Report finds star rating system does not follow federal guidelines

The Medicare five-star rating system, maintained by the Center for Medicaid and Medicare Services’ (CMS), has recently come under scrutiny by the Center for Regulatory Effectiveness (CRE). In a letter from last month, CRE officials report that multiple entities have contacted them about the system possibly violating federal regulations.

According to the letter, data from the rating system helps in determining rebates, eligibility and bonuses for patients.  Current law requires this information be posted on a federal register to receive comments from stakeholders.  CRE officials found CMS has instead been posting the information on their website and providing only summaries of comments. The report also notes that officials found little evidence of valid data collections. CRE was very critical in its report, mentioning if they were in the business of star ratings, CMS would receive only one star for establishing the system.

This is not the first time that the rating system has been examined; the letter states the program has been investigated at least three other times. CRE officials urge that the system needs to have an “independent expert review and test,” as it remains an important resource for consumers and providers looking for quality health facilities.  CRE emphasized the importance of ensuring quality and validity of the measures and data used in the star ratings program, a stance DPC has also taken throughout this process.

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