Compliance Monitor (02/04/2025)

Overall respiratory illness activity in the United States 

What to know 

• As of January 31, 2025, the amount of acute respiratory illness causing people to seek healthcare is at a high level.
• Seasonal influenza activity remains elevated and continues to increase across the country.
• COVID-19 activity is elevated in many areas of the country.

https://www.cdc.gov/respiratory-viruses/data/index.html

The Centers for Medicare & Medicaid Services (CMS) is granting exceptions¹ under certain Medicare quality reporting and value-based purchasing programs to providers and facilities located in areas affected by the California Wildfires and Straight-line Winds as identified by both Department of Health and Human Services (HHS) Public Health Emergency (PHE) declarations HHS.GOV.PHE.CA  Wildfires_January 2025, and the Federal Emergency Management Agency (FEMA) disaster declarations DR-4856-CA to assist these providers and facilities while they direct their resources toward caring for their patients and addressing potential infrastructure challenges affecting their healthcare operations. 

Affected areas covered by these exceptions are detailed on the Designated Areas: Disaster 4856  pages, under the section Public Assistance, designations PA-A and PA-B, of the FEMA website. If FEMA expands the emergency disaster declaration to include additional affected areas at a later date, CMS will likewise extend reporting requirement exceptions to accommodate these areas but will not necessarily publish updated communications. 

At the time of this communication, the exceptions being granted are for the reporting requirements and deadlines as detailed in the table below. 

¹ The terminology “exception” is used as a general term intended for ease of reference, to collectively refer to policies established under separate programs, and may not be consistent with the specific terminology established under each individual program 

The Centers for Medicare & Medicaid Services (CMS) is extending the exceptions¹previously granted under certain Medicare quality reporting and value-based purchasing programs to providers and facilities located in areas affected in the states of Georgia, North Carolina, and Tennessee by Hurricanes Helene, as identified by both Department of Health and Human Services (HHS) Public Health Emergency (PHE) renewal declarations (https://aspr.hhs.gov/legal/PHE/Pages/Helene-Renewal-27Dec24.aspx) and the Federal Emergency Management Agency (FEMA) disaster declarations (DR-4830-GA, DR-4827-NC, DR-4832- TN) to assist these providers and facilities while they direct their resources toward caring for their patients and addressing potential infrastructural challenges affecting their healthcare operations. 

Affected areas covered by these exceptions are detailed on the Designated Areas: Disaster 4830; Disaster  4827; and Disaster 4832 pages, under the section Public Assistance, designations PA-A and PA-B, of the FEMA website. If FEMA expands the emergency disaster declaration to include additional affected areas at a later date, CMS will likewise extend reporting requirement exceptions to accommodate these areas but will not necessarily publish updated communications. 

At the time of this communication, the exceptions being granted are for the reporting requirements and deadlines as detailed in the table below. 

¹ The terminology “exception” is used as a general term intended for ease of reference, to collectively refer to policies established under separate programs, and may not be consistent with the specific terminology established under each individual program. 

The Preliminary January 2025 IPRs for the expanded HHVBP Model have been published on the Internet Quality Improvement and Evaluation System (iQIES). The quarterly IPRs provide home health agencies (HHAs) with the cohort assignment, performance year measure data for the 12 most recent months, and the interim Total Performance Score (TPS). Using the IPRs, an HHA can assess and track their performance relative to peers in their respective cohort throughout the expanded Model performance year. 

The January 2025 IPRs include a new worksheet (“CY 2025 Baseline”) that reports on your HHA’s preliminary Improvement Thresholds for the CY 2025 applicable measure set. Note that Improvement Thresholds are based on CY 2023 data for all measures in the CY 2025 measure set other than the DTC-PAC measure. For the DTC-PAC measure, CY 2022 and CY 2023 data are used.   

An HHA receives a January 2025 IPR if the HHA: 

• Was Medicare certified prior to January 1, 2023, and 

• Meets the minimum threshold of data for at least one (1) quality measure in the quarterly reporting period for the performance year shown in Exhibit 1.  

Exhibit 1: January 2025 IPR quality measure performance scores time periods for each measure category 

Note: IPRs are only available to HHAs through iQIES. IPRs are not available to the public. 

https://www.cms.gov/priorities/innovation/files/hhvbp-newsletter-dec-2024.pdf