Announcement of Requirements and Registration for the 2019 Million Hearts® Hypertension Control Challenge
| Citation | 84 FR 3447 |
| Record Number | 2019-01914 |
| Published date | 12 February 2019 |
| Section | Notices |
| Court | Centers For Disease Control And Prevention,Health And Human Services Department |
Federal Register, Volume 84 Issue 29 (Tuesday, February 12, 2019)
[Federal Register Volume 84, Number 29 (Tuesday, February 12, 2019)]
[Notices]
[Pages 3447-3449]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-01914]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
Announcement of Requirements and Registration for the 2019
Million Hearts[supreg] Hypertension Control Challenge
Authority: 15 U.S.C. 3719.
AGENCY: Centers for Disease Control and Prevention (CDC), Department of
Health and Human Services (HHS)
Award Approving Official: Robert R. Redfield, MD, Director, Centers
for Disease Control and Prevention, and Administrator, Agency for Toxic
Substances and Disease Registry
ACTION: Notice.
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SUMMARY: The Centers for Disease Control and Prevention (CDC) located
within the Department of Health and Human Services (HHS) announces the
launch of the 2019 Million Hearts[supreg] Hypertension Control
Challenge.
Million Hearts[supreg] is a national initiative to prevent one
million heart attacks and strokes by 2022. In order to prevent one
million events, we need to decrease smoking, sodium consumption and
physical inactivity by 20%; improve performance on appropriate aspirin
use, blood pressure control, cholesterol management, and smoking
cessation to 80%; and improve outcomes for priority populations. Over
the last five years, we have seen tremendous progress by providers and
health care systems that focus on improving their performance in
controlling patients' blood pressure. Getting to 80% control would mean
that 10 million more Americans with hypertension would have their blood
pressure under control, and be at substantially lower risk for strokes,
heart attacks and other events. For more information about the
initiative, visit https://millionhearts.hhs.gov/ .
The challenge is an important way to call attention to the need for
improved control, provides a powerful motivation and target for
clinicians, and will improve understanding of successful implementation
strategies at the health system level. It will identify clinicians,
clinical practices, and health systems that have exceptional rates of
hypertension control and recognize them as 2019 Million Hearts[supreg]
Hypertension Control Champions. To support improved quality of care
delivered to patients with hypertension, Million Hearts[supreg] will
document the systems, strategies, processes, and staffing that
contribute to the exceptional blood pressure control rates achieved by
Champions.
DATES: The Challenge will accept applications from February 14, 2019
through April 1, 2019.
FOR FURTHER INFORMATION CONTACT: Mary George, Division for Heart
Disease and Stroke Prevention, National Center for Chronic Disease
Prevention and Health Promotion, Centers for Disease Control and
Prevention, 4770 Buford Hwy. NE, Mailstop F-73, Chamblee, GA 30341,
Telephone: 770-488-2424, Email: millionhearts@cdc.gov; subject line of
email: Million Hearts Hypertension Control Challenge; Attention: Mary
George.
SUPPLEMENTARY INFORMATION:
Subject of Challenge Competition
The challenge is authorized by Public Law 111-358, the America
Creating Opportunities to Meaningfully Promote Excellence in
Technology, Education and Science Reauthorization Act of 2010 (COMPETES
Act).
Applicants for the 2019 Million Hearts[supreg] Hypertension Control
Challenge will be asked to provide two hypertension control rates for
the practice's or health system's hypertensive population: a current
rate for the most recent 12-month reporting period (e.g., 1/1/2018-12/
31/2018) and a previous rate for a 12-month period 1 year before the
most recent reporting period (e.g., 1/1/2017-12/31/2017). Applicants
will also be asked to provide the prevalence of hypertension in their
population (more details provided below), describe some population
characteristics (such as urban/rural location, percent minority,
percent enrolled in Medicaid, percent with no health insurance, and
percent whose primary language is not English) and strategies used by
the practice or health system that support continued improvements in
blood pressure control. A copy of the application form will be
available on the Challenge website for the duration of the Challenge.
