.()1.~ PRM Fl R.icomtrHjl1d<1ti(ll"I~ R-.,.port be p\1b1i.~il.:ad in
Feb1\llawy 2024,
•
t<em
Irt 20:2. 3, 42 mea:.u r'i'!s w~He pllbllshe<I tin lhe. CMS MUC UsL. Cf.
1.9 htf:!,:11.s;u ~-~ wa,r~ ,1s:;:ig11ied to t~ c.I i rllkii'l n com mitt:ec~,, i i
me.1;,;;u res wei'ii- assigr,ed fo the Ho,!i!Pit.iil tmmn itte~, and lhr.ee
1r1ii~s.U res we;rn l:lilfligr1ed 11o· tti,m PAC/UC Cort1mltt~e. (Two rn~a ·
MU£ 199 and MUC210,.wt':'re j:m:i postid for r.:iragmt111s 1.111der
btidrcthilda11 .ind Hospi ml Ca rnmitti!ises). 111 I:. r¥.pt:itt<:avl:iis th~
tim1c pE;!ritKI c:d J'a 11ua rJ 1 f(} Dec'l:'mb~r tl'l, 2.023:, The anmiat f'RMR
rri,~et:ings ,:u:e n<:rii."l'letd in Ja!l~,11-y, Rt:<ommenidl.iti1)l1':l n1.!'lde by
the
PRMRComrnlt.te>i!
WIil
be,m
..(fa,
pu!.ille
~-- February
12024·
'
'
' '"
'
'
'
'
''
', ,,,
~'1
.ilnd u11ill bf!.indmf+1d in tITI/' ?'(1.?'4 Ai,nuai Rf'part tn Cnl'l.!Z,iP.'l.<:.
tl1P$!!,
4,5 PRMR.Gaps.lderi.tified
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tkelley on LAP7H3WLY3PROD with NOTICES2
III Octobtr. 2013, &atitelle <i:1 n'ilelled F'RM Rinembe(.!;tO :pr<1vide
~n Oti~n!..itlon t;:., the ifle\\i P!Rt~R pioce,ss~ t!MW.ll qt.1il!:.Llo11si aotl
riisc:us.o; pota1:it;i11l g;,ip I1raI!.'i. Th,!, 1.11·a~i1f.hp,altl:, equit~ ;md mra.l
h.e~Hhpfl 1'.!'lLi:t as lil rid urina; areas: tilf mil"l!'.'.l'?rn. to ni,n'lft:t:e-e m..!m b!!r~
o:mti1111~ to as.sert me.1,\ur:f d1evelopers, dihil~iali~, ,md p;;iye·rs
need d,,::kfiti.011l'Jl guidani:e• Ot'l llCI\\J t:Q. :eit":Clllll~ly mt~$U re l:'itld i'.lC: •
CQ u.nt for pradic~s.1:.1 E!-iili rtg p,o1tl,m Ls who .ire i.i l the higl,est,risk,
<lti.d 1.!fh() ma~ h.i;tve ~1~ ~,,restre\',Olj rces.,
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03SEN1
71329
EN03SE24.042</GPH>
tkelley on LAP7H3WLY3PROD with NOTICES2
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
71330
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
MSR eeiritars: on :tr1tl!!re,s:til!d pi!!rcyc rf!!\o'l11!w:. of: m~aprograms. The pmp~ie
oHhil MSR proi::;ess, is, to optlmin, the CMS m~a5u11;,
portfQllo vla mi;asu r~ rtmcM1 I recom me ndati10Ftli,
tin::cm,merrd 1ne;i!l1ir!i!ll
,
01111:Jp,dahid ir,ktrmaU,cin orithiemeo1:,-sure',\I
s1Jre/i,\!l<;;fQSl!- 111;1rious CM s
,.v,,,r<,,;,rj,,,~.
.plillrt'ol'l\i'lo'mi::\i.~ tr1:1nds, 811d whet fur thll.)
t'l\llilill!U l'i!l! ccn1Unllil!S: to,w 1)1:)t'.l~t thll
,and ~rloritlf:!!'l.
