CMS Publishes Annual Pre-Rulemaking List of Quality and Efficiency Measures

CMS has issued its List of Measures under Consideration (MUC) for 2014. The December 1, 2013, MUC list contains measures under consideration that were suggested by the public. As a result, the MUC list is larger than what will ultimately be adopted by CMS for optional or mandatory reporting programs in Medicare. The MUC list is required by section 1890A(a)(2) of the Social Security Act, as added by section 3014 of the Affordable Care Act (ACA) (P.L. 111-148), which requires that HHS establish a federal pre-rulemaking process for the selection of certain categories of quality and efficiency measures for use by the Department.

Pre-Rulemaking Process

One of the pre-rulemaking process steps requires that HHS make public annually, not later than December 1st, a list of quality and efficiency measures HHS is considering adopting, through the federal rulemaking process, for use in the Medicare program. The pre-rulemaking process also includes: (1) providing the opportunity for multi-stakeholder groups to provide input not later than February 1st on the selection of quality and efficiency measures; (2) considering the multi-stakeholder groups’ input in selecting quality and efficiency measures; (3) publishing in the Federal Register the rationale for the use of any quality and efficiency measures that are not endorsed by the entity with a contract under Soc. Sec. Act sec. 1890, which is currently the National Quality Forum (NQF); and (4) assessing the quality and efficiency impact of the use of endorsed measures and making a report of that assessment available to the public at least every three years. The first report was released in March 2012.

Navigating the List

The MUC list consists of three tables: (1) List of Measures under Consideration; (2) Appendix A: Measure Specifications; and (3) Appendix B: Measure Effectiveness. The List of Measures under Consideration contains the complete list of measures under consideration with basic information about each measure and the programs for which the measure is being considered. Appendix A: Measure Specifications details the numerator, denominator, and exclusions for each measure. It also includes the length of time the measure has been in use by any CMS quality reporting program if applicable. Appendix B: Measure Effectiveness describes the rationale for the measure and/or the impact the measure is anticipated to achieve.

Measure Applications Partnership

When public organizations request that CMS consider measures, the agency attempts to include those measures and make them available to the public so that the Measure Applications Partnership (MAP), the multi-stakeholder groups convened as required under Soc. Sec. Act sec. 1890A can provide their input on all potential measures. The 2012 MUC list and the Measures Application Partnership Report can be found on the NQF’s website.

This year’s MAP is beginning its third cycle of providing pre-rulemaking recommendations to HHS on performance measures under consideration. Prior to MAP’s deliberations, it is requesting public comments on the measures under consideration for 2014 rulemaking. Early public comments will be open from December 2 until December 9. The comments received will provide initial input to the MAP workgroups and Coordinating Committee.

In addition, MAP is currently convening several time-limited task forces to explore specific topics:

Learn more about MAP, its work, and its final reports.