(vi) * * * "Medicare pays for things differently based on the site of care, paying more or less for the same service, but different locations," Verma said in a speech last month. "Now sometimes it makes sense, as some facilities provide a higher level of service. But other times, it creates misaligned incentives -- decisions about whether a patient receives a service in a hospital or in a doctor's office is influenced by how Medicare pays."
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77. Section 423.564 is amended by revising paragraph (b) to read as follows: Search Plan Resources
We have also engaged NCQA and the PQA to examine their measure specifications used in the Star Ratings program to determine if re-specification is warranted. The majority of measures used for the Star Ratings program are consensus-based. Measure specifications can be changed only by the measure steward (the owner and developer of the measure). Thus, measure scores cannot be adjusted for differences in enrollee case mix unless required by the measure steward. Measure re-specification is a multiyear process. For example, NCQA has a standard process for reviewing any measure and determining whether a measure requires re-specification. NCQA's re-evaluation process is designed to ensure any resulting measure updates have desirable attributes of relevance, scientific soundness, and feasibility:
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