Voglio sapere a riguardo di…

Federal Register / Vol. 86, No. 147 / Wednesday, August 4, 2021 / Rules and Regulations clinicians using information from datadriven insights that are increasingly aligned with meaningful quality measures. We support technology that reduces burden and allows clinicians to focus on providing high-quality healthcare for their patients. We also support innovative approaches to improve quality, accessibility, and affordability of care while paying particular attention to improving clinicians and beneficiaries experiences when interacting with our programs. In combination with other efforts across the Department of Health and Human Services HHS, we believe the IPFQR Program helps to incentivize facilities to improve healthcare quality and value while giving patients and providers the tools and information needed to make the best decisions for them. Consistent with these goals, our objective in selecting quality measures is to balance the need for information on the full spectrum of care delivery and the need to minimize the burden of data collection and reporting. We have primarily focused on measures that evaluate critical processes of care that have significant impact on patient outcomes and support CMS and HHS
priorities for improved quality and efficiency of care provided by IPFs.
When possible, we also propose to incorporate measures that directly evaluate patient outcomes and experience. We refer readers to section VIII.F.4.a. of the FY 2013 IPPS/LTCH
PPS final rule 77 FR 53645 through 53646 for a detailed discussion of the considerations taken into account in selecting quality measures.

lotter on DSK11XQN23PROD with RULES5

1. Measure Selection Process Before being proposed for inclusion in the IPFQR Program, measures are placed on a list of measures under consideration MUC, which is published annually on behalf of CMS by the National Quality Forum NQF.
Following publication on the MUC list, the Measure Applications Partnership MAP, a multi-stakeholder group convened by the NQF, reviews the measures under consideration for the IPFQR Program, among other Federal programs, and provides input on those measures to the Secretary. We consider the input and recommendations provided by the MAP in selecting all measures for the IPFQR Program. In our evaluation of the IPFQR Program measure set, we identified two measures that we believe are appropriate for the IPFQR Program.

VerDate Sep<11>2014

21:11 Aug 03, 2021

Jkt 253001

2. COVID19 Vaccination Coverage Among Health Care Personnel HCP 66
Measure for the FY 2023 Payment Determination and Subsequent Years a. Background On January 31, 2020, the Secretary declared a PHE for the U.S. in response to the global outbreak of SARSCoV2, a novel new coronavirus that causes a disease named coronavirus disease 2019 COVID19.67 COVID19 is a contagious respiratory illness 68 that can cause serious illness and death. Older individuals and those with underlying medical conditions are considered to be at higher risk for more serious complications from COVID19.69
As of April 2, 2021, the U.S. had reported over 30 million cases of COVID19 and over 550,000 COVID19
deaths.70 Hospitals and health systems saw significant surges of COVID19
patients as community infection levels increased.71 From December 2, 2020
through January 30, 2021, more than 100,000 Americans were in the hospital with COVID19 at the same time.72
Evidence indicates that COVID19
primarily spreads when individuals are in close contact with one another.73 The virus is typically transmitted through respiratory droplets or small particles created when someone who is infected with the virus coughs, sneezes, sings, 66 This measure was previously titled, SARS
CoV2 Vaccination Coverage among Healthcare Personnel.
67 U.S. Dept of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response. 2020. Determination that a Public Health Emergency Exists. Available at: https
www.phe.gov/emergency/news/healthactions/phe/
Pages/2019-nCoV.aspx.
68 Centers for Disease Control and Prevention.
2020. Your Health: Symptoms of Coronavirus.
Available at: https www.cdc.gov/coronavirus/
2019-ncov/symptoms-testing/symptoms.html.
69 Centers for Disease Control and Prevention.
2020. Your Health: Symptoms of Coronavirus.
Available at https www.cdc.gov/coronavirus/2019ncov/symptoms-testing/symptoms.html.
70 Centers for Disease Control and Prevention.
2020. CDC COVID Data Tracker. Accessed on April 3, 2021 at: https covid.cdc.gov/covid-datatracker/cases_casesper100klast7days.
71 Associated Press. Tired to the Bone. Hospitals Overwhelmed with Virus Cases. November 18, 2020. Accessed on December 16, 2020, at https
apnews.com/article/hospitals-overwhelmedcoronavirus-cases74a1f0dc3634917a5dc13408455cd895. Also see:
New York Times. Just how full are U.S. intensive care units? New data paints an alarming picture.
November 18, 2020. Accessed on December 16, 2020, at: https www.nytimes.com/2020/12/09/
world/just-how-full-are-us-intensive-care-units-newdata-paints-an-alarming-picture.html.
72 U.S. Currently Hospitalized The COVID
Tracking Project https covidtracking.com/data/
charts/us-currently-hospitalized.
73 Centers for Disease Control and Prevention.
2021. How COVID19 Spreads. Accessed on April 3, 2021 at: https www.cdc.gov/coronavirus/2019ncov/prevent-getting-sick/how-covid-spreads.html.

