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Federal Register / Vol. 86, No. 147 / Wednesday, August 4, 2021 / Rules and Regulations
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G. January 2022 HH QRP Public Reporting Display Schedule with Fewer than Standard Number of Quarters Due to COVID19 Public Health Emergency Exemptions 1. Background and Statutory Authority We include this Home Health proposal in this rule because we plan to resume public reporting for the HH QRP
with the January 2022 refresh of Care Compare. In order to accommodate the exception of 2020 Q1 and Q2 data, we are proposing to resume public reporting using 3 out of 4 quarters of data for the January 2022 refresh. In order to finalize this proposal in time to release the required preview report related to the refresh, which we release 3 months prior to any given refresh October 2021, we need the rule containing this proposal to finalize by October 2021.
The HH QRP is authorized by section 1895b3Bv of the Act. Section 1895b3BvII of the Act requires that for 2007 and subsequent years, each HHA submit to the Secretary in a form and manner, and at a time, specified by the Secretary, such data that the Secretary determines are appropriate for the measurement of health care quality.
To the extent that an HHA does not submit data in accordance with this clause, the Secretary shall reduce the home health market basket percentage increase applicable to the HHA for such year by 2 percentage points. As provided at section 1895b3Bvi of the Act, depending on the market basket percentage increase applicable for a particular year, the reduction of that increase by 2 percentage points for failure to comply with the requirements of the HH QRP and further reduction of the increase by the productivity adjustment except in 2018 and 2020
described in section 1886b3BxiII
of the Act may result in the home health market basket percentage increase being less than 0.0 percent for a year, and may result in payment rates under the Home Health PPS for a year being less than payment rates for the preceding year.
For more information on the policies we have adopted for the HH QRP, we refer readers to the following rules:
CY 2007 HH PPS final rule 71 FR
65888 through 65891.
CY 2008 HH PPS final rule 72 FR
49861 through 49864.
CY 2009 HH PPS update notice 73
FR 65356.
CY 2010 HH PPS final rule 74 FR
58096 through 58098.
CY 2011 HH PPS final rule 75 FR
70400 through 70407.
CY 2012 HH PPS final rule 76 FR
68574.

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CY 2013 HH PPS final rule 77 FR
67092.
CY 2014 HH PPS final rule 78 FR
72297.
CY 2015 HH PPS final rule 79 FR
66073 through 66074.
CY 2016 HH PPS final rule 80 FR
68690 through 68695.
CY 2017 HH PPS final rule 81 FR
76752.
CY 2018 HH PPS final rule 82 FR
51711 through 51712.
CY 2019 HH PPS final rule with comment period 83 FR 56547.
CY 2020 HH PPS final rule 84 FR
60554 through 60611.
CY 2021 HH PPS final rule 85 FR
70326 through 70328.
2. Public Display of Home Health Quality Data for the HH QRP
Section 1895b3BvIII of the Act requires the Secretary to establish procedures for making HH QRP data, including data submitted under sections 1899Bc1 and 1899Bd1 of the Act, available to the public. Such public display procedures must ensure that HHAs have the opportunity to review the data that will be made public with respect to each HHA prior to such data being made public. Section 1899Bg of the Act requires that data and information regarding PAC provider performance on quality measures and resource use or other measures be made publicly available beginning not later than 2 years after the applicable specified application date.
We established our HH QRP Public Display Policy in the CY 2016 HH PPS
final rule 80 FR 68709 through 68710.
In that final rule, we noted that the procedures for HHAs to review and correct their data on a quarterly basis is performed through CASPER along with our procedure to post the data for the public on our Care Compare website.
We have communicated our public display schedule, which supports our Public Display Policy, on our websites whereby the quarters of data included are announced.
3. Proposal To Modify HH QRP Public Reporting To Address CMS Guidance To Except Data During the COVID19
PHE Beginning January 2022 Through July 2024
We proposed to modify our public display schedule to display fewer quarters of data than what we previously finalized for certain HH QRP
measures for the January 2022 refresh.
Under authority of section 319 of the PHS Act, the Secretary declared a PHE
effective as of January 27, 2020. On March 13, 2020, the President declared a national state of emergency under the
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Stafford Act, effective March 1, 2020, allowing the Secretary to invoke section 1135b of the Act 42 U.S.C. 1320b5
to waive or modify the requirements of titles XVIII, XIX, and XXI of the Act and regulations to the extent necessary to address the COVID19 PHE. Many waivers and modifications were made effective as of March 1, 2020 in accordance with the Presidents declaration.51
On March 27, 2020, we sent a guidance memorandum under the subject title, Exceptions and Extensions for Quality Reporting Requirements for Acute Care Hospitals, PPS-Exempt Cancer Hospitals, Inpatient Psychiatric Facilities, Skilled Nursing Facilities, Home Health Agencies HHAs, Hospices, Inpatient Rehabilitation Facilities, Long-Term Care Hospitals, Ambulatory Surgical Centers, Renal Dialysis Facilities, and MIPS Eligible Clinicians Affected by COVID19 to the MLN Connects Newsletter and Other Program-Specific Listserv Recipients,52 hereafter referred to as the March 27, 2020 CMS Guidance Memorandum. In the March 27, 2020
CMS Guidance Memo, we granted an exception to the HH QRP reporting requirements under the HH QRP
exceptions and extension requirements for Quarter 4 Q4 2019 October 1, 2019
through December 31, 2019, Q1 2020
January 1, 2020 through March 30, 2020, and Q2 2020 April 1, 2020
through June 30, 2020. The HH QRP
exception applied to the HH QRP
Outcome and Assessment Information Set OASIS-based measures, claimsbased measures, and HH CAHPS
Survey. We discuss the impact to the OASIS and claims here, and discuss to the HH CAHPS further in section III.G.
4, Update on Use of Q4 2019 HH QRP
Data and Data Freeze for Refreshes in 2021. For the OASIS, the exempted quarters are based upon admission and discharge assessments.
A subset of the HH QRP measures has been publicly displayed on Home 51 Azar, A. M. 2020 March 15. Waiver or Modification of Requirements Under Section 1135
of the Social Security Act. Public Health Emergency. https www.phe.gov/emergency/news/
healthactions/section1135/Pages/covid1913March20.aspx.
52 2020, March 27. Exceptions and Extensions for Quality Reporting Requirements for Acute Care Hospitals, PPS-Exempt Cancer Hospitals, Inpatient Psychiatric Facilities, Skilled Nursing Facilities, Home Health Agencies, Hospices, Inpatient Rehabilitation Facilities, Long-Term Care Hospitals, Ambulatory Surgical Centers, Renal Dialysis Facilities, and MIPS Eligible Clinicians Affected by COVID19. Centers for Medicare & Medicaid Services. .https www.cms.gov/files/document/
guidance-memo-exceptions-and-extensions-qualityreporting-and-value-based-purchasingprograms.pdf.

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