Code of Massachusetts Regulations › 957 CMR - CENTER FOR HEALTH INFORMATION AND ANALYSIS › Title 957 CMR 4.00 - Uniform Provider Reporting Of The Standard Quality Measure Set › Section 4.04 - Reporting Requirements

Current through Register 1525, July 5, 2024
(1)
Use of Existing Data
. Whenever feasible, the Center
			 shall use currently reported data to calculate Provider performance on SQMS
			 measures in a uniform manner. The Center may request additional data from
			 Providers, including data derived from electronic health records and patient
			 registries, to calculate the SQMS quality measures.
(2)
Data Submission
			 Manual
.
The Center will prepare a draft
Data
			 Submission Manual
prior to requiring data submissions from Providers.
			 Providers will be given 30 days to submit written comments on the draft
Data Submission Manual.
The Center will issue a final
Data Submission Manual
following the deadline for written
			 comments and will notify Providers of its availability.
(3)
Data Submission
			 Process
. Each Provider shall submit data directly to the Center or
			 the Betsy Lehman Center in the format specified by the
Data Submission
			 Manual.
Data submissions must conform to specifications set forth in
			 the
Data Submission Manual
by the Center. The Center will
			 notify a Provider whether the submission has been accepted or rejected.
			 Providers must correct and resubmit rejected data until notified that the
			 submission has been accepted.
(4)
Reporting Requirement Changes
. Providers will be
			 notified of changes to the
Data Submission Manual
and
			 corresponding changes in reporting requirements by administrative bulletin.
			 Providers will be given 30 days to submit written comments on the proposed
			 revisions to the
Data Submission Manual.
The Center will
			 finalize revisions to the
Data Submission Manual
no fewer than
			 15 days after the deadline to submit written comments.
(5)
Audits
. Data
			 submissions are subject to audit through whatever mechanisms the Center deems
			 necessary, including but not limited to matching and validating data in the All
			 Payer Claims Database and the Hospital Discharge Database, or through medical
			 record review.
(6)
Data
			 Verification Process
.
(a) The
			 Center will provide each Provider with a summary report of the data submitted
			 for review and verification. These reports will provide aggregate results
			 (aggregated to the reporting Provider level as defined in
			 957 CMR 4.02 ) of the
			 SQMS measures based on the data submitted by the Provider or collected through
			 alternative mechanisms as specified in the
Data Submission
			 Manual.
(b) Prior to the
			 Center's public release of Provider performance data on the SQMS, the Provider
			 will have an opportunity to correct and resubmit data or to provide comments. A
			 Provider may request the Center's approval to amend the Provider's data
			 submission. Regardless of whether the Center grants approval for data
			 resubmission or amendment, Provider comments shall be included in the public
			 data release.
(c) Providers will be
			 notified by the Center at least 15 days in advance of the publication or
			 release of Provider-specific data.