Eligibility Rules for Participating in the Competition
To be eligible to be recognized as a Million Hearts[supreg]
Hypertension Control
[[Page 3448]]
Champion under this challenge, an individual or entity--
(1) Shall have completed the application form in its entirety to
participate in the competition under the rules developed by HHS/CDC;
(2) Shall have complied with all the requirements in this section
and satisfy the requirements in one of the following subparts:
a. Be a U.S. licensed clinician, practicing in any U.S. setting,
who provides continuing care for adult patients with hypertension. The
individual must be a citizen or permanent resident of the U.S.;
b. Be a U.S. incorporated clinical practice, defined as any
practice with two or more U.S. licensed clinicians who by formal
arrangement share responsibility for a common panel of patients,
practice at the same physical location or street address, and provide
continuing medical care for adult patients with hypertension;
c. Be a health system, incorporated in and maintaining a primary
place of business in the U.S., that provides continuing medical care
for adult patients with hypertension. We encourage large health systems
(those that are comprised of a large number of geographically dispersed
clinics and/or have multiple hospital locations) to consider having one
or a few of the highest performing clinics or regional affiliates apply
individually instead of the health system applying as a whole;
(3) Must treat all adult patients with hypertension in the practice
seeking care, not a selected subgroup of patients;
(4) Must have a data management system (electronic or paper) that
allows HHS/CDC or their contractor to verify data submitted;
(5) Must treat a minimum of 500 adult patients annually and have a
hypertension control rate of at least 80%;
(6) May not be a Federal entity or Federal employee acting within
the scope of their employment;
(7) An HHS employee must not work on their application(s) during
assigned duty hours;
(8) Shall not be an employee of or contractor at CDC;
(9) Must agree to participate in a data validation process to be
conducted by a reputable independent contractor. Data will be kept
confidential by the contractor to the extent applicable law allows and
will be shared with the CDC, in aggregate form only (e.g., the
hypertension control rate for the practice not individual patients'
hypertension values);
(10) Must agree to sign, without revisions, a Business Associate
Agreement with the contractor conducting the data validation.
(11) Must have a written policy in place about conducting periodic
background checks on all providers and taking appropriate action based
on the results of the check. CDC's contractor may also request to
review the policy and any supporting information deemed necessary. In
addition, a health system background check will be conducted by CDC or
a CDC contractor that includes a search for The Joint Commission
sanctions and current investigations for serious institutional
misconduct (e.g., attorney general investigation). Eligibility status,
based upon the above-referenced written policy, appropriate action, and
background check, will be determined at the discretion of the CDC
consistent with CDC's public health mission.
(12) Must agree to be recognized if selected and agree to
participate in an interview to develop a success story that describes
the systems and processes that support hypertension control among
patients. Champions will be recognized on the Million Hearts[supreg]
website. Strategies used by Champions that support hypertension control
may be written into a success story, placed on the Million
Hearts[supreg] website, and attributed to Champions.
In addition to meeting the requirements listed in parts 1-12 above,
to be eligible to be recognized in the challenge, an individual or
entity also must comply with the conditions or requirements set forth
in each of the following paragraphs in this section.
Federal funds may not be used to develop COMPETES Act challenge
applications or to fund efforts in support of a COMPETES Act challenge.
Individual applicants and individuals in a group practice must be
free from convictions for or pending investigations of criminal and
health care fraud offenses such as felony health care fraud, patient
abuse or neglect; felony convictions for other health care-related
fraud, theft, or other financial misconduct; and felony convictions
relating to unlawful manufacture, distribution, prescribing, or
dispensing of controlled substances as verified through the Office of
the Inspector General List of Excluded Individuals and Organizations.
http://oig.hhs.gov/exclusions/background.asp.
Individual applicants must be free from serious sanctions, such as
those for misuse or mis-prescribing of prescription medications.
Eligibility status of individual applicants with serious sanctions will
be determined at the discretion of CDC. CDC or CDC's contractor may
perform background checks on individual clinicians and medical
practices.
Champions previously recognized through the 2013, 2014, 2015, 2017,
and 2018 Million Hearts[supreg] Hypertension Control Challenges retain
their designation as a ``Champion'' and are not eligible to be named a
Champion in the 2019 challenge.
