ASC Quality Program Deadlines Approach

Two more quality measures must be submitted by Ambulatory Surgery Centers to the Centers for Medicare and Medicaid Services (CMS) to continue to avoid payment adjustments.

Measure 6 for Safe Surgery Checklist Use and Measure 7 for ASC Facility Volume Data on Selected ASC Surgical Procedures for 2012 dates of service must be reported online via QualityNet during an open attestation period of July 1, 2013, through August 15, 2013. Reporting those two measures for 2012 activity, along with submitting claims-based measures 1-5 for 50 percent of primary and secondary Medicare claims for 2013 dates of service, will prevent a payment adjustment in 2015.

To submit measures 6 and 7, ambulatory surgery centers need to register for Quality Net Portal Access and enroll as a new user. Then, users can log in and complete the web-based tool in Quality Net during the open period of July 1, 2013, through August 15, 2013. (See step by step instructions below.)

Successfully reporting claims-based measures 1-5 for 50 percent of Medicare primary claims for October-December 2012 dates of service will allow ASCs to avoid a payment adjustment in 2014. Annual Payment Update determinations for that reporting period are expected to be released as early as September 2013. ASCs can submit reconsideration requests for 2014 determinations by March 17, 2014. More details about that process are still being determined and will be made available on QualityNet when they are released.

For avoiding a payment adjustment in 2016, claims-based measures 1-5, structural (web-based) measures 6-7, and an additional structural measures for influenza vaccination coverage will be required. Details for submitting this final measure are still being determined.

Just getting started? Here are the steps to take to ensure you can successfully submit quality measures for your ASC.

If you are not already, begin submitting claims-based measures on all ASC Medicare Primary and Secondary claims immediately. (See Measures 1-5 in the “Ambulatory Surgical Center Quality Reporting Program (ASCQRP) Quality Measures Specification Manual, Version 2.0.”) Since 50 percent of Medicare Primary and Secondary claims must have quality measures reported successfully, you may still have time to meet the criteria if you report QDCs for all claims for the rest of 2013.
Register for Quality Net Portal Access. Up to two “administrators” must be designated, and a notarized form must be mailed to the ASCQR Program Support Contractor. We have heard that the process may take up to 30 days to complete, so register now to ensure you will have access within the designated time period (July 1, 2013, through August 15, 2013).
While you are waiting for your registration verification, begin collecting data for Measures 6 and 7. For measure 6, simply determine your facility’s response to the following question: Did your facility use a safe surgery checklist based on accepted standards of practice during 2012 dates of service (for all patients; not limited to Medicare patients)? For measure 7, determine the number of procedures in each category listed in Measure 7 specifications for 2012 dates of service (for all patients; not limited to Medicare patients). Be certain you are using the correct version of the Measures Specifications Manual (Version 2.0.) An earlier manual had different procedures listed for the cardiovascular category. You will be expected to answer “0” for any category in which you did not perform any procedures. The following memo from QualityNet clarifies the Measure 7 requirements: “CMS Clarification on the Data Submission of ASC-7 into the Secure QualityNet Portal.”
With the User ID and Initial Password you receive from the support contractor, sign in to “My QualityNet” and change your password, then complete the “Enrollment, first-time login” process.
Once administrators are registered and enrolled with QualityNet, they can provide portal access to other users as well as log in to the Secure QualityNet Portal for completing the web-based tool for Measures 6 and 7 during the designated time period (July 1, 2013, through August 15, 2013).

For more information about the ASCQR Program, visit the CMS ASC Quality Reporting Pageor the “FAQ About the ASCQR Program” document.

For more information about registering or enrolling with QualityNet, visit the ASC Program Overview Page.

For more step by step details of participating with the program, review the ASCQR Program Reference Checklist.