[Federal Register Volume 79, Number 161 (Wednesday, August 20, 2014)]
[Notices]
[Pages 49321-49323]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-19754]


-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention


Announcement of Requirements and Registration for Million 
Hearts[supreg] Hypertension Control Challenge

AGENCY: Centers for Disease Control and Prevention (CDC), Department of 
Health and Human Services (HHS).

ACTION: Notice.

-----------------------------------------------------------------------

SUMMARY: The Centers for Disease Control and Prevention (CDC) located 
within the Department of Health and Human Services (HHS) announces the 
launch of the Million Hearts[supreg] Hypertension Control Challenge on 
August 20, 2014. The challenge will be open until October 10, 2014.
    Million Hearts[supreg] is a national initiative to prevent 1 
million heart attacks and strokes by 2017. Achieving this goal means 
that 10 million more Americans must have their blood pressure under 
control. Million Hearts[supreg] is working to control high blood 
pressure through clinical approaches, such as using health information 
technology to its fullest potential and integrating team-based 
approaches to care, as well as community approaches, such as 
strengthening tobacco control, and lowering sodium consumption. For 
more information about the initiative, visit www.millionhearts.hhs.gov.
    To support improved blood pressure control, HHS/CDC is announcing 
the 2014 Million Hearts[supreg] Hypertension Control Challenge. The 
challenge will bring prestige to organizations that invest in 
hypertension control, improve understanding of successful 
implementation strategies at the health system level, and motivate 
practices and health systems to strengthen their hypertension control 
efforts.
    The challenge will identify clinicians, clinical practices, and 
health systems that have exceptional rates of hypertension control and 
recognize them as Million Hearts[supreg] Hypertension Control 
Champions. To support improved quality of care delivered to patients 
with hypertension, Million Hearts[supreg] will document the systems, 
processes, and staffing that contribute to the exceptional blood 
pressure control rates achieved by Champions. Champions will receive a 
cash prize and local and national recognition.

DATES: Contest begins on August 20, 2014 and ends on October 10, 2014. 
Office of Management and Budget control number 0920-0976 expires 7/31/
2016.

FOR FURTHER INFORMATION CONTACT: Susan Ladd, 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-72, Atlanta, GA 30341, Telephone: 770-488-
2424, Fax: 770-488-8151, Attention: Hypertension Control Challenge, 
Email: [email protected].

SUPPLEMENTARY INFORMATION: 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).
    Subject of Challenge Competition:
    Entrants of the Million Hearts Hypertension Control Challenge will 
be asked to submit two point-in-time measures of the hypertension 
control rate for the practice's or health system's hypertensive 
population. One measure is for the previous 12 month period and the 
second for the previous 12 to 24 months. Entrants will also be asked to 
provide the prevalence of hypertension in their population and describe 
the sustainable systems used by the practice or health system that 
support continued improvements in blood pressure control and some 
population characteristics.
    Eligibility Rules for Participating in the Competition:
    To be eligible to win a prize under this challenge, an individual 
or entity--
    (1) Shall have completed the nomination form in its entirety to 
participate in the competition under the rules promulgated by HHS/CDC;
    (2) Shall have complied with all the requirements in this section 
and;
    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. Or be a U.S. incorporated medical practice, defined as any 
practice with two or more U.S. licensed clinicians who by formal 
arrangement share responsibility for a common panel of

