Cervical Cancer Screening Measure Updates (CMS #124) Change Review Process Meeting September 17, 2015 Jenna Williams-Bader Anne Marie Smith Stephanie Rodriguez Confidential

Cervical Cancer Screening Measure Update Revise measure to align with updated guidelines – 2012 U.S. Preventive Services Task Force Recommends screening with cytology every 3 years for women 21-29 years of age (Grade A recommendation) Recommends screening with cytology every 3 years or co-testing (cytology and HPV testing) every 5 years for women 30-65 years of age (Grade A recommendation)

Current Numerator Measure intent is to capture appropriate cervical cancer screenings for women 21-64 years of age Numerator Statement Women with one or more pap tests during the measurement period or the two years prior to the measurement period Confidential

Current Numerator Current Logic AND: "Laboratory Test, Performed: Pap Test (result)" <= 2 year(s) ends before end of "Measurement Period" Confidential

Updated Numerator Women 21–64 years of age who were screened for cervical cancer using either of the following criteria: Women age 21–64 who had cervical cytology performed every 3 years Women age 30–64 who had cervical cytology/human papillomavirus (HPV) co-testing performed every 5 years

Numerator Update Updated Logic Numerator = OR: AND: Age >= 23 year(s) at: "Measurement Period" AND: Age < 64 year(s) at: "Measurement Period" AND: "Laboratory Test, Performed: Pap Test (result)" <= 2 year(s) ends before end of "Measurement Period" AND: "Occurrence A of Laboratory Test, Performed: Pap Test (result)" <= 4 year(s) ends before end of "Measurement Period" AND: "Laboratory Test, Performed: HPV Test (result)" starts concurrent with “Occurrence A of Laboratory Test, Performed: Pap Test (result)” AND: Age >= 30 year(s) at: " Occurrence A of Laboratory Test, Performed: Pap Test (result)” Confidential

Numerator Questions Does the updated numerator logic make sense? Does it capture the intent of the measure? The claims-based measure specifies that the cervical cytology and the HPV test should occur 4 or less days apart Is this needed for an e-measure?

Next Steps: Public Comment Revised changes will be posted to JIRA for a two-week public comment period Comments will be reviewed and presented at the next CRP meeting before a final decision is made Measures updates will be implemented during Annual Update 2016

Question about HIV-PCP Question received through JIRA - Two medications, Dapsone and Pyrimethamine, (a combination option in the guidelines) no longer available in the U.S. Does anyone have more information about this? Should this medication combination be taken out of the specification?