### 75471 Federal Register / Vol. 75, No. 232 / Friday, December 3, 2010 / Notices

discussed in the Federal Register Notice and background paper that accompanied the public posting of the initial, recommended core set ( http:// www.ahrq.gov/chip/ chipraact.htm#Core ), not all CHIPRA
criteria were able to be met for the
initial core set. Public comments on the initial, recommended core set, and an expert meeting on measure criteria for the CHIPRA PQMP ( http:// www.AHRQ.gov/chipra/#Expert) provided additional insights into potential priorities for the PQMP. The
combination of these efforts and events led to the identification of the following potential priorities for measure enhancement and development of new

measures:

1. Development or enhancement of
methods to:

a. Standardize measures across all payers, programs, and providers, public and private, as appropriate, to ensure that comparisons are valid.

b. Assess disparities in quality by race, ethnicity, socioeconomic status, geographic region and residence, and special health care needs, for example by developing new measurement methods or enhancing existing
measurement methods.

c. Adjust for risk by enrollment
duration.

d. Stratify or adjust for risk by depth and breadth of coverage.

e. Stratify or adjust for risk by medical conditions, including severity and acuity.

f. Capitalize on current and coming
investments in health information technology ( e.g., patient and procedure registries, electronic health records, health information exchanges, interoperability), including meaningful
use criteria under the American Recovery and Reinvestment Act (ARRA).

g. Increase State programs’ and CMS’s ability to rely on non-Medicaid and CHIP data sources through improvement in public health sector measurement ( e.g., birth certificate data; immunization surveys).

h. Come to consensus on the meaning and application of ‘‘ evidence-based’’ in the context of healthcare quality
measurement for children.

i. Incorporate patient and family perspectives into measurement to increase understandability.

2. Development or enhancement of measures in key topic areas:

a. Most integrated healthcare settings. b. Availability of services.
c. Duration of enrollment as a
standalone measure.

d. Measures of the content (quality) of care now typically measured as broad utilization categories ( e.g., prenatal, postpartum, newborn care (including breastfeeding support), well-child and adolescent well-care visits, screening services, and follow-up visits for
chronic conditions and related medications).

e. Specific care settings and
conditions:

i. Perinatal care ( e.g., family planning clinics, obstetric and gynecological care, birth centers).

ii. Quality of mental/behavioral health and substance abuse services, including prevention and treatment services, across all settings.

iii. Quality of care in settings beyond traditional medical care settings ( e.g., for screening, diagnostic services and therapies).

iv. Inpatient settings (including specialty inpatient settings).

v. Specialty care for child conditions
and diseases.

vi. Care transitions for patients transitioning within and across health care settings.

vii. Additional measures related to family experiences of care ( e.g., child or adolescent self-reports; perinatal experiences of care; inpatient experiences)

viii. Health outcome measures ( e.g., measures of patient and population
health or other outcomes of healthcare). 2

ix. Structural measures ( e.g., measures of system design features that are causally linked to improved healthcare processes and outcomes).

Those submitting comments are encouraged to include a summary of evidence for the readiness of a topic for quality measurement and the importance of a topic or method. Additional background information may be attached. Commenters may wish to address these issues using the following questions. Commenters may also wish to include in their comments a summary score based on a scale of 1–5, where 1 is a high score, 3 is a medium score, and
5 is a low score.

Validity/Underlying Scientific
Soundness: To what extent is there a demonstrated causal relationship between the element of quality to be measured (as a structure, process, or health outcome of healthcare delivery)
and another element of the healthcare delivery system ( e.g., structure and process; process and outcome). Commenters may wish to use as a guide to assessing underlying scientific
soundness the method and criteria used by the AHRQ National Advisory
Council Subcommittee on Children’s Healthcare Quality Measures for Medicaid and CHIP, where appropriate http://www.AHRQ.gov/chipra/ corebackground/
corebacktab.htm#note5).

Importance: Importance has several
dimensions:

• To what extent is the topic important to children’s health outcomes, family functioning, or societal functioning, including but not necessarily limited to high monetary costs of poor quality healthcare to children, families, or Society?

• To what extent is the topic important to reducing disparities in the quality of care for particular racial and ethnic groups of children, socioeconomic groups, geographically underserved groups, and children with special healthcare needs?