[[Page 49322]]

patients, practice at the same physical location or street address, and 
provide continuing medical care for adult patients with hypertension;
    c. Or 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 check data submitted;
    (5) Must treat a minimum of 500 adult patients annually and have a 
hypertension control rate of at least 70%;
    (6) May not be a Federal entity or Federal employee acting within 
the scope of their employment;
    (7) Shall not be an HHS employee working on their applications or 
submissions during assigned duty hours;
    (8) Shall not be an employee or contractor at CDC;
    (9) Federal grantees may not use Federal funds to develop COMPETES 
Act challenge applications unless consistent with the purpose of their 
grant award and specifically requested to do so due to competition 
design;
    (10) Federal contractors may not use Federal funds from a contract 
to develop COMPETES Act challenge applications or to fund efforts in 
support of a COMPETES Act challenge;
    (11) Must agree to participate in a data validation process to be 
conducted by a reputable independent contractor. To the extent 
applicable law allows, data will be kept confidential by the contractor 
and will be shared with the CDC in aggregate form only i.e., the 
hypertension control rate for the practice not individual hypertension 
values;
    (12) Individual nominees and individuals in a group practice must 
be free from convictions 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, prescription, or 
dispensing of controlled substances as verified through the Office of 
the Inspector General List of Excluded Individuals and Entities. http://oig.hhs.gov/exclusions/background.asp. Individual nominees must be 
free from serious sanctions, such as those for misuse or mis-
prescribing of prescription medications. Such serious sanctions will be 
determined at the discretion of the agency consistent with CDC's public 
health mission. CDC's contractor may perform background checks on 
individual clinicians or medical practices.
    (13) Health systems must have a written policy in place that 
conducts periodic background checks as described in (12) on all 
providers and takes appropriate action accordingly. 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). CDC's contractor may also request the 
policy and any supporting information deemed necessary.
    (14) Champions previously recognized through the 2013 Million 
Hearts Hypertension Control Challenge retain their designation as a 
``Champion'' and are not eligible to be named a Champion in the 2014 
challenge.
    (15) Must agree to accept the prize and 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] Web site. Strategies used by Champions that support 
hypertension control may be written into a success story, placed on the 
Million Hearts[supreg] Web site, and attributed to Champions.
    An individual or entity shall not be deemed ineligible because the 
individual or entity used Federal facilities or consulted with Federal 
employees during a competition if the facilities and employees are made 
available to all individuals and entities 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 or 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.
    Federal organizations will be offered a simultaneous opportunity to 
participate in a separate but similar challenge, and will be eligible 
for recognition only. No cash prize will be awarded.
    Registration Process for Participants:
    To participate, interested parties will navigate to 
www.millionhearts.hhs.gov. On this site, nominees will find the rules 
and guidelines for participating as well as access to the entry form. 
Information required of the nominees on the nomination form includes:
     The size of the nominee's adult patient population, a 
summary of known patient demographics (e.g., age distribution), and any 
noteworthy patient population characteristics.
     The number of the nominee's adult patients who were seen 
during the past year and had a hypertension diagnosis (i.e., 
hypertension prevalence).
     The nominee's current hypertension control rate for their 
hypertensive population. In addition, the hypertension control rate 
during the previous year is required. In determining the hypertension 
control rate, CDC defines ``hypertension control'' as a blood pressure 
reading <140 mmHg systolic and <90 mmHg diastolic among patients with a 
diagnosis of hypertension. Million Hearts[supreg] supports use of the 
National Quality Forum (NQF) Measure #0018 for controlling high 
blood pressure or similar definitions. Details about NQF 0018 can be 
found at http://www.qualityforum.org/QPS/0018.
     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 hypertension control rate should be for the provider's or 
health system's entire adult hypertensive patient population, not 
limited to a sample. 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

[[Page 49323]]