IN h<;1re,;111 PR t,1 Rmeasurfs: art eval,u.at~dl thro1.1111;l1 th111
domta i11s (If tllQanl ngt'uln{is!., ""marfJt1>rli!1t@r1.as.~
illiid tl1t14'1. t(1V~l1.1~, r,iia lb:$1llon, the thr\ee
are:
lll"Feaiurt
criteria iror irril)Ortance;
!tl@l'\tlflc atuipttibilltY, :ind ll~b1Ht11
,ft~ IJ:\i,il! ai::roos,riril,gt\11 ms ai1d ,
popuia,t1o!11S,
t'!l~dsi
• ,(lirdd>tll'I i.flll~ ll\tn1mll'.: MeasLll"l!, redur)da n<:y 1n
1:fal~ s.t1'$iitl'1s,J1;11.$ bif..en
• Pilrt11l'!tjwm~y1 The m1aimraj(irnplem,e11tli?d,
""' ••,~~'"" ~ l}!'ltktnt Jomi:H:!',' as ln'tend!!!d !}!iii a me.i,mo.del, wh\i::f1 itiy:;;tri:it~ h;:wq 1l m~,il$llre
~ave
, , pathmf
<.,utcomes:,
[pJ~, consensus
Th~ :PRM~ ~r~ctai ~ak~~ ,
1,1,,,c<:,mmendat10ri:;
about
ld@11tif1e.::l ai'11:l 1i'1ltl,l'.li~,+,'!d.
on the MLIC List,
5.2 Enhanced MSR Process,
lhiE! MSR proc:eg btllds
cor1sen!:Su~ aiour'ld.rt1eatL1t&
ren"icwals to ,optirnizs the CMS rniti!,,SLm,'!
ponf,::ilio 111 thevaJJ,Je,l~ill,:lJiB'd pri)gr,;irn:S.
"'1'.'!ilJ1,,l;~'ii1,I,Ui1,lli:,lll,1!"1,!l!JI
1/11\ll:;,~,
pi1blishecU11 September
21'.!23, along with ~n acccimpa1•1y'lr1!:l. sitt, of .fltli$Wlilrs ta,
freqtiMfly a,,ikP.d ciu1~:i;;ti1i:l1TT1!\l,
(FAQs), B,att~llE!> E!Ohano@d
th~MSR
tn~CMS Q1iaiity $tr.i.t:i;,li-v
(Ci'1,5.(;:acleofM~ni11gM'
M<:iasul'l9sJ
m~,,,
/,!Ure tlt'1'ti':i,IIM;
p;!itill;!r'lt
,si'.!f'li'ty)
re111lliw, 1n:i;i'i/lcil17g i:tddiUi:>oa I and flirllel'
o.ppi,rtunlt:iie:~ for p1lblkctimm~rt,
!t'!>signii ng CSE
su1ff to
()re-il,~slf!sllm1.mt'!i usir111
, rr1te,thwlth E&M ,i!rld ~1RMRfo irl'h:M'm,i::i::immlt~ee
reVi!:!W$, The goal walii w.id il:w,e mor,:;, 1;,ff~lve .commlUt:1ll)I rl!Vl@WS b~' prOl:vkling tlf)OR!, Inform.11t1on frc;rn
p,u billc i:ornulll;!l"lt and
1l~!!i!!'!lllmerit!t
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tkelley on LAP7H3WLY3PROD with NOTICES2
a~
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
71331
13..lttelliii'$ iool "l'r.>$. to err.ta bi! ,m lt1dush.~
.Re.::ori,mi;,ndation t;rouplhat b.,:;,lani:ed
ln2(l23, PQM t;:isktd thi::; MSR
Rlilco/111rre1'1dllti1.:1r,s Comrri:itl!!J!! fo
reviaw me.l:$U l'e,!i .witnisn the {'.:MS Endf,;f.~ge, Rerial Di..e"sie, Qu am:y lncrmfa1>es
Pfogrnrn, \Ei.SROQIP)" Tile- !:5Ri!) Q:IP is.
ilt.1fhori i.'.E'O by, §ll:t9 l(li} of MIJ1PA (U ::s,
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es i rice11tive'!:. for tati IiU.es tc- .))(;hi-e11e
l1igh-qu~lit>J perfi'.:11r11ahce,<l'.>ri i11-e0su1es:
expeaieruce, eii;peiilS,t>, ;:ind pt'f!;pecti..,e,s,
:s.atteU-e ~olk:ited oile. patient cti•cha ill •
arici (me cl:lriici,m C)t)·d1;llir ta. h,~lp f~cili,
li:l.t!:! i:h-e 1t1e"'Llng.
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17, 2-023", ~tSR Recotnmic'mfatlon Gr(lu p.
41'.UfS.,.lfMi t:echnkol s.pw:dft~atlons
fhr F:.SRI) QI!' lilellsli.Jr!!<S ;ire, ll\<ai lab.le fl.:!,
11;11iew Oil the CMS i~b:iit!:"
••
members rece1Ve(h1 prelitni.nary. aMly-.
sis of.the 15. ESR[l Q!P Oi ea stll'I!-$ ii\ U1e
2013 M!:!asure Set Revie\ii• (MSR): Er1d;.
$f,;1J\1e Rena:! Pi:~iie Q1Ji!I ity irir,enti,.;..,.
