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Code of Federal Regulations Title 42. Public Health § 42.412.168 Special rule for FY 2022

Current as of January 02, 2025 | Updated by Findlaw Staff

<Text of section added by 86 FR 45520, effective Oct. 1, 2021.>

(a) This section sets forth the scoring and payment methodology for the fiscal year 2022 Hospital VBP Program.

(b) CMS calculates a measure rate for all measures selected under § 412.164(a) for fiscal year 2022 but only applies § 412.165(a) to the measures included in the Clinical Outcomes Domain for that fiscal year, which are the following:

(1) Hospital 30–Day, All–Cause, Risk–Standardized Mortality Rate Following Acute Myocardial Infarction (AMI) Hospitalization (MORT–30–AMI).

(2) Hospital 30–Day, All–Cause, Risk–Standardized Mortality Rate Following Heart Failure (HF) Hospitalization (MORT–30–HF).

(3) Hospital 30–Day, All–Cause, Risk–Standardized Mortality Rate Following Pneumonia Hospitalization (MORT–30–PN (updated cohort)).

(4) Hospital 30–Day, All–Cause, Risk–Standardized Mortality Rate Following Chronic Obstructive Pulmonary Disease (COPD) Hospitalization (MORT–30–COPD).

(5) Hospital 30–Day, All–Cause, Risk–Standardized Mortality Rate Following Coronary Artery Bypass Graft (CABG) Surgery (MORT–30–CABG).

(6) Hospital–Level Risk–Standardized Complication Rate Following Elective Primary Total Hip Arthroplasty (THA) and/or Total Knee Arthroplasty (TKA) (COMP–HIP–KNEE).

(c) CMS calculates a domain score for the measures described in paragraph (b)(1) of this section for hospitals that report the minimum number of measures in the Clinical Outcomes Domain.

(d) CMS does not award a Total Performance Score to any hospital.

(e) The total amount available for value-based incentive payments for fiscal year 2022 is equal to the total amount of base-operating DRG payment reductions for that fiscal year, as estimated by the Secretary.

(f) CMS awards value-based incentive payment percentages (as defined in § 412.160) for all hospitals to ensure that each hospital receives an incentive payment amount equal to the amount of the reduction made to its base-operating DRG payment amounts.

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Cite this article: FindLaw.com - Code of Federal Regulations Title 42. Public Health § 42.412.168 Special rule for FY 2022 - last updated January 02, 2025 | https://codes.findlaw.com/cfr/title-42-public-health/cfr-sect-42-412-168/

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