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  2. CQM-6796

Use of High-Risk Medications in the Elderly

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    • Resolution: Answered
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    • Christine Mach
    • 7166564481
    • we cannot move forward with measure if we don't know impact
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      Thank you for your inquiry for CMS156v12 (2024 performance period). Below you find the responses to each scenario pertaining to this measure:

      - If a patient is prescribed a 30-day supply of Digoxin with 2 refills, they would only meet the criteria if the average daily dose of Digoxin prescribed is greater than 0.125 mg/d. The same would apply if a patient was prescribed a 30-day supply of Digoxin with 3 refills.

      - If two providers prescribe 1 high-risk medication each from a different drug class, then that would count as a failure within the measure. A patient would need to have been prescribed at least 2 high-risk medications from the same the drug class on different days to pass that criteria within the measure.

      - In regards to the final scenario, due to there being multiple rates within this measure, we would first need to know which medication is being referred to in the question before determining whether it would pass/fail the measure.
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      Thank you for your inquiry for CMS156v12 (2024 performance period). Below you find the responses to each scenario pertaining to this measure: - If a patient is prescribed a 30-day supply of Digoxin with 2 refills, they would only meet the criteria if the average daily dose of Digoxin prescribed is greater than 0.125 mg/d. The same would apply if a patient was prescribed a 30-day supply of Digoxin with 3 refills. - If two providers prescribe 1 high-risk medication each from a different drug class, then that would count as a failure within the measure. A patient would need to have been prescribed at least 2 high-risk medications from the same the drug class on different days to pass that criteria within the measure. - In regards to the final scenario, due to there being multiple rates within this measure, we would first need to know which medication is being referred to in the question before determining whether it would pass/fail the measure.
    • CMS0156v12
    • Use of high-risk medications in th elderly

      Ticket number: CS2165027. For measure pertaining to high risk medications in the elderly - example:

      If patient is prescribed Digoxin x 30 days and given 2 refills; no other high risk medications, does this measure pass? If same scenario, but 3 refills are given, does this measure fail?

      Also, if a provider prescribes a high-risk medication from one class (benzo) and a different provider prescribes a high-risk medication from another class (endocrine), will that count as a fail?

      Lastly, if a patient is prescribed a high-risk medication and given 120 tabs x 1 refill, but the patient can take up to 4 tabs a day, is that still exceeding the dosing for this measure?

       

            edave Mathematica EC eCQM Team
            cmach99 Christine Mach
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