• To what extent is the topic important as a sentinel measure that could have spillover effects to the rest of the children’s healthcare delivery system?

• To what extent is the proposed methodology important for addressing current shortcoming of healthcare quality measurement?

We strongly encourage comments to be as succinct as possible (250 words or less per topic, with additional supporting data allowed).

3. Collection of Information Requirements

This voluntary request does not impose information collection and recordkeeping requirements. Consequently, it need not be reviewed by the Office of Management and Budget under the authority of the Paperwork Reduction Act of 1995 (44 U.S.C. 35).

4. Regulatory Impact Analysis

As this notice does not meet the significance criteria of Executive Order 12866, it was not reviewed by the Office of Management and Budget.

Dated: November 24, 2010. Carolyn M. Clancy,

AHRQ Director.

[FR Doc. 2010–30262 Filed 12–2–10; 8:45 am]

**BILLING CODE 4160–90–M**

**DEPARTMENT OF HEALTH AND**
**HUMAN SERVICES**

**Agency for Healthcare Research and Quality** 

**Patient Safety Organizations: Voluntary Delisting** 

**AGENCY :**  Agency for Healthcare Research and Quality, HHS.

**ACTION :**  Notice of Delisting.


### 75472 Federal Register / Vol. 75, No. 232 / Friday, December 3, 2010 / Notices

**SUMMARY :**  AHRQ has accepted a notification of voluntary relinquishment from ORQA, LLC of its status as a Patient Safety Organization (PSO). The Patient Safety and Quality Improvement Act of 2005 (Patient Safety Act), Public Law 109–41, 42 U.S.C. 299b–21—b–26, provides for the formation of PSOs, which collect, aggregate, and analyze confidential information regarding the quality and safety of health care delivery. The Patient Safety and Quality Improvement Final Rule (Patient Safety Rule), 42 CFR Part 3, authorizes AHRQ, on behalf of the Secretary of HHS, to list as a PSO an entity that attests that it meets the statutory and regulatory requirements for listing. A PSO can be

‘‘ delisted’’ by the Secretary if it is found to no longer meet the requirements of the Patient Safety Act and Patient Safety Rule, including when a PSO chooses to voluntarily relinquish its status as a PSO for any reason.

**DATES :**  The directories for both listed and delisted PSOs are ongoing and reviewed weekly by AHRQ. The delisting was effective at 12 Midnight ET (2400) on October 13, 2010.

**ADDRESSES :**  Both directories can be accessed electronically at the following
HHS Web site: http:// www.pso.AHRQ.gov/index.html.

**FOR FURTHER INFORMATION CONTACT :**  Diane Cousins, RPh., Center for Quality Improvement and Patient Safety, AHRQ, 540 Gaither Road, Rockville, MD 20850; Telephone (toll free): (866) 403–3697; Telephone (local): (301) 427–1111; TTY (toll free): (866) 438–7231; TTY (local): (301) 427–1130; E-mail: pso@AHRQ.hhs.gov.

**SUPPLEMENTARY INFORMATION :** 
Background

The Patient Safety Act authorizes the listing of PSOs, which are entities or component organizations whose mission and primary activity is to conduct activities to improve patient safety and the quality of health care delivery. HHS issued the Patient Safety Rule to implement the Patient Safety Act. AHRQ administers the provisions of the Patient Safety Act and Patient Safety Rule (PDF file, 450 KB. PDF Help) relating to the listing and operation of PSOs. Section 3.108(d) of the Patient Safety Rule requires AHRQ to provide public notice when it removes an organization from the list of federally approved PSOs. AHRQ has accepted a notification from ORQA, LLC, PSO number P0013, to voluntarily relinquish its status as a PSO. Accordingly, ORQA, LLC was delisted effective at 12 Midnight ET (2400) on October 13, 2010. More information on PSOs can be obtained through AHRQ’s PSO Web site

at http://www.pso.AHRQ.gov/
index.html.

Dated: November 24, 2010. Carolyn M. Clancy,

Director.

