Extraordinary Circumstances

ESRD Quality Incentive Program (QIP)

CMS offers a process for dialysis facilities to request, and for CMS to grant, exemptions when extraordinary circumstances occur beyond the control of the facility. In this way, CMS ensures that facility performance during the extraordinary circumstance does not factor into ESRD QIP scores.

In the event of such circumstances, dialysis facilities must submit an Extraordinary Circumstances Exceptions (ECE) Request Form* (PDF-71 KB), with all required questions completed. The facility may request consideration for an exemption from the ESRD QIP for that payment year. The form must be signed by the dialysis facility’s chief executive officer (CEO) or designee, and submitted via email to the ESRD QIP Mailbox at ESRDQIP@cms.hhs.gov. This form must be submitted within 90 days of the extraordinary circumstances event for the ESRD QIP.

In September 2017, CMS issued several memoranda granting exceptions under certain Medicare quality reporting and value-based purchasing programs for facilities impacted by the 2017 Hurricanes. As a part of this effort, the ESRD QIP has issued a Frequently Asked Questions (FAQ) document offering additional clarification around how facilities will be impacted by these exceptions. CMS has released a Blanket Waiver spreadsheet containing the facilities that will be included in the ESRD QIP ECE for a portion of the PY 2019 ESRD QIP.

*Note: This process does not preclude CMS from granting exemptions to dialysis facilities when it is determined that an extraordinary circumstance, such as an act of nature, affects an entire region or locale. If CMS makes the determination to grant an exemption to dialysis facilities in a region or locale, then CMS will communicate this decision to facilities, vendors, and ESRD Networks through routine communication channels, including memos, emails, and notices on QualityNet.

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