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Federal Register / Vol. 86, No. 147 / Wednesday, August 4, 2021 / Rules and Regulations
path forward towards adopting such a measure as soon as possible.

functional outcomes measure for this setting.

2. Functional Outcomes Instrument for Use in a Patient Reported Outcomes Measure When we introduced the Meaningful Measures Framework, we stated that we wanted to focus on meaningful outcomes 83 FR 38591. As we have assessed the IPFQR Program measure set against the Meaningful Measures Framework, we have identified functional outcomes as a potential gap area in the IPFQR Programs measure set. Therefore, we are evaluating whether a patient reported outcomes measure that assesses functional outcomes, such as global functioning, interpersonal problems, psychotic symptoms, alcohol or drug use, emotional lability, and self-harm, would be an appropriate measure to include in the IPFQR program measure set. If we were to develop such a measure, we would develop a measure that compares a patients responses to a standardized functional outcomes assessment instrument at admission with the patients results on the same assessment instrument at discharge. We sought public comment on the value of such a measure in the IPFQR program measure set, what would be an appropriate functional outcome assessment instrument to use in the potential development of such a measure, and any additional topics or concepts stakeholders believe would be appropriate for patient reported outcomes measures.
We received the following comments in response to our request.
Comment: Many commenters supported the concept of a functional outcomes measure and recommended preceding development of such a measure with an attestation measure which asks IPFs whether they use an assessment, and if so which one.
Some commenters expressed concern regarding outcome measures in this setting. One commenter specifically observed that short lengths of stay often lead to minimal progress on outcomes.
One commenter mentioned the lack of endorsed, public domain outcome measures for this setting.
A few commenters recommended that CMS convene a technical expert panel TEP on patient reported outcomes for this setting.
One commenter uses PHQ9 to assess outcomes. Another commenter uses BASIS32 or CABAY depending on the patient population.
Response: We thank the commenters for their input and will consider this feedback as we continue to evaluate a
3. Measures for Electronic Data Reporting As we seek to improve digital measurement across our quality reporting and value-based payment programs, we are considering measures both within and appropriate to adopt for the IPFQR Program measure set that would be appropriate for digital data collection. In our assessment of the current measure set, we identified the Transition Record with Specified Elements Received by Discharged Patients Discharges from an Inpatient Facility to Home/Self Care or Any Other Site of Care measure as a potential option for digital data collection. We sought stakeholder input on the current data collection burden associated with this measure, concerns regarding potential electronic specification and data collection for this measure, and other measures that may be appropriate for electronic data collection, either those currently in the IPFQR Program measure set, or those that we could adopt in the future.
We received the following comments in response to our request.
Comment: Several commenters supported transitioning the IPFQR
Program to electronic reporting.
Many commenters observed that IPFs have not received Federal incentives to support EHR adoption and expressed the belief that electronic data reporting without such funding is premature.
Some commenters observed that the Transition Record measure is a complicated measure for e-specification.
Some of these commenters noted that this measure requires a large number of data elements, some of which are not available in structured fields. One commenter recommended considering Metabolic Screening or Influenza Immunization for electronic specification as these measures have fewer data elements and those elements are available in structured fields.
Another commenter observed that especification of existing chart measures often does not provide comparable results.
Response: We thank commenters for this input. We acknowledge that IPFs were not eligible to receive prior Federal incentives to support EHR adoption and will consider this and other input as we seek to transition the IPFQR Program to electronic data reporting.

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I. Public Display and Review Requirements We refer readers to the FY 2013 IPPS/
LTCH PPS final rule 77 FR 53653

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through 53654, the FY 2014 IPPS/LTCH
PPS final rule 78 FR 50897 through 50898, and the FY 2017 IPPS/LTCH
PPS final rule 81 FR 57248 through 57249 for discussion of our previously finalized public display and review requirements. We did not propose any changes to these requirements.
J. Form, Manner, and Timing of Quality Data Submission for the FY 2022
Payment Determination and Subsequent Years 1. Procedural Requirements for the FY
2023 Payment Determination and Subsequent Years We refer readers to the FY 2013 IPPS/
LTCH PPS final rule 77 FR 53654
through 53655, the FY 2014 IPPS/LTCH
PPS final rule 78 FR 50898 through 50899, and the FY 2018 IPPS/LTCH
PPS final rule 82 FR 38471 through 38472 for our previously finalized procedural requirements. In this final rule, we are finalizing our proposal to use the term QualityNet security official instead of QualityNet system administrator, finalizing our proposal to revise 412.434b3 by replacing the term QualityNet system administrator with the term QualityNet security official, and clarifying our policy under the previously finalized requirement that hospitals identify a QualityNet Administrator who follows the registration process located on the QualityNet website 77 FR 53654.
a. Updated References to QualityNet System Administrator and to No Longer Require Active Account To Qualify for Payment The previously finalized QualityNet security administrator requirements, including those for setting up a QualityNet account and the associated timelines, are described in the FY 2013
IPPS/LTCH final rule 77 FR 53654.
In the FY 2022 IPF PPS proposed rule, we proposed to use the term QualityNet security official instead of QualityNet system administrator to denote the exercise of authority invested in the role and align with the Hospital Outpatient Quality Reporting Program and other programs 86 FR 19512. The term security official would refer to the individuals who have responsibilities for security and account management requirements for a IPFs QualityNet account. To clarify, this update in terminology will not change the individuals responsibilities or add burden.
We invited public comment on our proposal to replace the term QualityNet system administrator with QualityNet security official.

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