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Wednesday, October 9, 2013

Next deadline on the Physician Quality Reporting System timeline is close

October 15 is the next significant deadline for individuals and groups looking to participate in the Physician Quality Reporting System (PQRS) and avoid reimbursement penalties in the future.

Firstly, October 15 is the last day for groups to register for the group practice reporting option (GPRO) for the 2013 PQRS program year, which they can do either through Web Interface or registry reporting. Either is required to qualify for the 2013 PQRS payment incentive. More information is available in the Centers for Medicare & Medicaid Services (CMS) Quick Reference Guide for Group Practices.

It is also the last day for individuals and groups participating in the GPRO – and wanting to avoid a PQRS payment "adjustment" in 2015 – to choose to participate in the administrative claims-based reporting mechanism. Under this option, CMS calculates quality data from administrative claims. While this option avoids a penalty, it cannot be used to earn a 2013 PQRS incentive payment. Individual health care professionals should consult CMS's Quick Reference Guide for Individual Eligible Professionals.

Finally, October 15 is the last day for groups of 100 or more eligible professionals to self-nominate/elect quality-tiering for the Value Modifier that CMS will implement beginning in 2015. The Value Modifier will not apply to groups of less than 100 eligible professionals in 2015.

To qualify for either the GPRO's administrative claims-based reporting mechanism or quality-tiering to calculate the Value Modifier for 2015, individuals and groups must use the Physician Value-Physician Quality Reporting System (PV-PQRS) Registration System. It can be accessed at http://portal.cms.gov using a valid Individuals Authorized Access to the CMS Computer Services (IACS) User ID and password. For additional information regarding registration and obtaining or modifying an IACS account, please see the CMS Self Nomination/Registration webpage.

– Kent Moore, Senior Strategist for Physician Payment for the American Academy of Family Physicians

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