Post the TEP summary report

Work with the Measures Manager to post the approved TEP Summary report— using the posting process detailed in Step 3. It is important for measure contractors to understand that the posting process can take up to 5 business days and should be factored into their timeline. Note: materials sent at the end of a business day may not be reviewed until the next business day.

The report should remain available for at least 21 calendar days or as directed by the COR/GTL. After the public comment period, the contractor may want to reconvene the TEP to discuss the comments received. Refer to the Public Comment section.

It is important to note that the TEP may be consulted for their advice during any stage of the measure development including when the measure is undergoing the NQF endorsement process.

A Blueprint for the CMS Measures Management System, Version 9 Page 7-9 Template for Call for TEP Web Page Posting

TEP Project Overview: <insert title>

The Centers for Medicare & Medicaid Services (CMS) has contracted with <contractor name> to develop <measure set

name or description>. The purpose of the project is to develop measures that can be used to provide quality care to

Medicare beneficiaries.

Due date for nominations: <xx> Specific project objectives include:

 <list contract objectives>

The development process includes:

 Identifying important quality goals related to a topic/condition or setting of focus.

 Conducting literature reviews and grading evidence.

 Defining and developing specifications for each quality measure.

 Obtaining evaluation of proposed measures by technical expert panels.

 Posting for public comment.

 Testing measures for reliability, validity, and feasibility.

 Refining measures, as needed.

Details about the measure development process can be found in the Measures Management System Blueprint at https://www.cms.gov/MMS/19 MeasuresManagementSystemBlueprint.asp#TopOfPage.

TEP requirements:

A TEP of approximately <insert desired TEP size> individuals will recommend <insert objective>. The TEP will be comprised of individuals with the following areas of expertise and perspectives:

 Topic knowledge: <insert specific topic>

 Performance measurement

 Quality improvement

 Consumer perspective

 Purchaser perspective

 Health care disparities

All potential TEP members must disclose any current and past activities that may pose a potential conflict of interest for performing the tasks required of the TEP. All potential TEP members must also commit to the anticipated time frame needed to perform the functions of the TEP.

TEP expected time commitment:

 <list anticipated meeting dates, locations>

 <if applicable, list expected time frame for measure endorsement activities>

TEP nomination:

Self-nominations are welcome. Third-party nominations must indicate that the individual has been contacted and is willing to serve.

Required information:

 A letter of interest (not to exceed two pages), highlighting experience/knowledge relevant to the expertise described above and involvement in measure development.

 Curriculum vitae and/or list of relevant experience (e.g., publications), a maximum of 10 pages total. The TEP Nomination and Disclosure Form can be found in the Download section of

https://www.cms.gov/MMS/15 TechnicalExpertPanels.asp#TopOfPage. If you wish to nominate yourself or other individuals for consideration, complete the form and email to: <insert email address for receipt of the nominations>.

TEP Nomination/Disclosure/Agreement Form

Instructions

Applicants/Nominees must submit the following documents along with this completed and signed form:

 A statement of interest summarizing relevant expertise and knowledge of the applicant (2-page maximum).

 A curriculum vitae (CV) and/or list of relevant experience (e.g., publications) (10-page maximum).

 A disclosure of any current and past activities that may indicate a conflict of interest. As a contractor for CMS, <measure contractor’s name>, must ensure balance, independence, objectivity and scientific rigor in its measure development activities.

 Send completed and signed form, statement of interest, and CV to <insert measure contractor name> with “Nomination” in the subject line at <insert email address>. Due by close of business <insert date> ET.

All potential TEP members must disclose to the contractor, CMS and other TEP members any significant financial interest or other relationships that may affect their judgment or perceptions. The intent of this disclosure is not to prevent individuals with potential for conflict of interest from serving on the TEP, but to provide the measure contractor, other TEP members, and CMS the information to form their own judgments. It is for the measure contractor, other TEP members, and CMS to decide if the individual’s interest or relationships may affect the discussions or conclusions.Conflict of interest glossary of terms can be found at https://www.cms.gov/MMS/15_TechnicalExpertPanels.asp#TopOfPage.

Applicant/Nominee Information (Self-nominations Are Acceptable)

First and last name:

Suffix/degrees (RN, MD, PhD, etc.)/Title: Organization:

Mailing address:

Telephone/fax number(s): Email address:

Person Recommending the Nominee

Complete this section only if you are nominating a third party for the TEP. You must sign this form and attest that you have notified the nominee of this action and that they are agreeable to serving on the TEP. The measure contractor will request the required information from the nominee.

First and last name:

Suffix (RN, MD, PhD, etc.)/Title: Organization:

Mailing address:

Telephone/fax number(s): Email address:

Signature: ______________________________________________ Date: _________________

Applicant/Nominee’s Disclosure

1. Do you or any family members have a financial interest, arrangement or affiliation with any corporate organizations that may create a potential conflict of interest? Yes  / No .

If yes, please describe (grant/research support, consultant, speaker’s bureau, major stock shareholder, other financial or material support). Please include the name of the corporation/organization.

2. Do you or any family members have intellectual interest in a study or other research related to the quality measures under consideration? Yes  / No .

If yes, please describe the type of intellectual interest and the name of the organization/group.

Applicant/Nominee’s Agreement

 If at any time during my service as a member of this TEP, my conflict of interest status changes, I will notify the measure contractor and the TEP chair.

 It is anticipated that there will be <approximate time commitment that is required>. I am able to commit to attending at least 90 percent of all TEP meetings (face-to-face or by telephone).

 If selected to participate in the TEP and the measures are submitted to a measure endorsement organization (e.g., NQF, AQA) for approval, I will be available to discuss the measures with the organization or its representatives, and work with the measure contractor to make revisions to the measures if necessary.

 If selected to participate in the TEP, I will keep confidential all materials and discussions until such time that CMS authorizes their release.

I have read the above and agree to abide by it.

Template for Technical Expert Panel Charter TEP title:

Measure contractor convening the TEP:

Scope and objective of TEP activities:

Description of TEP duties:

Estimated number and frequency of meetings:

Member composition (attach Final List of TEP Members form):

Subgroups (if needed):