Progr.11111 (ES~DQ.IP.j t.iieportand were
oskcd l:O•Wi:lmit itlitfol foodba'ickoti
pcibi•1t:io1 L6eni:afi'ls arid 1Lsk.s Of t,i!b;mtior\.
orr1;-movat for. l:.\:ich rlie,,l!;:Ure,• •
MS RC:Q mmitt!!-e mi!!ITI bF!r!-> W&N? .r;ele,;:ted
J.4 A.nnual MSR Fiesults
with tll'le g,i)i!il oflni prwlrig outcotMefo1
FSlHJ bei111lfici11rii;,.~. E'SRO QI P' polir.i i,5
are outlined in 42, CrR 41:3.117 and
from itmong th!!- i1ldividU1als suitablefur
tht t;S:RD tJIP rt¥i;'i•llwand al.ieiiidy $eHI
ing on ~he flRMR Com:riiittEie.i. As .~u:i:h,
re-cru itmentfor tile MSR Co:rn 1•ni~e
mi:lirt:woo tltt:< ~pprooch lti ci <Jtlt in
S.!i:J:li!:ill:4~Q. El<!l~lie itartcol"idltitted ll
•public ell Iii f4k nor111i·1atlons ilr1d tB rgeted
o utri;.;:idi ro so!i cit nom irii-es for Pfl:t,1 R
C:ttmm itrees, E!atti::lle :prioritltied indi·
vidu:O!l:s wh6 i~d pr-e\'i6u:s!y p;ar.ti<;iip.:it.ed
lri cSrrni!a r ~r1el:./c01tl1rrl I.tie es iir ha.,d
a d~rn<em nstr<lted kno\\ 1~~ ,;:if tlMl!i:e
iJo1't:loeS$ies: fit i11b:, more th,,'lt1 ,,111e m.ster •
1
Uitego 1y;.B nd pos!lle:smd Uv!.ld e:,,:pQff.
!i'l7t!'! inti'rar.ti ng i.l'lith t'he heaitii tare
s~stern .. El;itte.ll!i!,(;0.11.iidii!rii!d members
.:Dmlnt; ~hs<lG'<tt<:ib~ru rm.~t/rig; 21 of
Ule 21 MSR ~ttX:Otrll'ill?ndbtkm Grou:p •
r1wml:ii!tc\l, ;iU;mdla1d lb~ mee"llne !i!'lfher
i11 peM:'O:n (Bl or v·im1,1 Ily {8) tlwotigh
the lMm. me~ijng pfatfo,rm t:o di,s.:(1 s--~·.
Uie·tr1~sure:s<at1d \olD'IX!, tor 1t>:tornmer1,.
datiari:ii .. ti,t~ and. Batt.iJ!l[e f:adlitato,rs
Joined these mtl'm biers,
Spetifii:::atid,i,;; for~~d, me,~'lllfi;/. c.i11
be lbUIIH1 ill the◊nli11e i':Ms 1/ili:aia!iJI~
~:w.:J~U!:MLU. Ad00,111oc1 m,
Vi!!W ,:,fttiii1 MSR dt!i>t:U!l$Jon ;irid n;,sutts
,:.:i;n be found frlthe: "11.:...l.l:~W!ll~!!.:l...
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Mt hiNE' h~ d ,, ~,re-.,, OU-? opfJO rtl1111ty t<em 1Jta.rtici1)<1te i11these ptiot,e!;;$!eS,
71332
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
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71333
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71334
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
71335
The
ri1-easu rie :,,ets,, i11d iG,ted l>Y
and howthes,e ,:an ll€ ;::,·,,er<:l.)\1'1e,
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71336
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
l/f;ti!'illli ~111l!t/~nii!i£<!1HE!a~i llilmiffii!l' lml ~nmu~I ~~Eti lin! i!rl~!lll~llW oi1il!'tt tffltill ~!!tiil:'~~i'!lt i11!H,!,J~!Ud !l\1!1!11! IE!!llm\m'in i"1l!o/1il ,:,,~
0
th!'! CRF in XO 3 wa.s: th!, l:ir;m:<;iHrm ofth;, NC flC ;ind l;rnn<".h of
CBE Qc1<1!ity
VerDate Sep<11>2014
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71337
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
r
II
r
c tl[ -:011 !rnie.tm lc,vi •~J
f;,;,_s;
cm their mf!mbf!r~, wher.,;i:<; Piattr!le rlcJ:'.
