PPS-Exempt Cancer Hospital (PCH) Quality Reporting Program

Overview

The PCH Quality Reporting Program is intended to equip consumers with quality-of-care information to make more informed decisions about healthcare options. It is also intended to encourage hospitals and clinicians to improve the quality of inpatient care that is provided to Medicare beneficiaries. A major part of the program supports improvement by ensuring that providers are aware of and reporting on best practices for their respective facilities and type of care. Section 1866(k) of the Social Security Act sets forth the requirements for the PCH Quality Reporting Program and applies to hospitals described in section 1886(d)(1)(B)(v) of the Social Security Act as PPS-exempt Cancer Hospitals (PCHs). The PCHs are excluded from payment under the inpatient prospective payment system (IPPS). 

To meet the PCH Quality Reporting Program requirements, PCHs are required to submit specific quality measures related to the PCH Quality Reporting Program to the Centers for Medicare & Medicaid Services (CMS). Participating facilities must publicly report measure results on the data.catalog on data.cms.gov. 

PPS-Exempt Cancer Hospital (PCH) Quality Reporting  Program Eligibility

Eligible hospitals are described in section 1886(d)(1)(B)(v) and referred to as a Prospective Payment System (PPS)-Exempt Cancer Hospitals, or PCHs. These hospitals are excluded from payment under the Inpatient Prospective Payment System. The Centers for Medicare & Medicaid Services (CMS) has designated 11 hospitals as PPS-Exempt Cancer Hospitals, or Medicare PPS-Excluded Cancer Hospitals.

Final Rules for Hospital Inpatient Prospective Payment Systems

Information regarding the PCH Quality Reporting Program can be found in the following Inpatient Prospective Payment System and Long-Term Care Hospitals Prospective Payment System (IPPS/LTCH) Final Rule (FR) publications. (Previous Year Rules)

• FY 2027 IPPS LTCH PPS Final Rule (50008-50018) CMS hereby finalized the removal of the COVID-19 Vaccination Coverage Among Healthcare Personnel measure. Finalized the adoption of two electronic clinical quality measures (eCQMs): Advance Care Planning eCQM and Malnutrition Care Score eCQM.
• FY 2026 IPPS/LTCH PPS Final Rule (pages 37027-37032) CMS hereby finalized the removal of three measures: Hospital Commitment to Health Equity, Screening for Social Drivers of Health, and Screen Positive Rate for Social Drivers of Health. Finalized an update and codification of the ECE policy. Finalized modification to the public reporting requirements to allow for public reporting PCHQR Program data on the Compare tool in addition to current publication on the Provider Data Catalog.

Refer to the Federal Register for other official Medicare Final Rule publications.