PO 00000

Frm 00027

Fmt 4701

Sfmt 4700

42633

talks, or breathes.74 Thus, the CDC
advises that infections mainly occur through exposure to respiratory droplets when a person is in close contact with someone who has COVID19.75 Experts believe that COVID19 spreads less commonly through contact with a contaminated surface although that is not thought to be a common way that COVID19 spreads,76 and that in certain circumstances, infection can occur through airborne transmission.77
Subsequent to the publication of the proposed rule, the CDC confirmed that the three main ways that COVID19 is spread are: 1 Breathing in air when close to an infected person who is exhaling small droplets and particles that contain the virus; 2 Having these small droplets and particles that contain virus land on the eyes, nose, or mouth, especially through splashes and sprays like a cough or sneeze; and 3 Touching eyes, nose, or mouth with hands that have the virus on them.78 According to the CDC, those at greatest risk of infection are persons who have had prolonged, unprotected close contact that is, within 6 feet for 15 minutes or longer with an individual with confirmed SARSCoV2 infection, regardless of whether the individual has symptoms.79 Although personal protective equipment PPE and other infection-control precautions can reduce the likelihood of transmission in health care settings, COVID19 can spread between health care personnel HCP
and patients, or from patient to patient given the close contact that may occur during the provision of care.80 The CDC
has emphasized that health care settings, including long-term care 74 Centers for Disease Control and Prevention.
2021. How COVID19 Spreads. Accessed on April 3, 2021 at: https www.cdc.gov/coronavirus/2019ncov/prevent-getting-sick/how-covid-spreads.html.
75 Centers for Disease Control and Prevention.
2021. How COVID19 Spreads. Accessed on April 3, 2021 at: https www.cdc.gov/coronavirus/2019ncov/prevent-getting-sick/how-covid-spreads.html.
76 Centers for Disease Control and Prevention.
2021. How COVID19 Spreads. Accessed on April 3, 2021 at: https www.cdc.gov/coronavirus/2019ncov/prevent-getting-sick/how-covid-spreads.html.
77 Centers for Disease Control and Prevention.
2021. How COVID19 Spreads. Accessed on April 3, 2021 at: https www.cdc.gov/coronavirus/2019ncov/prevent-getting-sick/how-covid-spreads.html.
78 Centers for Disease Control and Prevention.
2021. How COVID19 Spreads. Accessed on July 15, 2021 at: https www.cdc.gov/coronavirus/2019ncov/prevent-getting-sick/how-covid-spreads.html.
79 Centers for Disease Control and Prevention.
2021. When to Quarantine. Accessed on April 3, 2021 at: https www.cdc.gov/coronavirus/2019ncov/if-you-are-sick/quarantine.html.
80 Centers for Disease Control and Prevention.
2020. Interim U.S. Guidance for Risk Assessment and Work Restrictions for Healthcare Personnel with Potential Exposure to COVID19. Accessed on April 2, 2021 at: https www.cdc.gov/coronavirus/
2019-ncov/hcp/faq.htmlTransmission.

E:FRFM04AUR5.SGM

04AUR5