tree;
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•
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cxpctY;es include g1Jnts ,.1nd ber~fits
other
hbli;; 8. 13att&UIEl's Umm,:Ht&d f:lmni:cial Stat>em&~t of R'.eYo!!OOe:;
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an-d E~peme:;, kier F't:2023
71338
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
f'ur:ouant tri
ordrr and
".c,
hre."lk,fo,,m of H!tf! amrnmt award~ pH cnntra,:;ff!d ta,c;k
thP.
fable l} Iisl!; th;, t;isk:, ,•rith ;iwa rd
as,;<:11"·11~:f:1 to
,mes,""'"
J!!nOii.ml;,;
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Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
71339
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evalui:it.:.,cL
71340
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
l)9tt!!Uil mVl!!l',ilild U!!ii! disdo::;ures
In the, il,~MR
the 1:l.:M commiH'R~,
as member.'> ir,·E!r;; si!ated, and rm1-tir1uEd
c;ommitrees' activities
... ,.,.-><,-, .•,
P-llMlt cofinri:::,c,1,1S,;11is osout1i11,1:d octcow.
mitte-;:-i. hod
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CBE:#3151.
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ronflict l;;,d b.'.l thii;, n1;o.r¥1l:ier:">
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tkelley on LAP7H3WLY3PROD with NOTICES2
,)11
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
Dµpr-0sxi1nutel~4,m
"ff''"''"""' or Of\'!,,ilf1irntirms, ilnoss ten multi.'.;t<l k:ef,(, klH
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groups
71341
One additkm.a[ mult!sl:f1keholdc1
Co!labmative, L"> r,arM"""''~t,,,,1
CDtml:s ot lmique
p,err,ons.
thi;;;
mem!Jer!,;,~nd nc:,t it'ldi·
ide.a of the prupor liurkl I repr esen latiou
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71342
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
Clinical
and costireso1Jrc€ us;, measl1res ,Jre 1.i.~fol for improving ll-5, he,;1ltJ, care. HHS,
CMS, ,.;1nd others must b1:
to review ,:md nwnit::,r these me<i!.ms:s
per kl<lic, anJ co r,:;,;;rn,u s.-bas;;d li'l et.hods to t!nSLirt! ht!am1 {.ate 1.11.1.i Ii l:i1 p1ci fo rln anc-1 wi U1111
a
"n::rn11n,iarnc,,
dini.rian,
health
Thi,,;
nHhe NC:flC
""'",."''"'rn,,,,.n pn,gr<lms in pro m-0ting tlw
con::, iupported
cK:,·,;.:,.uu11rn,·, Jnd use of clinical
ct,st,lr0somi::c us0 ri10nsme,;,
Tbe •!!ffadiver1>2ss uhhi::i wm k il! detE!rmJne.d tl\J' the• LI5e of measurement sde n,::e p•l lnciples
af!d
,rnM<:!"-""""'"' The VJ Iu e Qf thi;; work
b;i robllSt <':'ilfi:;l gernt1-nt 0f
div>Prse ..,,..,,., 111..~r,,n
Rc.1ttf!Ue "" the (f,f l,;i.s; nl;,,m.,mti>.!'I
tmw n,easurns
a1,,'" revi<1:'o';'ed J ncl how popLihtions illre
eff0cti'\le ond tb.itmen,;u1lf;~, i1) tms pr-0grnms nr0 ie:as,moblc ;:md tiicc;;;,ssoty, t.id1 vc~r Ll.JU-€:lle
1ui ll
i:mtreadi •,vi th PQM memlr?r.~ a rid other i ntereste.d
re fine our pro,e-s.<;e:,;
to
remain
and
Vl'e k,ok
our PQM rnem be1 s in ;,.,:!(Ii essi n g the mo,5't o:im pl(:X i ss..ies
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Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
.
