びびなび : ワシントンDC : (アメリカ合衆国) Washington DC

Centers for Medicare & Medicaid Services Quality Payment Program
2024 Truncated and Suppressed Merit-based Incentive Payment System (MIPS) Quality Measures List

*Policies on Truncation and Suppression of MIPS Quality Measures*

In the Calendar Year (CY) 2023 Physician Fee Schedule (PFS) Final Rule, the Centers for Medicare & Medicaid Services (CMS) established truncation and suppression policies for MIPS quality measures. For each MIPS quality measure that is submitted, and if applicable, impacted by significant changes or errors prior to the start of the 2024 data submission period (January 2, 2025 through March 31, 2025), performance will be based on data for the first 9 consecutive months of the 2024 performance period (January 1, 2024 through September 30, 2024) (42 C.F.R. § 414.1380(b)(1)(vii)(A)). 

If such data aren’t available or CMS determines that the significant changes or errors may result in patient harm or misleading results, the MIPS quality measure is excluded from a MIPS eligible clinician's total measure achievement points and total available measure achievement points, per CMS’ suppression policy [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3194/2024-Truncated-Suppressed-MIPS-Quality-Measure-List.pdf ].

Additionally, CMS established an annual review process to identify and analyze MIPS quality measures that are significantly impacted by the International Classification of Diseases, Tenth Revision (ICD-10) coding changes made during the 2024 performance period. ICD-10 updates are effective annually on October 1. However, the 2024 quality measure specifications can’t be updated to account for such coding changes until the 2025 performance period. The criteria used to determine whether a MIPS quality measure is significantly impacted by ICD-10 coding changes are as follows:


* Changes in measure scope or ability to successfully report as reflected in ICD-10 code updates that cause the last three months of data to be incongruent with the first nine months of data.

If a MIPS quality measure is impacted by ICD-10 coding changes, then the MIPS quality measure will be truncated or suppressed (case applicable to the eCQM collection type). The assessment of performance for the affected MIPS quality measure will be based on the first nine months (January through September) of the 12-month performance period for the 2024 performance period. For more information regarding truncation and suppression of MIPS quality measures due to annual ICD-10 coding changes, please review the 2024 MIPS Quality Measures Impacted by ICD-10 Updates (PDF, 269KB) [ https://qpp-cm-prod-content.s3.amazonaws.com/uploads/3030/2024-Quality-Measures-ICD-10-Coding-Updates-Fact-Sheet.pdf ] document on the QPP Resource Library [ https://qpp.cms.gov/resources/resource-library ].

Based on an analysis of the ICD-10 coding changes effective October 1, 2024, one MIPS quality measure (see Table 1) was identified as being significantly impacted by ICD-10 coding changes and, as a result, this MIPS quality measure will be truncated for the 2024 performance period.

Additionally, 2 MIPS quality measures (see Table 2) will be suppressed for the 2024 performance period.

________________________________________________________________________



*Table 1: MIPS Quality Measures Identified for Truncation*

*Quality Measure Number/Title*



*Collection Type Impacted*



*Truncation Rationale*



*Measure **185:* Colonoscopy Interval for Patients with a History of Adenomatous Polyps – Avoidance of Inappropriate Use



MIPS CQM



*ICD-10 Code Updates:* ICD-10 coding changes significantly impacted the coding for the last three months of the 2024 performance period (October through December) leading to data that may not be comparable to data collected during the first nine consecutive months of the 2024 performance period (January through September).

*Truncation Rationale:* In order to stabilize measure data for the 2024 performance period, performance will be truncated and based on data for the first nine consecutive months of the 2024 performance period (January through September).



*Table 2: MIPS Quality Measures Identified for Suppression*

*Quality Measure Number/Title*



*Collection Type Impacted*



*Truncation Rationale*



*Measure 389:* Cataract Surgery: Difference Between Planned and Final Refraction



MIPS CQM



*Quality Measure Implementation Resulting in Misleading Results: *The current measure does not indicate a timeframe for capturing the planned (target) refraction; however, some third party intermediaries have implemented a restricted timeframe only including planned (target) refractions assessed and documented in the 90 days preceding the cataract surgery procedure. This leads to each patient with a target refraction documented outside of the 90-day pre-operative window being reported as a “Performance Not Met.” This revised workflow creates a more constricted numerator and holds some clinicians to a more stringent standard than what is specified.

*Suppression Rationale:* Due to the inconsistency in data reported for this measure, and differing standards being implemented across submissions, CMS determined that measure implementation across reporters may have significant errors that may result in misleading results.



*Measure 488:* Kidney Health Evaluation



eCQM



*Quality Measure Implementation Resulting in Misleading Results:* The current eCQM logic requires a numeric value to be recorded for the urine albumin-to-creatinine ratio (uACR) result to be recognized for the numerator. When the urine albumin level is below detectable limits the uACR result recorded by many laboratory information systems is “unable to calculate”. Because this result is a non-numeric value, these cases are counted as not meeting measure performance even though the appropriate testing has been performed in accordance with guideline recommendations and the measure specification.

*Suppression Rationale: *Due to the inability to accurately capture the quality action and the misalignment between the measure narrative and logic, CMS determined that this measure has significant errors that may result in misleading results.



 

________________________________________________________________________


QPP Footer 2023 [ https://qpp.cms.gov/resources/help-and-support ]


________________________________________________________________________

You're getting this message because you subscribed to get email updates from the Centers for Medicare & Medicaid Services (CMS) [ http://www.cms.gov/ ].

Update your subscriptions, modify your password or email address, or stop subscriptions at any time on your Subscriber Preferences Page [ https://public.govdelivery.com/accounts/USCMS/subscriber/edit?preferences=true#tab1 ]. You will need to use your email address to log in. If you have questions or problems with the subscription service, please contact subscriberhelp.govdelivery.com [ https://subscriberhelp.govdelivery.com/ ].

This service is provided to you at no charge by Centers for Medicare & Medicaid Services (CMS) [ http://www.cms.gov ].


________________________________________________________________________

This email was sent to mshinji3056@gmail.com using GovDelivery Communications Cloud 7500 Security Boulevard · Baltimore MD 21244


body .abe-column-block { min-height: 5px; } table.gd_combo_table img {margin-left:10px; margin-right:10px;} table.gd_combo_table div.govd_image_display img, table.gd_combo_table td.gd_combo_image_cell img {margin-left:0px; margin-right:0px;} table.govd_hr {min-width: 100%;}