Hospital OQR and ASCQR drop the colonoscopy follow-up measure; OQR validation adds eCQM scoring, a 3-year lag between reporting and payment determination, and smaller samples; REH program unchanged
Published November 8, 2026 · Coverage November 1–7, 2026, Pacific · Lower priority
CMS removed the Appropriate Follow-Up Interval for Normal Colonoscopy in Average Risk Patients measure from both the Hospital Outpatient Quality Reporting (OQR) and Ambulatory Surgical Center Quality Reporting (ASCQR) Programs beginning with the CY 2027 reporting period/CY 2029 payment determination, and made no other OQR measure-set changes. For OQR validation, CMS will validate each electronic clinical quality measure (eCQM) once a full year of data exists, give hospitals separate chart-abstracted and eCQM validation scores, move to a 3-year lag between reporting period and payment determination from the CY 2030 payment determination, and sample up to 28 cases per applicable measure per year (up to 7 per quarter; the proposal was up to 8 per quarter). The 75 percent eCQM validation threshold is finalized with a modification: payment penalties start only after an eCQM's first full mandatory year; for the ST-Segment Elevation Myocardial Infarction (STEMI) eCQM, CY 2027 data is educational except for failure to submit at least 75 percent of requested records. Beginning with data from the CY 2026 reporting period affecting the CY 2028 payment determination, hospitals no longer resubmit materials previously submitted to CMS with a validation reconsideration request, unless CMS specifically requests them. No changes were made to the Rural Emergency Hospital (REH) Quality Reporting Program. The rule also summarizes comments on two requests for information (Advance Care Planning eCQM for OQR; stratification of the ambulatory surgical center (ASC) transfer/admission measure) without adopting anything.
Background
Under section 1833(t)(17)(A) of the Social Security Act, hospitals as defined in section 1886(d)(1)(B) of the Act that fail to report data required for the quality measures selected by the Secretary under the Hospital OQR Program incur a 2.0 percentage point reduction to their annual payment update factor, and the ASCQR Program has affected ASC payment rates since CY 2014. An earlier rule already requires hospitals to submit all four quarters of STEMI eCQM data beginning with the CY 2027 reporting period.
Who this affects
Hospitals in the Hospital OQR Program; ASCs in the ASCQR Program. REHs: no change.
Why it matters
Quality and health information management teams should plan for eCQM record requests and validation scoring, including the STEMI eCQM for CY 2027 data. Inference: hospitals with weak eCQM data mapping face a payment risk from CY 2031 determinations.
Required actions
- If selected for validation of CY 2027 STEMI eCQM data, submit at least 75 percent of requested records to avoid a payment penalty (CY 2030 payment determination)
Recommended action
- From the CY 2027 reporting period, stop abstraction work for the colonoscopy follow-up measure after confirming specifications on QualityNet
- Test eCQM data accuracy against source records before CY 2028 reporting
Scope and timing
- Authority status
- Final
- Responsible owner
- Quality / Health information management
- Publication date
- 2026-11-06
- Effective date
- 2027-01-01
- Other dates
- Measure removal from CY 2027 reporting period/CY 2029 payment determination; validation changes from CY 2030 payment determination; eCQM submission deadline May 15 (existing)
Not established
The revised regulation at 42 CFR 419.46(f)(3) provides for a random sample of up to 200 hospitals and up to an additional 200 hospitals selected on targeting criteria, beginning with validation affecting the CY 2030 payment determination. Tables 97 and 100 are images, not retrieved.
Sources
Complete edition and supplemental material
This article in the complete report →
Executive triage, source-coverage limitations, context and forward horizons remain in the complete report.
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