The 2006 Tax Relief and Health Care Act required the establishment of a physician quality reporting system, including an incentive payment for eligible professionals who satisfactorily report data on quality measures for covered professional services furnished to Medicare beneficiaries.
More background info from the AMA.
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CMS Physician Quality Reporting System (PQRS)
Establishment of PQRS
Why should I participate?
PQRS is just one manifestation of the general trend to use and report clinical performance measures. As time goes on, using measures for improvement will be part of the fabric of how we do our daily work. Using a registry to organize and present clinical information to use while seeing patients actually makes your visit more efficient and feeds the reporting system without additional work.
PQRS is an easy way to get started on this path. For eligible members who do not successfully report data in 2013, there will be a penalty in 2015, so it is important to begin the process now.
PQRS is an easy way to get started on this path. For eligible members who do not successfully report data in 2013, there will be a penalty in 2015, so it is important to begin the process now.
What measures are specific to family medicine?
There are 210 available quality performance measures and 22 measure groups for 2012, but you need only select a few measures or one group that is most appropriate to your practice and the conditions that are common. A large number of the current measures and measure groups could be applicable to the average family medicine practice.
What is the time period for reporting?
There are two reporting periods for the 2012 program:
Six months: The six-month option is only available for reporting of measure groups via a registry.
Full year: This option is available for individual measures reported either via a registry or claims.
Six months: The six-month option is only available for reporting of measure groups via a registry.
Full year: This option is available for individual measures reported either via a registry or claims.
What are the incentives for reporting data or penalties for not reporting?
For 2012, an incentive of 0.5% is available. An additional incentive can be obtained by reporting data through the MOC option, offered through a specialty body of the American Board of Medical Specialties, such as the American Board of Family Medicine. This additional incentive payment of 0.5% is authorized for three years, from 2011 through 2014.
Information found at CMS-MOC details additional requirements that must be met. Penalties for not reporting, starting with the reporting period for 2013, will apply in 2015 and future years.
Information found at CMS-MOC details additional requirements that must be met. Penalties for not reporting, starting with the reporting period for 2013, will apply in 2015 and future years.
| 2012 | 0.5% if no MOC; 1% if MOC |
| 2013 | 0.5% if no MOC; 1% if MOC |
| 2014 | 0.5% |
| 2015 | -1.5% if no reporting for 2013 |
| 2016 | -2% |
How do I get started?
You do not need to sign-up or pre-register in order to participate in the Physician Quality Reporting. Eligible professionals or group practices may report data on individual PQRS measures or measure groups for the care provided to Medicare beneficiaries. Large group practices, with over 25 eligible professionals, must go through a self-nomination process and be selected by CMS to participate. The data may be reported to CMS on their Medicare part B claims; to a qualified PQRS registry, or to CMS via a qualified EHR product.
Qualified Registries
A list of CMS qualified registries for 2012 is available on the CMS web site. (25-page PDF file; About PDFs)
PQRIwizard
A discount on the PQRIwizard registry, offered by CECity, is available to members.
Claims Reporting
For claims reporting: A 2012 Physician Quality Reporting System (PQRS) Toolkit is now available on the AMA web site. These tools include a description, specifications and data collection sheet for all PQRS claims measures, as well as links for the individual measures or measures groups.
General information on the PQRS program and details for reporting on individual measures or measure groups is available on the AMA and the CMS web sites.
General information on the PQRS program and details for reporting on individual measures or measure groups is available on the AMA and the CMS web sites.
National Programs and Resources
