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CMS-1403-FC 2009 PQRI quality measure set that is required to be finalized via publication in the Federal Register by November 15, 2008 in accordance with section 1848(k)(2)(B)(iii) of the Act. However, we have captured these recommendations and will have them available for consideration in identifying measure sets for future years’ PQRI and other initiatives to which those measures may be pertinent or possibly to be introduced as part of a PQRI Test Measures Process. Comment: We received a few comments that suggested that some measures are not conducive to claims-based reporting but are good measures if submitted via a registry or an EHR. Response: We are not finalizing the proposal to allow submission of clinical quality data extracted from EHRS for the 2009 PQRI. We, however, agree that some measures are not conducive to claims-based reporting. For the 2009 PQRI, there are 18 measures that will only be accepted for reporting via registries due to their complex measure specifications, which require multiple diagnosis codes; a low number of satisfactory submissions during the 2007 PQRI; and a high occurrence of inaccurate quality date codes reporting for the 2007 PQRI. These measures are 608

CMS-1403-FC identified in Tables 15, 16, 18, and 22 with a “+” after the Measure Title. For the 2009 PQRI, the following 5 quality measures in Table 15 will be reportable only through registries as individual quality measures: ● Measure #7 CAD: Beta-Blocker Therapy for CAD Patients with Prior Myocardial Infarction (MI) ● Measure #33 Stroke and Stroke Rehabilitation: Anticoagulant Therapy Prescribed for Atrial Fibrillation at Discharge ● Measure #46 Medication Reconciliation: Reconciliation After Discharge from an Inpatient Facility ● Measure #81 End-Stage Renal Disease (ESRD): Plan of Care for Inadequate Hemodialysis in ESRD Patients ● Measure #82 ESRD: Plan of Care for Inadequate Peritoneal Dialysis The following 8 quality measures in Tables 16 and 22 will be reportable only through registries as individual quality measures or part of the CABG measures group for the 2009 PQRI: ● CABG: Prolonged Intubation (Ventilation) ● CABG: Deep Sternal Wound Infection Rate ● CABG: Stroke/Cerebrovascular Accident (CVA) ● CABG: Post-operative Renal Insufficiency 609

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

identified in Tables 15, 16, 18, and 22 with a “+” after<br />

the Measure Title.<br />

For the 2009 PQRI, the following 5 quality measures in<br />

Table 15 will be reportable only through registries as<br />

individual quality measures:<br />

● Measure #7 CAD: Beta-Blocker Therapy for CAD<br />

Patients with Prior Myocardial Infarction (MI)<br />

● Measure #33 Stroke and Stroke Rehabilitation:<br />

Anticoagulant Therapy Prescribed for Atrial Fibrillation at<br />

Discharge<br />

● Measure #46 Medication Reconciliation:<br />

Reconciliation After Discharge from an Inpatient Facility<br />

● Measure #81 End-Stage Renal Disease (ESRD): Plan of<br />

Care for Inadequate Hemodialysis in ESRD Patients<br />

● Measure #82 ESRD: Plan of Care for Inadequate<br />

Peritoneal Dialysis<br />

The following 8 quality measures in Tables 16 and 22<br />

will be reportable only through registries as individual<br />

quality measures or part of the CABG measures group for the<br />

2009 PQRI:<br />

● CABG: Prolonged Intubation (Ventilation)<br />

● CABG: Deep Sternal Wound Infection Rate<br />

● CABG: Stroke/Cerebrovascular Accident (CVA)<br />

● CABG: Post-operative Renal Insufficiency<br />

609

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