CMS to Grant Exceptions to ASCs Affected by Maria

September 27, 2017

Surgery centers located in the path of Maria will be exempt from quality reporting requirements

Due to the devastating impact of Hurricane Maria, the Centers for Medicare & Medicaid Services (CMS) will grant exceptions for Medicare quality reporting requirements to ASCs located in areas affected by the storm.

ASCs will get exceptions without having to submit an extraordinary circumstances exception (ECE) request if they are located in the Puerto Rico municipios or U.S. Virgin Islands county-equivalents listed below, all of which have been designated by the Federal Emergency Management Agency (FEMA) as a major disaster locality. The scope and duration of the exception under the Medicare quality reporting program for ASCs is described below. All of the exceptions, however, will be granted to assist these providers while they direct their resources toward caring for their patients and repairing structural damages to facilities.

The affected municipios and county-equivalents designated by FEMA as of the date of this communication are as follows:

Puerto Rico Municipios

U.S. Virgin Islands County-Equivalents

All 78 municipios in Puerto Rico are within the FEMA designated areas.

All 3 county-equivalents in the U.S. Virgin Islands are within the FEMA designated areas.

Please note: This exception expands the list of Puerto Rico municipios that received exceptions for Hurricane Irma.

ASCs located in the municipios and county-equivalents described above will get an exception for the following reporting requirements under the Ambulatory Surgical Center Quality Reporting (ASCQR) Program:

  • Data collection and submission requirements that apply for the remainder of Calendar Year (CY) 2017 and the 2017/2018 Influenza Season that relate to CY 2019 payment determinations. These exemptions apply to all data submitted via the QualityNet Secure Portal and the National Healthcare Safety Network (NHSN) web-based measure collection tools that are due May 15, 2018, including claims-based measures calculated from submitted Quality Data Codes (QDCs). This exemption does not apply to claims-based measures that do not utilize QDCs for calculation purposes.

Circumstances Under Which an Exception Due to Hurricane Maria Must Be Requested to Be Considered by CMS

ASCs located outside of the municipios and county-equivalents listed above are not covered by this communication, but may request an exception to the reporting requirements using the applicable ECE procedure. If FEMA expands the current disaster declaration for Hurricane Maria to include additional counties, municipios and county-equivalents, CMS will update this communication to expand the list of providers eligible to receive an exception without submitting a request.  In addition, CMS will continue to monitor the situation and adjust exempted reporting periods and submission deadlines accordingly.

ASCs in municipios, county-equivalents and states outside of the designated areas may submit ECE requests based on individual circumstances by one of the following methods:

  • Secure File Transfer via QualityNet Secure Portal, “WAIVER EXCEPTION WITHHOLDING” group,
  • E-mail to,
  • Secure fax to 877.789.4443 or
  • Mail to HSAG, Attention: Quality Reporting Support Contractor, 3000 Bayport Drive, Suite 300, Tampa, FL 33607.

Additional information about the ECE Request process and form can be found here. The National Support Team for the ASCQR Program is available to answer questions or supply any additional information you may need. Please contact the team at or or call toll-free at (866) 800-8756.

For further assistance regarding the information contained in this message, please contact the Health Services Advisory Group (HSAG) (formerly FMQAI) online or via phone 866.800.8756 Monday through Friday, 7 am to 6 pm EST.