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<strong>CMS</strong>-1403-FC<br />

administrative or judicial review under sections 1869 or<br />

1879 of the Act, or otherwise of (1) the determination of<br />

measures applicable to services furnished by eligible<br />

professionals; (2) the determination of satisfactory<br />

reporting; and (3) the determination of any incentive<br />

payment. Therefore, we have no authority to establish an<br />

appeals process for the subject of eligible professionals<br />

“not deemed to be successful” which we read to fall within<br />

the determination of satisfactory reporting.<br />

Comment: We received numerous comments providing general<br />

recommendations for enhancing the Medicare program, such as<br />

suggestions to transition the PQRI from a pay-for-reporting<br />

program to a pay-for-performance program as quickly as<br />

possible; addressing problems of underuse, overuse, and<br />

misuse of services; assuring that all Americans receive the<br />

right care by reducing health care disparities and<br />

encouraging that quality care be provided to at-risk<br />

populations; encouraging care coordination and support for<br />

the integration and delivery of services across providers<br />

and across care settings; and providing payment that<br />

supports the re-engineering of care, such as providing<br />

payment for e-visits and efficiency-enhancing forms of<br />

telemedicine. One commenter expressed a desire to see the<br />

development of a quality reporting mechanism similar to the<br />

533

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