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  1. eCQM Issue Tracker
  2. CQM-4881

Revise medication duration language to align with intent and logic

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Details

    • EP/EC eCQMs
    • Status: Open
    • Moderate
    • Resolution: Unresolved
    • None

    Description

      Brief Description of Measure:

      CMS136: Follow-Up Care for Children Prescribed ADHD Medication (ADD):
      Percentage of children 6-12 years of age and newly dispensed a medication for attention-deficit/hyperactivity disorder (ADHD) who had appropriate follow-up care. Two rates are reported.
      a. Percentage of children who had one follow-up visit with a practitioner with prescribing authority during the 30-Day Initiation Phase.
      b. Percentage of children who remained on ADHD medication for at least 210 days and who, in addition to the visit in the Initiation Phase, had at least two additional follow-up visits with a practitioner within 270 days (9 months) after the Initiation Phase ended.

      Description of Issue:

      ​The measure intent is to look for patients remaining on medication for at least 210 days during the 301-day period, beginning on the Index Prescription Start Date (IPSD) through 300 days after the IPSD, because a patient can start taking medication on the day of the IPSD. The current header states: "at least 210 days out of the 300 days following the IPSD", which does not include IPSD.​

      To align with measure intent and current logic, NCQA will update the header so it is clear that the requirement is to look for patients remaining on medication for at least 210 days during the 301-day period, beginning on IPSD through 300 days after the IPSD.

      Proposed Solution:

      ​Before
      //Header: Initial Population
      Initial Population 2: Children 6-12 years of age who were dispensed an ADHD medication during the Intake Period and who remained on the medication for at least 210 days out of the 300 days following the IPSD, and who had a visit during the measurement period.

      After
      //Header: Initial Population
      ... at least 210 days during the 301-day period, beginning on the IPSD through 300 days after the IPSD....

      Rationale for Change:

      ​The goal of this change is to clarify in the header description the timeframe required by the measure.

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            khancock Mathematica EC eCQM Team
            sgearhart Mathematica EH eCQM Team
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            Dates

              Created:
              Updated: