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Federal Register / Vol. 86, No. 147 / Wednesday, August 4, 2021 / Rules and Regulations Quality-Reporting. We also encourage members of the public to go to the HQRP web page and sign-up for the Hospice Quality ListServ to stay informed about HQRP.
d. Update on Transition to iQIES
In the FY 2020 Hospice Wage Index and Payment Rate Update final rule 84
FR 38484, we finalized the proposal to migrate our systems for submitting and processing assessment data. Hospices are currently required to submit HIS
data to CMS using the Quality Improvement and Evaluation System QIES Assessment and the Submission Processing ASAP system. The FY 2020
Hospice Wage Index and Payment Rate Update final rule 84 FR 38484
finalized the proposal to migrate to a new internet Quality Improvement and Evaluation System iQIES that will enable us to make real-time upgrades.
We are designating that system as the data submission system for the Hospice QRP. We will notify the public about any system migration updates using subregulatory mechanisms such as web page postings, listserv messaging, and webinars.
We received several on the transition to iQIES. A summary of these comment and our responses to those comment appear below:
Comment: Several commenters requested 6-month minimum notice prior to the transition of hospice to the iQIES system. Some of these commenters further requested that CMS
provide announcements about the upcoming implementation of hospice in iQIES through all CMS and MAC
communication platforms to ensure wide penetration of the message, and ensure a smooth transition given lessons from the transition of other settings to iQIES.
Response: We appreciate that providers will benefit from advanced notice regarding the transition of hospice to the iQIES systems. We plan to communicate with the provider community via sub-regulatory means about the upcoming transition as the timing becomes clear, and will provide sufficient time and appropriate information for a smooth transition.

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10. Public Display of Quality Measures and Other Hospice Data for the HQRP
a. Background Under section 1814i5E of the Act, the Secretary is required to establish procedures for making any quality data submitted by hospices available to the public. These procedures shall ensure that individual hospices have the
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opportunity to review their data prior to these data being made public on our designated public website. To meet the Acts requirement for making quality measure data public, we launched Hospice Compare in August 2017. This website allows consumers, providers, and other stakeholders to search for all Medicare-certified hospice providers and view their information and quality measure scores. In September 2020, CMS transitioned Hospice Compare to the Care Compare website. Hospice Compare was discontinued in December 2020. Care Compare supports all Medicare settings and fulfills the Acts requirements for the HQRP. For more information about Care Compare, please see the Update on the Hospice Quality Reporting Requirements for FY 2022 in section D.
Since 2017, we have increased and improved available information about the care hospices provide for consumers. To indicate the quality of care hospices provide, we first posted the seven HIS Measures NQF 1641, NQF 1647, NQF 1634, NQF 1637, NQF 1639, NQF 1638, and NQF
1617 in 2017, and then added the CAHPS Hospice Survey measure NQF
2651 and the HIS Comprehensive Assessment at Admission NQF 3235
in 2018. In 2019, we added the Hospice Visits When Death is Imminent Measure 1 to the website.
As discussed previously, we are finalizing our proposal to remove the seven HIS Measures from public reporting on Care Compare no earlier than May 2022. The Hospice Item Set V3.00 PRA Submission replaced the HVWDII measure with a more robust version: The claims-based measure HVLDL. We will publicly report the HVLDL no earlier than May 2022. We are also finalizing our proposal to publicly report the HCI, another claimsbased measure no earlier than May 2022. In addition to the publiclyreported quality measure data, in 2019
we added to public reporting, information about the hospices characteristics, taking raw data available from the Medicare Public Use File and other publicly-available government data sources and making them more consumer friendly and accessible for people seeking hospice care for themselves or family members, 83 FR
38649. This publicly reported information currently includes diagnoses, location of care, and levels of care provided.

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b. Data Collection and Reporting During a Public Health Emergency 1. Background: COVID19 Public Health Emergency Temporary Exemption and Its Impact on the Public Reporting Schedule Under authority of section 319 of the Public Health Service 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 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 46 47 in accordance with the presidents declaration. 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, Hospices, Inpatient Rehabilitation Facilities, LongTerm Care Hospitals, Ambulatory Surgical Centers, Renal Dialysis Facilities, and MIPS Eligible Clinicians Affected by COVID19 48 to the Medicare Learning Network MLN
Connects Newsletter and Other Program-Specific Listserv Recipients,49
hereafter referred to as the March 27, 2020 CMS Guidance Memorandum. In that memo, which applies to HIS and CAHPS Hospice Survey, CMS granted an exemption to the HQRP reporting requirements for Quarter 4 Q4 2019
October 1, 2019 through December 31, 2019, Quarter 1 Q1 2020 January 1, 46 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.
47 https www.phe.gov/emergency/news/
healthactions/section1135/Pages/covid1913March20.aspx.
48 https www.cms.gov/files/document/guidancememo-exceptions-and-extensions-quality-reportingand-value-based-purchasing-programs.pdf.
49 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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