CMS releases guidance on state-directed payment quality evaluations

The Centers for Medicare & Medicaid Services yesterday issued guidance on state-directed payment quality evaluations, clarifying the minimum elements necessary for CMS review of SDP renewals or applications. The requirements include a description of how the SDP explicitly ties to goals and objectives in a state's managed care program quality strategy; an evaluation plan with specific evaluation measures, with each to include baseline statistics, the baseline year and a measurable performance target for improvement or attainment against the baseline measure; and CMS' expectation that states that request renewal of an SDP in place for at least two rating periods to provide complete evaluation results based on the evaluation plan provided in prior preprint submissions. The guidance also reminds states about the availability of technical assistance resources, as well as best practices for SDP evaluation plans and reporting evaluation findings.