Inpatient Psychiatric Facility Quality Reporting (IPFQR) Program
Annual Payment Update (APU) Recipients
Inpatient Psychiatric Facilities (IPFs) eligible for the Inpatient Psychiatric Facility Quality Reporting Program are included annually in one of three lists:
- Inpatient Psychiatric Facilities receiving full APU – IPFs that satisfactorily met the requirements for the Inpatient Psychiatric Facility Quality Reporting Program. These IPFs will receive the full annual market basket update.
- Inpatient Psychiatric Facilities not receiving full APU – IPFs that did not satisfactorily meet the criteria for the Inpatient Psychiatric Facility Quality Reporting Program. These IPFs will receive their annual market basket update with a 2.0 percentage point reduction.
- Inpatient Psychiatric Facilities that choose not to participate – IPFs that actively chose not to participate and will receive their annual market basket update with a 2.0 percentage point reduction.
Fiscal Year 2014
- Facilities receiving full APU – PDF or XLSX (revised 10/03/13)
- Facilities not receiving full APU – PDF or XLSX
- Facilities that chose not to participate – PDF or XLSX
IPFQR Program FY 2014 Annual Payment Update (APU) Reconsideration Process Overview
CMS provides Inpatient Psychiatric Facilities the opportunity to request a reconsideration of adverse decisions. Facilities requesting IPFQR Program reconsideration from CMS must submit their request within 30 days following the date identified on the IPFQR Program APU notification letter.
The request must identify the facility’s specific reason(s) for believing the IPFQR Program requirements were met and why the facility should receive the full FY 2014 Inpatient Psychiatric Facility Prospective Payment Systems (IPFPPS) Annual Payment Update (APU).
Facilities must address one or more of the following requirements for reconsideration:
- Identify a QualityNet Security Administrator. (They must have previously completed the Security Administrator Registration Process on QualityNet, regardless of the method used for submitting data.)
- Complete a Notice of Participation.
- Submit aggregated numerator and denominator for all age groups, for each required measure by the posted submission deadline.
- Complete a Data Accuracy and Completeness Acknowledgement form.
CMS will officially respond to the reconsideration request submitted by each facility.
Filing an Appeal
When a facility is dissatisfied with the result of CMS’s reconsideration, the facility may file a claim under 42 CFR Part 405, Subpart R (a Provider Reimbursement Review Board [PRRB] appeal). Details are available at PRRB Review Instructions. An appeal can be filed with the Provider Reimbursement Review Board (PRRB) only after the facility has submitted a request for reconsideration and received a decision on the request.
For More Information
For assistance in completing and/or submitting the Reconsideration Request, refer to the following reconsideration resources.
Two types of resources are offered to assist facilities with data collection for reporting measures to the Centers for Medicare & Medicaid Services (CMS).
- Event Tracking Log – optional, informal mechanisms to aid in the collection of data for the Hospital-Based Inpatient Psychiatric Services measures (HBIPS-2 through HBIPS-3)
- Paper Abstraction Tools for Inpatient Psychiatric Facilities – optional, informal mechanisms to aid in the collection of data for the Hospital-Based Inpatient Psychiatric Services measures (HBIPS-4 through HBIPS-7)
For questions related to specific data element abstraction guidelines, refer to the Specifications Manual.
- Notice of Participation form, PDF-353 KB (02/04/13) –an alternative for use by facilities electing to participate in the Inpatient Psychiatric Facility Quality Reporting (IPFQR) Program, if experiencing difficulty accessing the online Notice of Participation application
- Data Collection Tool, PDF-158 KB (11/06/13) – an alternative for use by facilities electing to participate in the Inpatient Psychiatric Facility Quality Reporting (IPFQR) Program, if experiencing difficulty accessing the online Notice of Participation application
- Data Accuracy and Completeness Acknowledgement, PDF-118 KB (08/22/13) – an alternative for use by facilities electing to participate in the Inpatient Psychiatric Facility Quality Reporting (IPFQR) Program, to complete the Data Accuracy and Completeness Acknowledgement following the submission of the HBIPS measures to CMS, if experiencing difficulty accessing the online Structural/Web-Based Measures application
- Fiscal Year 2014 Reference Checklist – a checklist outlining the steps that facilities participating in the IPFQR Program must follow to receive the full Annual Payment Update for Fiscal Year 2014
The following websites provide more information about the IPFQR program.
- Inpatient Psychiatric Facility PPS (CMS) additional background information and documentation related to the program
- The Joint Commission additional resource for information related to Clinical Quality Measures (CQMs)
- National Quality Forum general information related to CQMs
- HealthCare.gov details regarding the Affordable Care Act (ACA)
Final Rule for Hospital Inpatient Prospective Payment Systems (IPPS)
- Final Rule for Fiscal Year 2014, CMS-1599-F (Centers for Medicare & Medicaid Services) – Information regarding the Inpatient Psychiatric Facilities Quality Reporting (IPFQR) Program can be found on on pages 1565–1630 of the document.
Timeline for IPFQR Program Fiscal Year 2014 Payment Determination
|Oct 1, 2012||Quality measure data collection begins|
|Oct 1, 2012 Mar 31, 2013||Initial measure collection period|
|Jul 1, 2013 Aug 15, 2013||Initial measure data submission period|
|Aug 15, 2013||Deadline to submit Notice of Participation (NOP)|
|Aug 15, 2013||Deadline to complete Data Accuracy Completion Agreement (DACA)|
|Sept 20, 2013 Oct 19, 2013||Public preview period|
|Early CY 2014||Annual Payment Update (APU) 2% reduction for nonparticipation|
|Beginning in CY 2014||Public posting on CMS.gov|
IPFQR Disaster Extension/Waiver Process
The Centers for Medicare & Medicaid Services (CMS) offers a process for facilites to request and for CMS to grant extensions or waivers with respect to the reporting of required quality data when there are extraordinary circumstances beyond the control of the facility.
In the event of such circumstances, an Extraordinary Circumstance/Disaster Extension or Waiver Request Form, (PDF-184 KB) with all questions completed is required. The facility may request consideration for an extension or waiver of the requirement to submit quality data for one or more quarters.
The completed Extraordinary Circumstance/Disaster Extension or Waiver form should be submitted via either:
- fax, to:
Program Manager, Telligen
- mail, to:
Telligen IPFQR Support
Attn.: Program Manager
1776 Westlakes Parkway
West Des Moines, IA 50266
NOTE: This process does not preclude CMS from granting waivers or extensions to facilities when it is determined that an extraordinary circumstance, such as an act of nature, affects an entire region or locale. If CMS makes the determination to grant a waiver or extension to facilities in a region or locale, CMS will communicate this decision to facilities and vendors through routine communication channels, including but not limited to issuing memos, e-mails and notices on QualityNet.