Proposed Changes to the Medicare PI Program for Hospitals

On May 11, the Centers for Medicare & Medicaid Services (CMS) (@CMSGov) issued the Fiscal Year 2021 Inpatient Prospective Payment Systems (IPPS) for Acute Care Hospitals and the Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) Proposed Rule.

Proposed changes to the Medicare Promoting Interoperability Program include:

  • Maintaining an electronic health record (EHR) reporting period of a minimum of any continuous 90-day period in CY 2022 for new and returning participants (eligible hospitals and critical access hospitals [CAHs]);
  • Maintaining the Electronic Prescribing Objective’s Query of Prescription Drug Monitoring Program (PDMP) measure as optional worth 5 bonus points for CY 2021;
  • Modifying the name of the Support Electronic Referral Loops by Receiving and Incorporating Health Information measure to the Support Electronic Referral Loops by Receiving and Reconciling Health Information measure to better reflect the actions required by hospitals; and
  • Increasing the number of quarters of electronic clinical quality measure (eCQM) data reported, from one self-selected quarter of data to four quarters of data, over a three year period, and to begin public reporting of eCQM data for eligible hospitals and CAHs as early as the fall of 2022 using CY 2021 data.

CMS is soliciting feedback on these proposed changes. The deadline for submitting comments on the proposed rule is no later than 5 p.m. Eastern Daylight Time on July 10, 2020.

For More Information
To learn more about these and other proposed changes, review the proposed rule, press release, and this fact sheet.