,~~ill! ~1lti~T!iiltil:l\;!Wlrt~liit l!l~:ffiillf;:ai!~-
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42
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indic.~tors. HE'c~ltll $e1vices ll~ea1d1. 2C·11
71344
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
AA.I
.~voidam:e ;,fArrtlbiotit Tre<1tmentir1Adl.!lt5
1Nlth .liwtc Brond1i1tis
Patients
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71345
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
a~n ~t1©~1t1s011'1:ii;li<1r,ll!ii'l
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th"" r,•s11i,•,,·t1ve t:l:-1,I<
Pmdi,to;er
Ht:,,lth .Ser.ices R!!.~<em re her;. (.ltiller
lntt·rest<?cl Po 1t1(:s
\/.~. f:a5tem Colc.r;icki 1-!;,,.,.lth Care.Sy.stem
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ha,1.,l
71346
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
Roster
Mn rris, .J'."c111
Mu1nfo1d, QUirr:,•~tt:a
CliniciJtn
Pryor, David
lritermuunlain Health
Patient Partner
Rn:r<'ni c:h, J;,1111ifer
s,min, Parr1Bto L
rnsti tu tkm;.,I
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Clinii::icui; f'oti(:nfP-il1tner
71347
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
S/~'lffl~ t'~i'tii~ll.i~li·~~~iil ltiiiri!tllti~~ml~llliniOC!liilf ~!il,m\mli {s,1 '1ll!ll'{~11Sl!t ii!Ft,\Hllile ~ill1"1ll1io~~~!J:' ,zil'i ~ilfi l!l!\l'iil ltt!IJ211mt!il!t1-l\lllll~
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71348
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
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Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
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Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
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Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
71351
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71352
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
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Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
71353
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22:46 Aug 30, 2024
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Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
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71356
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
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Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
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Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
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Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
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71370
Federal Register / Vol. 89, No. 170 / Tuesday, September 3, 2024 / Notices
[FR Doc. 2024–19479 Filed 8–28–24; 4:15 pm]
BILLING CODE 4120–01–C
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Administration for Children and
Families
Submission for Office of Management
and Budget Review; Office of
Community Services Affordable
Housing and Supportive Services
Demonstration Data Collection (Office
of Management and Budget #: 0970–
0628)
Office of Community Services,
Administration for Children and
Families, U.S. Department of Health and
Human Services.
AGENCY:
ACTION:
Request for public comments.
The Office of Community
Services (OCS), Administration for
Children and Families (ACF), U.S.
Department of Health and Human
Services, is requesting an extension of
approval for a recently approved
information collection: OCS Affordable
Housing and Supportive Services
Demonstration (Office of Management
and Budget (OMB) #: 0970–0628,
Expiration Date: September 30, 2024).
This information collection was
originally approved for 6 months as an
emergency approval. In addition to
extending the approval, OCS seeks to
update the burden estimates to
accommodate an anticipated increase in
the number of grant recipients, as well
as to collect additional responses to
several of the instruments. OCS also
seeks to make updates to approved
forms.
SUMMARY:
Comments due October 3, 2024.
OMB must make a decision about the
collection of information between 30
and 60 days after publication of this
document in the Federal Register.
Therefore, a comment is best assured of
having its full effect if OMB receives it
within 30 days of publication.
DATES:
Written comments and
recommendations for the proposed
information collection should be sent
within 30 days of publication of this
notice to www.reginfo.gov/public/do/
PRAMain. Find this particular
information collection by selecting
‘‘Currently under 30-day Review—Open
for Public Comments’’ or by using the
search function. You can also obtain
copies of the proposed collection of
information by emailing infocollection@
acf.hhs.gov. Identify all emailed
tkelley on LAP7H3WLY3PROD with NOTICES2
ADDRESSES:
VerDate Sep<11>2014
22:46 Aug 30, 2024
Jkt 262001
requests by the title of the information
collection.
SUPPLEMENTARY INFORMATION: OCS is
seeking to continue collecting the
information requested from grant
recipients under OMB #: 0970–0628. In
order to determine best practices in the
implementation of supportive services
in the affordable housing context and
describe how supportive services help
residents to improve well-being and
economic mobility, OCS will engage in
the following activities:
• Conducting interviews with
program directors and caseworkers to
understand program implementation.
• Conducting focus groups with
residents to understand their needs and
how the services funded by this grant
impacted their lives.
• Administering a self-sufficiency
matrix to residents receiving intensive
services to understand the impact of the
program on various domains of wellbeing.
• Conducting a questionnaire with
residents, to see if they were able to
access more services due to the funding.
• Collecting information from
program officers about the number and
types of services/events provided,
aggregate demographics of residents
served, partner organizations and
referrals, and how the housing
community was impacted by the grant
funding.
• Collecting narrative reports from
program officers about the progress of
implementation of the program.
This request is to extend the approved
collection period to 3 years, which will
permit OCS to complete the collection
with current grant recipients as well as
future grant recipients. With an
extended timeline, OCS will request
additional responses for several
approved instruments to observe
activities over the course of the full
project period for grant recipients. The
self-sufficiency matrix and service
receipt questionnaires will be
administered every 6 months during the
project period. The semi-annual
quantitative report mandatory and
optional forms will be required every 6
months, with a final cumulative report.
The quarterly narrative PPR will be
requested every quarter of the project
period.
OCS has developed substantially
revised 2024 versions of the semiannual quantitative report forms for the
mandatory and optional reports to
broaden the measures of service
delivery and outcomes to better
accommodate the universe of potential
services offered by future cohorts of
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grant recipients. The new mandatory
form combines the direct services and
referrals tabs of the original form into a
single tab where grant recipients will
report the number of individuals
receiving services through AHSSD
funding and through the organization’s
other funding sources, alongside the
information reported about referrals.
