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Type:
EC eCQMs - Eligible Clinicians
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Resolution: Answered
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Priority:
Moderate
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Component/s: None
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None
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Basmy Basher
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2122639384
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NYU Langone
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CMS0142v14
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CMS0142v13
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CMS0142v12
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Current Impact: Non-ophthalmology providers are being penalized for not performing a communication task that is clinically and logically outside their scope of responsibility.
The clinical intent of Measure CMS 142, "Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care," is for the eye care specialist (ophthalmologist/retinal specialist) who performs the dilated exam to communicate the findings back to the primary care physician (PCP) or the physician managing the patient's diabetes.
However, the current logic of the measure does not restrict the "Performance" of the measure to ophthalmology providers. Instead, it identifies any patient who had the required exam and diagnosis during a broad set of encounters, and then scores the provider associated with that encounter. This forces PCPs and endocrinologists to be scored on a process where they are the recipient of the communication, not the sender.