Despite the submission of AASM comments urging the Centers for Medicare & Medicaid Services (CMS) to retain all four of the AASM-stewarded sleep apnea measures in the Merit-based Incentive Payment System (MIPS), CMS finalized the removal of two measures for the 2019 reporting year and 2021 payment year.

The following sleep apnea measures will be removed from the program:

QPP #276 – Sleep Apnea: Assessment of Sleep Symptoms

QPP #278 – Sleep Apnea: Positive Airway Pressure Therapy Prescribed

CMS stated that measure 276 was removed because it is duplicative of QPP #277 (Sleep Apnea: Severity Assessment at Initial Diagnosis), the measure lacked a quality action for a positive assessment, and it did not require the use of a standardized tool. Measure 278 was removed because it is duplicative of QPP #279 (Sleep Apnea: Assessment of Adherence to Positive Airway Pressure Therapy), and CMS thought measure 279 was more robust in requiring assessment of adherence to therapy.

CMS also noted that neither measure assesses a clinical outcome, and neither one is included in the MIPS high priority areas, despite AASM explaining how these should be categorized as patient safety measures.  Measures 277 and 279 will remain in the MIPS program and also will be included in the internal medicine specialty measure set.

Although this decision further limits the number of sleep medicine-specific measures that are available for reporting, AASM urges eligible sleep medicine professionals to review the measure list on the Quality Payment Program website, once updated to include 2019 measures, to identify additional measures to report.  Some measures that may be reportable by sleep medicine professionals include:

Preventive Care and Screening measures

  • #128 – Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
  • #134 – Preventive Care and Screening: Screening for Depression and Follow-Up Plan
  • #226 – Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
  • #317 – Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
  • #431 – Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling

Additional Process measures

  • #130 – Documentation of Current Medications in the Medical Record

Outcome measures

  • #236 – Controlling High Blood Pressure (Intermediate outcome measure)
  • #321 – CAHPS for MIPS Clinician/Group Survey (Patient-reported outcome measure)

You can review the final rule from CMS to see the complete list of measures finalized for inclusion and removal for the 2019 reporting year.

Learn how to report using MIPSwizard.