The new optional form broadens the list
of outcome measures that grant
recipients can choose to report for the
individuals they serve. In consideration
of the overall reporting burden for grant
recipients, the 2024 version of the forms
continue draw upon the service and
outcome categories that grant recipients
already use to report their Community
Services Block Grant-related activities
(OMB# 0970–0492). Additionally, the
2024 version of the forms request
cumulative counts across the grant
period, negating the need for a separate
final report.
Current grant recipients will be able
to choose between using the current
2023 version of the forms and the
revised 2024 version of the forms
through the completion of their current
project. New grant recipients will be
required to use the 2024 version of the
forms.
Respondents: There will be three
types of respondents to the proposed
instruments. First, the direct
beneficiaries, the clients receiving
supportive services, will participate in
the service receipt questionnaire, selfsufficiency matrix, and focus groups,
and they will also provide information
about their characteristics, needs, and
outcomes for the grant recipients’ semiannual quantitative reporting. Second,
the program directors and social
services staff will respond to interview
instruments tailored to their roles. Grant
recipients will also be asked to complete
quarterly narrative PPRs and semiannual quantitative reports to describe
their service delivery activities, and
outcomes.
Annual Burden Estimates
Burden estimates show the total
number of responses per respondent
over the next 3 years. The current grant
recipients (9 total) will be able to choose
between using the 2023 version of the
semi-annual quantitative report forms
and the 2024 version of those forms
through the completion of their current
project. New grant recipients (9 new
recipients estimated) will be required to
use the 2024 version of the forms.
U:\REGISTER\03SEN1.SGM
03SEN1
]]>Agencies
[Federal Register Volume 89, Number 170 (Tuesday, September 3, 2024)]
[Notices]
[Pages 71284-71371]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-19479]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-3447-N]
Secretarial Review and Publication of the Consensus Based Entity
Report of 2023 Activities to Congress and the Secretary of the
Department of Health and Human Services
AGENCY: Office of the Secretary of Health and Human Services, HHS.
ACTION: Notice.
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SUMMARY: This notice acknowledges receipt and review by the Secretary
of the Department of Health and Human Services (the Secretary) of the
2023 Consensus Based Entity Annual Report to Congress as mandated by
section 1890(b)(5) of the Social Security Act (the Act). The Secretary
has reviewed and is publishing the report in the Federal Register
together with the Secretary's comments on the report.
FOR FURTHER INFORMATION CONTACT: Charlayne Van, (410) 786-8659.
SUPPLEMENTARY INFORMATION:
I. Background
The United States (U.S.) Department of Health and Human Services
(HHS) has long recognized that a high functioning health care system
that provides higher quality care requires accurate, valid, and
reliable measurement of quality and efficiency. The Medicare
Improvements for Patients and Providers Act of 2008 (Pub. L. 110-275)
added section 1890 of the Social Security Act (the Act), which requires
the Secretary of HHS (the Secretary) to contract with a consensus-based
entity (CBE) to help improve performance measurement. Section 3014 of
the Patient Protection and Affordable Care Act (the Affordable Care
Act) (Pub. L. 111-148) expanded the duties of the CBE to include the
identification of gaps in available measures and to improve the
selection of measures used in health care programs. The Secretary
extends his appreciation to the CBE in their partnership for the
fulfillment of these statutory requirements.
Section 1890(b) of the Act requires the following:
Priority Setting Process: Formulation of a National Strategy and
Priorities for Health Care Performance Measurement. The CBE must
synthesize evidence and convene key stakeholders to make
recommendations on an integrated national strategy and priorities for
health care performance measurement in all applicable settings. In
doing so, the CBE must give priority to measures that: (1) address the
health care provided to patients with prevalent, high-cost chronic
diseases; (2) have the greatest potential for improving quality,
efficiency, and patient-centered health care; and (3) may be
implemented rapidly due to existing evidence, standards of care, or
other reasons. Additionally, the CBE must take into account measures
that: (1) may assist consumers and patients in making informed health
care decisions; (2) address health disparities across groups and areas;
and (3) address the continuum of care furnished by multiple providers
or practitioners across multiple settings.
Endorsement of Measures. The CBE must provide for the endorsement
of standardized health care performance measures. This process must
consider whether measures are evidence-based, reliable, valid,
verifiable, relevant to enhanced health outcomes, actionable at the
caregiver level, feasible to collect and report, responsive to
variations in patient characteristics such as health status, language
capabilities, race or ethnicity, and income level and are
[[Page 71285]]
consistent across types of health care providers, including hospitals
and physicians.
Maintenance of CBE Endorsed Measures. The CBE is required to
establish and implement a process to ensure that endorsed measures are
updated (or retired if obsolete) as new evidence is developed.
