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IPPS Measure Exceptions Form Centers for Medicare & Medicaid Services (CMS) Hospital Inpatient Quality Reporting (IQR) Program Hospital Associated Infection (HAI) Exception Form. Hospital Associated Infection (HAI) Exception Form

IPPS Measure Exceptions Form Centers for Medicare & Medicaid Services (CMS) Hospital Inpatient Quality Reporting (IQR) Program Hospital Associated Infection (HAI) Exception Form. Hospital Associated Infection (HAI) Exception Form 2025

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4.2 out of 5

47 votes

The document outlines the Measure Exception Form for the Inpatient Prospective Payment System (IPPS) Quality Reporting Programs by the Centers for Medicare & Medicaid Services (CMS). It details the process for hospitals to request exceptions for specific quality measures related to Perinatal Care, Emergency Department services, and Healthcare-Associated Infections. The form must be renewed annually and includes required fields for hospital information and applicable reporting periods. It also specifies eligibility criteria for exceptions based on hospital capabilities and outlines submission instructions.

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Click ‘Get Form’ to open it in the editor.
Begin by filling out the required fields marked with an asterisk (*). Start with the 'IPPS Measure Exception Information' section, selecting all applicable measures such as Perinatal Care, Emergency Department, and Healthcare-Associated Infection.
Specify the applicable quarter(s) for your Measure Exception request. Ensure you enter the correct Calendar Year (YYYY) and select the relevant time frame.
Complete the 'Facility Contact Information' section by entering your CMS Certification Number, Facility Name, and CEO/Designee details including their name, title, email address, and telephone number.
Certify that your facility meets the exception criteria by signing your name and providing your position before submitting the form.
Submit the completed form via email to QRSupport@hcqis.org or through secure fax or QualityNet Secure Portal as instructed.

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Versions	Form popularity	Fillable & printable
2019	4.8 Satisfied (140 Votes)
2016	4.2 Satisfied (47 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What are the measures of the hospital inpatient quality reporting program?

Hospital Inpatient Quality Reporting Program Measures These measures include indicators of patient safety, clinical process of care, patient experience of care (see CAHPS Hospital Survey below), maternal morbidity, mortality outcomes, coordination of care, and payment for specific diagnoses.

How many eCQMs are offered by the CMS IQR program?

Mandatory eCQM Reporting Requirements for the Hospital IQR Program. Hospitals must submit six eCQMs annuallythree CMS-mandated and three self-selectedfrom a menu of 15. All must be submitted using a certified EHR.

What is CMS APU?

Page 1 of 3. When the Centers for Medicare Medicaid Services (CMS) determines that a facility did not meet the Quality Reporting Program requirement(s) for the Annual Payment Update (APU), the facility may submit a request for reconsideration to CMS by the deadline identified on the APU Notification Letter.

What is the hospital inpatient quality program?

The Hospital Inpatient Quality Reporting (IQR) Program is a pay-for-reporting program for acute care hospitals. Under this program, CMS requires subsection (d) hospitals to submit data on quality measures to CMS each year.