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CMS Offers Value-Based Purchasing Exceptions After Hurricane Harvey

Providers in 32 Texas counties and five Louisiana parishes will be exempt from value-based purchasing and quality reporting requirements because of Hurricane Harvey.

Hurricane Harvey and value-based purchasing

Source: Thinkstock

By Jacqueline LaPointe


- Providers practicing in areas affected by Hurricane Harvey will not have to report to several Medicare and Medicaid quality reporting and value-based purchasing programs, CMS recently announced in an email. 

Physicians and other providers employed by certain care sites in 32 Texas counties and five Louisiana parishes will automatically receive exemptions from CMS-run value-based purchasing initiatives. The care sites include acute care hospitals, prospective payment system-exempt cancer hospitals, inpatient psychiatric facilities, skilled nursing facilities, home health agencies, hospices, inpatient rehabilitation facilities, outpatient dialysis facilities, long-term care hospitals, and ambulatory surgical centers. 

The impacted areas have all been designated as major disaster counties by the Federal Emergency Management Agency (FEMA), CMS noted.  

The federal agency intends for the exceptions to "assist these providers while they direct their resources toward caring for their patients and repairing structural damages to facilities." 

Those granted exceptions will not have to report data to care site-specific quality reporting programs, such as the End-Stage Renal Disease Quality Incentive initiative, Home Health Quality Reporting Program, Hospital Inpatient Quality Reporting Program, and Inpatient Psychiatric Facility Quality Reporting Program. 

The exceptions generally delay the submission deadlines for quarters two and three of 2017. 

Although, CMS pointed out that hospitals in the designated counties and parishes should understand how the reporting requirement postponements will affect their performance in value-based purchasing initiatives, such as the Hospital Value-Based Purchasing Program, Hospital Readmissions Reduction Program, and Hospital-Acquired Condition Reduction Program. 

Hospitals should be aware that minimum case threshold counts in the 2019 fiscal year could be impacted. 

"For example, hospitals might be scored solely on the HAC [Hospital-Acquired Condition] Reduction Program Domain 1 claims-based measure due to non-submissions resulting in not meeting the minimum number of CDC HAI [Hospital-Acquired Infection] measures with sufficient cases in HAC Reduction Program Domain 2," wrote CMS. 

The federal agency also stated that it will evaluate hospital performance in the value-based purchasing programs after Hurricane Harvey

"Unlike our reporting programs, we must also assess measure performance of affected providers to assess any systemic impact on performance, such as a possible increase in affected hospital readmission rates due to patients evacuated from flooded facilities," the email stated.  

CMS urged providers or facilities affected by flood damage to submit their own Extraordinary Circumstances Exceptions request to the national support contractor for these value-based purchasing programs. The federal agency will only consider requests that comply with the appropriate procedures. 

In addition, providers located outside of the regions may request an exception to reporting requirements for one or more Medicare value-based purchasing or quality reporting programs. They must use the appropriate extraordinary circumstances exception process based on care site. 

CMS will also extend automatic exceptions to any additional counties that are identified as major disaster regions by FEMA. 

The federal agency stated it will "continue to monitor the situation and adjust exempted reporting periods and submission deadlines accordingly." 


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