Here's extreme Medicare nerdism, but it's one I've never seen before.
CMS released a "typescript" or "inspection copy" of the Physician Fee Schedule annual rule on November 2, and the fully printed and typeset version appeared today November 19 in the Federal Register.
They've badly mispaginated it, which I assume they'll eventually correct.
If you go to the home page for this publication, the PFS rule, today, it's here:
And it gives a link to the PDF rule, and lists the pagination as 508 pages from page 65524-66031.
This pagination, and the document offered for download, are incorrect. They have posted a document that starts in the middle of the CY2022 PFS rule.
I tracked back and downloaded the entire Federal Register issue. The correct pagination is not 65524-66031, but 64996-66091 (about 1095 pages). Another observation is that, at 1095 pages, the PFS rule is almost the entire Federal Register for today (the whole issue is 1364 pages). The PFS weighs in at 165MB of a total of 174 MB.
See a discussion of the PFS rule CY2022 by Suzanne Michelle Joy at Holland & Knight, here.
400 Pages of Quality Measure Appendix
Up to Secretary Becerra's signature, on page 65686, it's 691 pages. After that, 400 pages of Appendix regarding quality measure rulemaking.
Anti-Racism Plan For Quality Measure Activities
On Page 65384, discussion of a quality measure anti-racism plan. The goal is to help "clinicians move beyond analyzing data, to taking real steps to naming and eliminating the causes of the racial disparities identified ." It includes "an organization's plan to prevent and address racism and/or improve language access and accessibility."
In Appendix 2: Improvement
Activities of this final rule, we
discussed an improvement activity
titled ‘‘create and implement an anti-
racism plan’’. This improvement
activity acknowledges it is insufficient
to gather and analyze data by race, and
document disparities by different
population groups. Rather, it
emphasizes systemic racism is the root
cause for differences in health outcomes
between socially defined racial groups.
Further, we also proposed to modify
five existing improvement activities to
address health equity. We note that
some improvement activities within our
current Inventory already aim to
improve equity. We believe further
modifying them can more explicitly link
the activity to health equity without
changing the core activity. In other
cases, our proposals to modify an
activity fundamentally shifts the activity
to focus on health equity specifically.
See tables, page 65969. A quality measure for anti-racism actions and activities in the healthcare setting implements Executive Order 13985, January 20, 2021.
For a 20p PDF of equity & quality measures discussions, see here.