[FR Doc. 2010–30263 Filed 12–2–10; 8:45 am]

**BILLING CODE 4160–90–M**

**DEPARTMENT OF HEALTH AND**
**HUMAN SERVICES**

**Agency for Healthcare Research and Quality** 

**Patient Safety Organizations: Voluntary Delisting** 

**AGENCY :**  Agency for Healthcare Research and Quality, HHS.

**ACTION :**  Notice of Delisting.

**SUMMARY :**  AHRQ has accepted a notification of voluntary relinquishment from Helmet Fire, Inc. Patient Safety Group (A Component of Helmet Fire, Inc. of its status as a Patient Safety Organization (PSO). The Patient Safety and Quality Improvement Act of 2005 (Patient Safety Act), Public Law 109–41, 42 U.S.C. 299b–21—b–26, provides for the formation of PSOs, which collect, aggregate, and analyze confidential information regarding the quality and safety of health care delivery. The Patient Safety and Quality Improvement Final Rule (Patient Safety Rule), 42 CFR Part 3, authorizes AHRQ, on behalf of the Secretary of HHS, to list as a PSO an entity that attests that it meets the statutory and regulatory requirements for listing. A PSO can be ‘‘ delisted’’ by the Secretary if it is found to no longer meet the requirements of the Patient Safety Act and Patient Safety Rule, including when a PSO chooses to voluntarily relinquish its status as a PSO for any reason.

**DATES :**  The directories for both listed and delisted PSOs are ongoing and reviewed weekly by AHRQ. The delisting was effective at 12 Midnight ET (2400) on October 13, 2010.

**ADDRESSES :**  Both directories can be accessed electronically at the following
HHS Web site: http:// www.pso.AHRQ.gov/index.html.

**FOR FURTHER INFORMATION CONTACT :**  Diane Cousins, RPh., Center for Quality Improvement and Patient Safety, AHRQ, 540 Gaither Road, Rockville, MD 20850; Telephone (toll free): (866) 403–3697; Telephone (local): (301) 427–1111; TTY (toll free): (866) 438–7231; TTY (local): (301) 427–1130; E-mail: pso@AHRQ.hhs.gov. **SUPPLEMENTARY INFORMATION :** 
Background

The Patient Safety Act authorizes the listing of PSOs, which are entities or component organizations whose mission and primary activity is to conduct activities to improve patient safety and the quality of health care delivery.

HHS issued the Patient Safety Rule to implement the Patient Safety Act. AHRQ administers the provisions of the Patient Safety Act and Patient Safety Rule (PDF file, 450 KB. PDF Help) relating to the listing and operation of PSOs. Section 3.108(d) of the Patient Safety Rule requires AHRQ to provide public notice when it removes an organization from the list of federally approved PSOs. AHRQ has accepted a notification from Helmet Fire, Inc. Patient Safety Group (A Component of Helmet Fire, Inc., PSO number P0023, to voluntarily relinquish its status as a PSO. Accordingly, Helmet Fire, Inc. Patient Safety Group (A Component of Helmet Fire, Inc) was delisted effective at 12 Midnight ET (2400) on October 13,

2010.

More information on PSOs can be obtained through AHRQ’s PSO Web site

at http://www.pso.AHRQ.gov/
index.html.

Dated: November 24, 2010. Carolyn M. Clancy,

Director.

[FR Doc. 2010–30267 Filed 12–2–10; 8:45 am]

**BILLING CODE 4160–90–M**

**DEPARTMENT OF HEALTH AND**
**HUMAN SERVICES**

**Agency for Healthcare Research and Quality** 

**Patient Safety Organizations: Voluntary Delisting** 

**AGENCY :**  Agency for Healthcare Research and Quality (AHRQ), HHS.

**ACTION :**  Notice of Delisting.

**SUMMARY :**  AHRQ has accepted a notification of voluntary relinquishment from Human Performance Technology Group, Inc. of its status as a Patient Safety Organization (PSO). The Patient Safety and Quality Improvement Act of 2005 (Patient Safety Act), Public Law 109–41, 42 U.S.C. 299b–21—b–26, provides for the formation of PSOs, which collect, aggregate, and analyze confidential information regarding the quality and safety of health care delivery. The Patient Safety and Quality Improvement Final Rule (Patient Safety Rule), 42 CFR Part 3, authorizes AHRQ,