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Federal Register / Vol. 86, No. 147 / Wednesday, August 4, 2021 / Rules and Regulations
determination and continuing for each quarter in subsequent years. For more details on data submission, we refer readers to section V.J.2.a of this final rule.
We proposed that IPFs would report the measure through the CDC National Healthcare Safety Network NHSN web3. NQF Endorsement based surveillance system.111 While the Under section 1886s4Di of the IPFQR Program does not currently Act, unless the exception of clause ii require use of the NHSN web-based applies, measures selected for the surveillance system, we have previously quality reporting program must have required use of this system. We refer been endorsed by the entity with a readers to the FY 2015 IPF PPS final contract under section 1890a of the rule in which we adopted the Influenza Act. The NQF currently holds this Vaccination Coverage Among contract. Section 1886s4Dii of the Healthcare Personnel NQF 0431
Act provides an exception to the measure for additional information on requirement for NQF endorsement of reporting through the NHSN web-based measures: In the case of a specified area surveillance system 79 FR 45968
or medical topic determined appropriate through 45970.
by the Secretary for which a feasible and IPFs would report COVID19
practical measure has not been endorsed vaccination data in the NHSN
by the entity with a contract under Healthcare Personnel Safety HPS
section 1890a of the Act, the Secretary Component by reporting the number of may specify a measure that is not so HCP eligible to have worked at the IPF
endorsed as long as due consideration is that week denominator and the given to measures that have been number of those HCP who have received endorsed or adopted by a consensus a completed vaccination course of a organization identified by the Secretary. COVID19 vaccination numerator. For This measure is not NQF endorsed additional information about the data and has not been submitted to NQF for reporting requirements, see IV.J.4. of endorsement consideration. The CDC, in this final rule.
collaboration with CMS, are planning to We invited public comment on our submit the measure for consideration in proposal to add a new measure, COVID
the NQF Fall 2021 measure cycle.
19 Vaccination Coverage Among HCP, Because this measure is not NQFto the IPFQR Program for the FY 2023
endorsed, we considered other available payment determination and subsequent measures. We found no other feasible years.
and practical measures on the topic of Comment: Some commenters supported the proposed COVID19
COVID19 vaccination among HCP, Vaccination Coverage Among therefore, we believe the exception in Healthcare Personnel measure. One Section 1186s4Dii of the Act commenter observed that data on applies.
vaccination coverage are important for c. Data Collection, Submission and patients and for individuals seeking Reporting employment at IPFs. Several Given the time-sensitive nature of this commenters noted the importance of measure considering the PHE, in the FY vaccines to reduce transmission, and 2022 IPF PPS proposed rule, we one commenter specifically observed proposed that IPFs would be required to that vaccination is particularly begin reporting data on the proposed important in settings such as IPFs COVID19 Vaccination Coverage because non-pharmaceutical Among HCP measure beginning October interventions are challenging in such 1, 2021 for the FY 2023 IPFQR Program institutional settings. Another year 86 FR 19504. Thereafter, we commenter expressed the belief that the proposed quarterly 110 reporting periods. measure is methodologically sound.
To report this measure, facilities Response: We thank these would report COVID19 vaccination commenters for their support.
Comment: Many commenters data to the NHSN for at least one week expressed concern that using NHSN for each month, beginning in October 2021
reporting is too burdensome and for the October 1, 2021 through disproportionately affects smaller and December 31, 2021 reporting period freestanding IPFs. Some of these affecting FY 2023 payment
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possible to address the urgency of the COVID19 PHE and its impact on vulnerable populations, including IPFs.
We continue to engage with the MAP to mitigate concerns and appreciate the MAPs conditional support for the measure.

110 We note that the proposed rule incorrectly read annual reporting periods however the section of the proposed rule on data submission IV.J.2.a correctly described the data submission process and timelines.

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111 Centers for Disease Control and Prevention.
Surveillance for Weekly HCP COVID19
Vaccination. Accessed at: https www.cdc.gov/
nhsn/hps/weekly-covid-vac/index.html. on February 10, 2021.

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commenters further expressed that requiring reporting through NHSN is inconsistent with the removal of Influenza Vaccine Coverage among HCP
measure because the rationale for removing the Influenza Vaccine Coverage among HCP measure was the high reporting burden associated with NHSN reporting.
Response: We believe that there are many significant benefits to collecting and reporting data on COVID19
vaccination coverage among HCP that outweigh its burden. As discussed in our proposal to adopt this measure, HCP
vaccination can potentially reduce illness that leads to work absence and limit disruptions to care 86 FR 19502.
The CDC has emphasized that health care settings can be high-risk places for COVID19 exposure and transmission.112 In these 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.113
Subsequent to the publication of the IPF PPS proposed rule, the CDC
updated its Science Brief on COVID19
Vaccines and Vaccination and observed that the growing body of evidence indicates that people who are fully vaccinated with an mRNA vaccine are less likely to have asymptomatic infection or to transmit SARSCoV2 to others. The CDC further noted that the studies are continuing on the benefits of the Johnson & Johnson/Janssen vaccine.114 Therefore we believe that vaccination coverage among HCP will reduce the risk of contracting COVID19
for patients in IPFs, and that IPFs reporting this information can help patients identify IPFs where they may have lower risk of COVID19 exposure.
Publishing the HCP vaccination rates will be helpful to many patients, including those who are at high-risk for developing serious complications from COVID19, as they choose IPFs from which to seek treatment.
While we agree with the commenters that there is some burden associated with reporting this measure see Section VA2c of this final rule, we believe the benefits of data collection and 112 Dooling, K, McClung, M, et al. The Advisory Committee on Immunization Practices Interim Recommendations for Allocating Initial Supplies of COVID19 VaccineUnited States, 2020. Morb Mortal Wkly Rep. 2020; 6949: 18571859.
113 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.
114 https www.cdc.gov/coronavirus/2019-ncov/
science/science-briefs/fully-vaccinated-people.html.

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