Quality Improvement

All issuers offering QHPs through the Exchanges that meet the Quality Improvement Strategy (QIS) participation criteria must comply with the QIS requirements as a condition of certification and participation in the Exchanges. CMS annually publishes the QIS Technical Guidance and User Guide, a detailed guide to the QIS requirements, and the QIS Implementation Plan and Progress Report Form, which is the QIS reporting tool for issuers applying for QHP certification.

In April 2020, CMS released the COVID-19 Marketplace Quality Initiatives Memo to announce that CMS suspended activities related to the collection and reporting of clinical quality measure information related to QIS submissions. In line with this guidance, issuers applying for QHP certification in the Exchanges for the 2021 plan year that met the applicable QIS participation criteria were not expected to submit a QIS Implementation Plan and Progress Report Form during the 2021 QHP Application Submission and Review Period.

Plan Year 2022 QIS Issuer List

CMS intends to resume quality data collection for PY2022 QHP certification. In order to address impacts of suspension of QIS collection for PY2021, CMS will combine the PY2021 and PY2022 QIS Issuer Lists to develop a list for issuers to review and verify their eligibility for PY2022 QIS submission.

This will allow submissions from a more inclusive group of issuers, minimizing the amount of data lost due to the interruptions caused by COVID-19, while remaining consistent with the requirement of two years of reporting progress.

CMS plans to post a draft QIS Issuer List in the spring of 2021 to allow issuers to review and identify any discrepancies as well.

Please direct any questions about the PY2022 QIS Issuer List to CMS_FEPS@cms.hhs.gov with the subject “QIS.”