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

2. 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 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 years of age (Grade A recommendation)

3. Current Numerator
Measure intent is to capture appropriate cervical cancer screenings for women 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

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

5. 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

6. 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

7. 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?

8. 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

9. 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?