Recertify in CMS Computer Base by June 30 Deadline

June 28, 2016 04:19 pm Sheri Porter

Every day, family physicians face an onslaught of information, to-do lists and a huge number of acronyms and program announcements associated with the nation's monumental shift from its fee-for-service payment system to one tied to quality and value.

But sometimes, a message comes through loud and clear. Now is one of those moments: It's time to act to save someone in your practice from slogging through unnecessary paperwork.

Here's the deal. All physician groups that bill Medicare Part B should designate a security official who can access Physician Quality Reporting System (PQRS) and value modifier reports from CMS' online system. That official can, among other things, designate others from the practice to access reports.

But now, with fewer than three full days to act, all designated security officials must recertify those user accounts in the government system by June 30.

CMS used its PQRS listserv to relay that message in an email to subscribing physicians late last week: "Take action today," said the email. Security officials "must recertify their accounts annually. This year, recertification is required by the end of June."

Furthermore, "Current certification will expire after that date, and user roles will be revoked," wrote CMS.

AAFP Provides Context

Practices want to avoid certification expiration, said Sandy Pogones, AAFP senior strategist for health care quality.

"If you don't recertify, and your practice's account expires, then someone has to go back in and start the process all over again applying for an account. It's painful to start over from scratch," said Pogones.

"To avoid unnecessary work and worry, log in, recertify the account, and be done with it," she advised.

Pogones stressed that this particular call to action was for security officials. Individuals who hold that title should know who they are.

"There's only one security official with authorized access to CMS computer services per practice group," said Pogones. Each group is defined by a single tax identification number, whether it's a solo physician or a 3,000-physician health care system.

"The designated security official could be a physician -- for instance, in the case of a solo practice -- but oftentimes is an administrator or office manager," said Pogones.

Bottom line: If you are a security official, take care of business today. Or if you know the security official in your practice, it can't hurt to pass this important message along.

Understand the Big Picture

Family physicians should be mindful of the bigger picture here -- namely, why that information stored in CMS' Enterprise Identity Management system is critically important to Medicare Part B-participating physicians.

In short, it all relates back to Medicare's Value-based Payment Modifier (VBPM) program.

"This program represents the first step for physicians on the road to converting to value-based payment," said Pogones. In effect, CMS uses administrative claims and PQRS data to produce midyear and annual reports that show how physicians compare with their colleagues.

"That report is called the Quality and Resource Use Report (QRUR)," said Pogones.

Importantly, the QRURs released in September 2016 (based on 2015 data) will spell out for physicians how they'll be paid for professional Medicare Part B fee-for-service claims in 2017; in other words, the VBPM adjusts a physician's Medicare payment based on quality and cost.

Physicians can use those QRURs to their advantage because the information the reports hold can pinpoint exactly where practice improvement activities can make a difference. Ultimately, physicians want to avoid CMS-imposed penalties -- potentially as high as a 9 percent reduction in Medicare reimbursement for some practices -- and instead celebrate bonus payments.

Related AAFP News Coverage
QRUR 101: Understand, Utilize Quality and Resource Use Reports

More From AAFP

Family Practice Management: What You Need to Know About Medicare's New "Quality and Resource Use Report"
(November-December 2015)

MACRA Ready: The Shift to Value-Based Payment

Additional Resource
CMS: 2015 QRUR and 2017 Value Modifier(