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CMS Makes Changes to PQRI, e-Rx Incentive Programs

November 2, 2009
by root
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The Baltimore-based Centers for Medicare and Medicaid Services (CMS) has announced changes to its physician quality reporting initiative (PQRI) and e-prescribing incentive programs.

The new PQRI guidelines state that for calendar year 2010, participants may earn an incentive payment of 2.0 percent of estimated total allowed charges for Medicare Part B-covered services provided during the reporting period. CMS is also offering additional reporting options, with some requiring data on quality measures to be submitted by Dec. 31, 2010. Those who submit through registries, however, will not be required to submit quality measures data until 2011, it says.

Key changes in the Medicare Physician Fee Schedule (MPFS) final rule will:

Add 30 individual PQRI measures and six measures groups on which individual eligible professionals may report;

· Implement provisions of the Medicare Improvement for Patients and Providers Act of 2008 (MIPPA) that will enable group practices to qualify for incentive payments based on a determination at the group practice level, rather than at the individual level;

· Add an EHR-based reporting mechanism to promote the adoption and use of EHRs and to provide both eligible professionals and CMS with experience on EHR-based quality reporting;

· Add a six-month reporting period, beginning Jul. 1, 2010, for claims-based reporting of individual measures.

MIPPA has also established a five-year program of incentive payments to “successful electronic prescribers,” as defined by the statute, and will impose penalties on those who are not successful. The reporting period for the E-Prescribing Incentive Program for 2010 will be the entire calendar year, and incentives will be paid based on the covered professional services furnished by an eligible professional during the reporting year, says CMS. To view a copy of the final rule with comment period, please click

here. A fact sheet providing more information about the e-Prescribing Program and PQRI provisions can be found at:

www.cms.hhs.gov/apps/media/fact_sheets.asp.

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