Removal of Measures. Section 102(c) of Division CC of the
Consolidated Appropriations Act, 2021 (Pub. L. 116-260) amended section
1890(b) of the Act to permit the CBE to provide input to the Secretary
on measures that may be considered for removal.
Convening Multi-Stakeholder Groups. The CBE must convene
multistakeholder groups to provide input on: (1) the selection of
certain categories of quality and efficiency measures, from among such
measures that have been endorsed by the entity and from among such
measures that have not been considered for endorsement by such entity
but are used or proposed to be used by the Secretary for the collection
or reporting of quality and efficiency measures; and (2) national
priorities for improvement in population health and in the delivery of
health care services for consideration under the national strategy. The
CBE provides input on measures for use in certain specific Medicare
programs, for use in programs that report performance information to
the public, and for use in health care programs that are not included
under the Act. The multi-stakeholder groups provide input on quality
and efficiency measures for various federal health care quality
reporting and quality improvement programs including those that address
certain Medicare services provided through hospices, ambulatory
surgical centers, hospital inpatient and outpatient facilities,
physician offices, cancer hospitals, end stage renal disease (ESRD)
facilities, inpatient rehabilitation facilities, long-term care
hospitals, psychiatric hospitals, and home health care programs.
Transmission of Multi-Stakeholder Input. Not later than February 1
of each year, the CBE must transmit to the Secretary the input of
multi-stakeholder groups.
Annual Report to Congress and the Secretary. Not later than March 1
of each year, the CBE is required to submit to Congress and the
Secretary an annual report. The report is to describe:
The implementation of quality and efficiency measurement
initiatives and the coordination of such initiatives with quality and
efficiency initiatives implemented by other payers;
Recommendations on an integrated national strategy and
priorities for health care performance measurement;
Performance of the CBE's duties required under its
contract with the Secretary;
Gaps in endorsed quality and efficiency measures,
including measures that are within priority areas identified by the
Secretary under the national strategy established under section 399HH
of the Public Health Service Act (National Quality Strategy), and where
quality and efficiency measures are unavailable or inadequate to
identify or address such gaps;
Areas in which evidence is insufficient to support
endorsement of quality and efficiency measures in priority areas
identified by the Secretary under the National Quality Strategy, and
where targeted research may address such gaps; and
The convening of multi-stakeholder groups to provide input
on: (1) the selection of quality and efficiency measures from among
such measures that have been endorsed by the CBE and such measures that
have not been considered for endorsement by the CBE but are used or
proposed to be used by the Secretary for the collection or reporting of
quality and efficiency measures; and (2) national priorities for
improvement in population health and the delivery of health care
services for consideration under the National Quality Strategy.
Section 50206(c)(1) of the Bipartisan Budget Act of 2018 (Pub. L.
115-123) amended section 1890(b)(5)(A) of the Act to require the CBE's
annual report to Congress to include the following: (1) an itemization
of financial information for the previous fiscal year ending September
30th, including annual revenues of the entity, annual expenses of the
entity, and a breakdown of the amount awarded per contracted task order
and the specific projects funded in each task order assigned to the
entity; and (2) any updates or modifications to internal policies and
procedures of the entity as they relate to the duties of the CBE
including specifically identifying any modifications to the disclosure
of interests and conflicts of interests for committees, work groups,
task forces, and advisory panels of the entity, and information on
external stakeholder participation in the duties of the entity.
The statutory requirements for the CBE to annually report to
Congress and the Secretary also specify that the Secretary must review
and publish the CBE's annual report in the Federal Register, together
with any comments of the Secretary on the report, not later than 6
months after receiving it.
This Federal Register notice implements the statutory requirement
for Secretarial review and publication of the CBE's annual report. The
CBE submitted a report on its 2023 activities to Congress and the
Secretary on February 26, 2024. The Secretary's Comments on this report
are presented in section II of this notice, and the CBE's 2023
Activities Report to Congress and the Secretary is provided, as
submitted to HHS, in the addendum to this Federal Register notice in
section IV.
II. Secretarial Comments on the CBE's (Battelle Memorial Institute)
2023 Activities: Report to Congress and the Secretary of the Department
of Health and Human Services
As part of its core mission, HHS seeks to stabilize and improve the
quality of health care throughout the country. In response to recent
public health crises and to prudently prepare for imminent threats in
the future, HHS must continue to focus on advancing equity and
inclusion, strengthening public trust, and building meaningful
engagement and learning across the health care system. By embedding the
cross-cutting principles \1\ of equity, public trust and collaboration
into its diverse programs and initiatives, HHS is working to improve
the health and well-being of individuals and families. The following
comments are regarding the 2023 activities performed within the
Partnership for Quality Measurement (PQM) forum, created by Battelle in
its capacity as the CBE.
