PPS-Exempt Cancer Hospital Quality Reporting (PCHQR) Program Overview

The Prospective Payment System (PPS)-Exempt Cancer Hospital Quality Reporting (PCHQR) Program was developed as mandated by Section 3005 of the Affordable Care Act (Public Law 111-148).

The PCHQR program is intended to equip consumers with quality-of-care information to make more informed decisions about healthcare options. It is also intended to encourage hospitals and clinicians to improve the quality of inpatient care provided to Medicare beneficiaries by ensuring that providers are aware of and reporting on best practices for their respective facilities and type of care.

To meet the PCHQR Program requirements, PPS-Exempt Cancer Hospitals (PCHs) will be required to submit all quality measures to the Centers for Medicare & Medicaid Services (CMS), beginning with the Fiscal Year (FY) 2014 payment determination year. Participating facilities must comply with the program requirements set forth, including public reporting of the measure rates.

Final Rule for Hospital Inpatient Prospective Payment Systems (IPPS)

Information regarding the PPS-Exempt Cancer Hospital Quality Reporting (PCHQR) Program can be found on pages 1363–1429 of the Final Rule for Fiscal Year 2014, CMS-1599-F, available on the CMS website.

PCHQR Program Eligibility

Eligible hospitals are described in section 1886(d)(1)(B)(v) and referred to as a PPS-Exempt Cancer Hospital or PCH. These hospitals are excluded from payment under the Inpatient Prospective Payment System (IPPS). CMS has designated 11 hospitals as PPS-Exempt Cancer Hospitals (Medicare PPS-Excluded Cancer Hospitals).

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