Monday, May 10, 2021

Brief Blog: CMS Releases Inpatient Rule, Says Nothing About SEP-1 Despite Controversy

I posted some earlier remarks on the recent release of Medicare's FY2022 inpatient proposed rule, which is open for comment until June 28, 2021.  For example, I discussed the multiple AI software devices being discussed for inpatient new tech add-on payments.

On May 10, CMS officially published the Federal Register version - hereComments to June 28.

In other news, the NTAP section runs about 200 of the 700 pages (25203-25395, PDF 134-326). Turning to SEP1.

Nothing About SEP-1

Nothing about CMS's increasingly debate-ridden SEP-1 measure.  

The proposed rule just says that SEP-1 is officially slated to remain in place for FY2023 (p. 25583), FY2024 (p. 25584), FY2025 (p. 25586), FY2026 (p. 25587).  They say this by listing the name of the measure in the tables for each year.

In mid-2020, IDSA sharply criticized SEP-1 and officially called for changes in the measure.   Herehere.  See also an Op Ed by Rhee, "Time to Improve Sep-1," here.

In April 2021, see a major negative paper by Barbash et al. with Op Ed by Klompas.  Herehere.  (For much additional literature, see the bibliographies of these two items.)  Klompas notes that one of the key things we need is better diagnostics.

In May 2021, see a brand guidance article by Yealy et al. (representing the Emergency Medicine specialty) and a boldly argued Op Ed by Harvard's Jeremey Faust (herehere).  

Faust notes the emerging body of negative publications about CMS SEP-1 may make it nearly impossible for NQF to re-affirm this measure when it comes up for review and vote this year.  He also notes that even Congress has weighed in on the SEP-1 issue and asked CMS to act (here, p. 144).


In March 2021, NQF Measures Applications Partnership reviewed a proposed episode-based economics measure for sepsis hospital care (for which physicians would be rated), here.  NQF MAP recommended against this.