Policy

In the 2008 proposed rule for hospital outpatient departments, CMS proposes to establish the Hospital Outpatient Quality Data Reporting Program (HOP QDRP) to begin reporting quality measures from hospital outpatient departments. None of the initial 10 measures affect gastroenterology, but CMS is proposing an additional 30 measures to be reported starting in 2010, including a description of polyp characteristics measure related to polyp surveillance. CMS however, is allowing comments on whether any of these additional measures should be included effective for services furnished on or after Jan. 1, 2008, for the calendar year 2009 update.

To participate in the HOP QDRP for CY 2009 and subsequent calendar years, hospitals must meet administrative, data collection and submission, and data validation requirements. Hospitals must complete their Notice of Participation form by Nov. 15, 2007 for the CY 2009 HOP QDRP. Hospitals not wishing to participate must submit a nonparticipation form.

We encourage AGA members to inquire whether their facility plans on participating since hospitals must participate in HOP QDRP and begin reporting measures in 2008 in order to receive their full payment update starting in 2009. Hospitals that don't participate, withdraw from the program or do not meet the reporting requirements will be subject to a payment reduction of 2.0 percentage points in their updates for the affected payment year. On average, hospital outpatient payments see updates of slightly more than 3 percent annually, so not participating or reporting appropriately will have a large financial impact on a facility.

For specific requirements on the HOP QDRP, see pages 42803-42806 of the proposed rule.