An individual or organization shall not be disqualified from the
2019 Million Hearts Hypertension Control Challenge for utilizing
Federal facilities or consulting with Federal employees during a
competition so long as the facilities and Federal employees are made
available to all individuals and organizations participating in the
competition on an equal basis.
By participating in this challenge, an individual or organization
agrees to assume any and all risks related to participating in the
challenge. Individuals or organizations also agree to waive claims
against the Federal Government and its related entities, except in the
case of willful misconduct, when participating in the challenge,
including claims for injury; death; damage; or loss of property, money,
or profits, and including those risks caused by negligence or other
causes.
By participating in this challenge, individuals and organizations
agree to protect the Federal Government against third party claims for
damages arising from or related to challenge activities.
Individuals or organizations are not required to hold liability
insurance related to participation in this challenge.
No cash prize will be awarded. Champions will receive national
recognition.
Registration Process for Participants
To participate and submit an application, interested parties should
go to https://millionhearts.hhs.gov or https://www.challenge.gov. On
this site, applicants will find the application form and the rules and
guidelines for participating. Information required of the applicants on
the application form includes:
The size of the applicant's adult primary care patient
population, a summary of known patient demographics (e.g., age
distribution), and any noteworthy patient population characteristics
(such as urban/rural location, percent minority, percent enrolled in
Medicaid, percent with no health insurance, and percent whose primary
language is not English).
The number of the applicant's adult primary care patients,
ages 18-85, who were seen during the measurement year
[[Page 3449]]
and had a hypertension diagnosis (i.e. hypertension prevalence).
The applicant's current hypertension control rate for
their hypertensive population ages 18-85 during the measurement year is
required. In determining the hypertension control rate, CDC defines
``hypertension control'' as a blood pressure reading The hypertension control rate should be for the provider's
or health system's entire adult hypertensive patient population ages
18-85, and not limited to a sample. The provider's or health system's
hypertensive population ages 18-85 should include only patients in
primary care or in cardiology care in the case of a cardiology clinic.
Patients seen only in dental care or behavioral health care should not
be included. Examples of ineligible data submissions include
hypertension control rates that are limited to treatment cohorts from
research studies or pilot studies, patients limited to a specific age
range (such as 18-35 only), or patients enrolled in limited scale
quality improvement projects.
Completion of a checklist of sustainable clinic systems or
processes that support hypertension control. These may include provider
or patient incentives, dashboards, staffing characteristics, electronic
record keeping systems, reminder or alert systems, clinician reporting,
service modifications, etc. The estimated burden for completing the
application form is 30 minutes.
Amount of the Prize
Up to 35 of the highest scoring clinical practices or health
systems will be recognized as Million Hearts[supreg] Hypertension
Control Champions. No cash prize will be awarded. Champions will
receive national recognition.
Basis Upon Which Winner Will Be Selected
The application will be scored based on two hypertension control
rates: one for your most recent 12-month reporting period ending not
earlier than December 31, 2017, and consistency with a previous rate
for a 12-month period 1 year before the current rate.
Phase 1 includes verification of the hypertension prevalence and
blood pressure control rate data submitted and a background check. For
applicants whose Phase 1 data is verified as accurate and who pass the
background check without concerns, phase 2 consists of a medical chart
review. The medical chart review will verify the diagnosis of
hypertension during the reporting year as well as blood pressure being
controlled to Challenge.gov website, that information is used to respond to
Contestants in matters regarding their submission, announcements of
applicants, finalists, and winners of the Contest.
General Conditions
HHS/CDC reserves the right to cancel, suspend, and/or modify the
Contest, or any part of it, for any reason, at HHS/CDC's sole
discretion.
Participation in this Contest constitutes a contestants' full and
unconditional agreement to abide by the Contest's Official Rules found
at https://www.Challenge.gov and https://millionhearts.hhs.gov/.
Authority: 15 U.S.C. 3719.
Dated: February 6, 2019.
Sandra Cashman,
Executive Secretary, Centers for Disease Control and Prevention.
[FR Doc. 2019-01914 Filed 2-11-19; 8:45 am]
BILLING CODE 4163-18-P