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\1\ HHS Strategic Cross-Cutting Principles available at https://www.hhs.gov/about/strategic-plan/2022-2026/overview/.
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Over the past year, the CBE has supported HHS' commitment to
promoting a resilient, high value, and safe health care system for all
Americans. In 2023, HHS supported the work conducted by the CBE to
identify health care quality measurement priorities and to provide
consensus-based recommendations about measures to use for assessing and
improving quality. As the new CBE beginning in 2023, Battelle
established the PQM and continued the use of rigorous standards to
review measures for quality measure endorsement and maintain highly
reliable and scientifically sound measures across priority health care
topic areas.
The PQM is comprised of diverse representatives in health care that
engage with the health care quality improvement community. Members of
the PQM help shape the future of health care by taking an active role
in the quality measurement process, using
[[Page 71286]]
their health care experiences and/or professional expertise to review
and provide feedback on quality measures HHS is considering for use in
Medicare programs. The CBE's processes have evolved with a renewed
focus on advancing measurement science, ensuring transparency, and
increasing diversity in engagement of interested parties as evidenced
by its Annual Report and feedback received by the Centers for Medicare
& Medicaid Services (CMS). This focus has resulted in increased
engagement from patients, patient advocacy groups, and clinicians, as
well as a shared sense of ownership.
The CBE focused on four key initiatives, including Endorsement &
Maintenance (E&M) of clinical quality measures, Pre-Rulemaking Measure
Review, Measure Set Review and Core Quality Measures Collaborative
(CQMC). In 2023, the CBE completed three endorsement cycles. A combined
81 measures were submitted for endorsement consideration in the first
two cycles (Fall 2022 and Spring 2023) that were started under the
previous CBE. The third cycle (Fall 2023) which launched the revised
process, began in October 2023 and was completed in March 2024.
Over the past year, the CBE expanded committee and public
engagement by creating five new project committees that are focused on
a patient's journey through the health care system. A description of
these five new committees can be found on the CBE's website at https://p4qm.org/EM/projects. The committee structure is not based solely on a
health care condition or disease state but by the type of function the
health care system is performing (for example, prevention/screening,
advanced illness, and post-acute care), including the type of evidence
submitted in support of that function (for example, screening results
in a referral). The focus areas of the committees include primary
prevention; initial recognition and management; management of acute
events, chronic disease, surgery and behavioral health; advanced
illness and post-acute care and cost and efficiency.
HHS recognizes that, concurrent with the CBE's efforts to engage
the quality measurement community on enhancing the E&M process, the CBE
engaged the same community on ways to create a more transparent and
impactful measure review process to support quality reporting and
value-based purchasing programs as evidenced in the CBE's Annual Report
and feedback received by CMS. Like E&M, enhancements were centered
around increasing efficiency in the process while expanding committee
and public engagement. HHS believes that these process enhancements
resulted in increased quantity and quality of the feedback CMS received
on quality measures.
The CBE convened the CQMC Full Collaborative in late 2023 to set
priorities for the upcoming year. The goal of the meeting was to
explore the CQMC's role in three key areas, including health equity
measurement, movement to digital measures and alignment around
measurement models. In addition, the CQMC discussed the leading
barriers to adoption of measures within the core sets and achieving the
desired impact of the core sets and how these can be overcome. The CQMC
also began to develop a vision and strategy for the next phases of
work.
HHS and the CBE both recognize the importance of clinical quality
and cost/resource use measures in improving U.S. health care.
Maintaining these measures through transparent, periodic, and
consensus-based reviews is critical for ensuring health care quality
performance can not only be measured but can also be improved upon. HHS
and the CBE recognize that a true consensus process must be
transparent, reliable, and equitable. The CBE is building relationships
within the health care quality community, including patients and
clinicians, necessary to advancing the national goal of attaining the
highest level of health and wellness for the widest range of
individuals possible as evidenced by its Annual Report and feedback
received by CMS.
III. Collection of Information Requirements
This document does not impose information collection requirements,
that is, reporting, recordkeeping, or third-party disclosure
requirements. Consequently, there is no need for review by the Office
of Management and Budget under the authority of the Paperwork Reduction
Act of 1995 (44 U.S.C. 3501 et seq.).
IV. Addendum
In this Addendum, we are publishing the CBE Report on 2023
Activities to Congress and the Secretary of the Department of Health
and Human Services, as submitted to HHS.
Xavier Becerra,
Secretary, Department of Health and Human Services.
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[FR Doc. 2024-19479 Filed 8-28-24; 4:15 pm]
BILLING CODE 4120-01-C