(such as 18-35), or patients enrolled in limited scale quality 
improvement projects.
    The estimated burden for completing the nomination form is 30 
minutes.
    Amount of the Prize:
    Up to a total of 20 of highest scoring individual clinicians, 
clinical practices or health systems will be recognized as Million 
Hearts[supreg] Hypertension Control Champions and will receive a cash 
award of $2,000. A maximum of $40,000 will be awarded in this 
challenge.
    Payment of the Prize:
    Prizes awarded under this challenge will be paid by electronic 
funds transfer and may be subject to Federal income taxes. HHS will 
comply with the Internal Revenue Service withholding and reporting 
requirements, where applicable.
    Basis Upon Which Winner Will Be Selected:
    The nomination will be scored based on hypertension control rate 
(95% of score); and sustainable systems in the practice that support 
hypertension control (5% of score).
    Nominees with the highest score will be required to participate in 
a two-phase process to verify their data. Nominees who are non-
compliant or non-responsive with the data requests or timelines will be 
removed from further consideration. Phase 1 includes verification of 
the hypertension prevalence and blood pressure control rate data 
submitted and a background check. For nominees whose Phase 1 data is 
verified as accurate, phase 2 consists of a medical chart review. 
National Quality Forum Measure #0018 for controlling high blood 
pressure will be used to evaluate the submitted data. Details about NQF 
0018 can be found at http://www.qualityforum.org/QPS/0018.
    A CDC-sponsored panel of three to five experts consisting of HHS/
CDC staff will review the nominations that pass the verification to 
select Champions. Final selection will take into account all the 
information from the nomination form, the background check, and data 
verification. Geographic location and population treated may be used to 
break ties in the event of tie scores at any point in the selection 
process.
    Some Champions will participate in a post-challenge telephone 
interview. The interview will include questions about the strategies 
employed by the individual or organization to achieve high rates of 
hypertension control, including barriers and facilitators for those 
strategies. The interview will focus on systems and processes and 
should not require preparation time by the Champion. The estimated time 
for the interview is two hours, which includes time to review the 
interview protocol with the interviewer, respond to the interview 
questions, and review a summary data about the Champion's practices. 
The summary will be written as a success story and will be posted on 
the Million Hearts[supreg] Web site.
    Additional Information:
    Information received from nominees will be stored in a password 
protected file on a secure server. The challenge Web site may post the 
number of nominations received but will not include information about 
individual nominees. The database of information submitted by nominees 
will not be posted on the Web site. Information collected from nominees 
will include general details, such as the business name, address, and 
contact information of the nominee. This type of information is 
generally publically available. The nomination will collect and store 
only aggregate clinical data through the nomination process; no 
individual identifiable patient data will be collected or stored. 
Confidential or propriety data, clearly marked as such, will be secured 
to the full extent allowable by law.
    Information for selected Champions, such as the provider, practice, 
or health system's name, location, hypertension control rate, and 
clinic practices that support hypertension control will be shared 
through press releases, the challenge Web site, and Million 
Hearts[supreg] and HHS/CDC resources.
    Summary data on the types of systems and processes that all 
nominees use to control hypertension may be shared in documents or 
other communication products that describe generally used practices for 
successful hypertension control. HHS/CDC will use the summary data only 
as described.
    Compliance With Rules and Contacting Contest Winners:
    Finalists and Champions must comply with all terms and conditions 
of these official rules, and winning is contingent upon fulfilling all 
requirements herein. The initial finalists will be notified by email, 
telephone, or mail after the date of the judging.
    Privacy:
    Personal information provided by entrants on the nomination form 
through the challenge Web site will be used to contact selected 
finalists. Information is not collected for commercial marketing. 
Winners are permitted to cite that they won this challenge.
    The names, cities, and states of selected Champions will be made 
available in promotional materials and at recognition events.
    General Conditions:
    The HHS/CDC reserves the right to cancel, suspend, and/or modify 
the challenge, or any part of it, for any reason, at HHS/CDC's sole 
discretion.
    Award Approving Official: Thomas R. Frieden, MD, MPH, Director, 
Centers for Disease Control and Prevention, and Administrator, Agency 
for Toxic Substances and Disease Registry

    Authority: 15 U.S.C. 3719.

    Dated: August 15, 2014.
Ron A. Otten,
Acting Deputy Associate Director for Science, Centers for Disease 
Control and Prevention.
[FR Doc. 2014-19754 Filed 8-19-14; 8:45 am]
BILLING CODE 4163-18-P