Navigating the New Antipsychotic Quality Measure: Compliance, Coding, and Five-Star Impact

The January 2026 CMS revisions to the Long-Stay Antipsychotic Quality Measure—now incorporating Medicare Fee-for-Service, Medicaid, and Medicare Advantage claims—create a more expansive and sensitive methodology that can trigger the measure even when antipsychotics were not administered during the MDS look-back period. This shift, combined with CMS concerns around underreporting and inaccurate diagnosis coding, places heightened pressure...