2014 REPORTING TO AVOID PENALTIES IN 2016 PQRS Presented by: Marcy Le

 PQRS (Physician Quality Reporting System) was formerly know as PQRI (Physician Quality Reporting Initiative)  PQRI was introduced by CMS in 2007  Notice this was an initiative then they decided to keep it around so they received additional funding and it was renamed to PQRS  PQRS is NOT going away anytime soon!!!  PQRS is per provider NOT per practice PQRS FACTS

HOW HAS STI BEEN EDUCATING OFFICES ABOUT PQRS?  At our User Group Meeting for the past 2-3 years we covered this  STI University offered >25 free PQRS webinars  PQRS information was placed in client newsletters  We have a PQRS page on our website REMINDER: CMS has also been publicizing this information since 2006

PQRS PENALTY & INCENTIVE PER CALENDAR YEAR  incentive  2013 incentive AND penalty (1 st year of penalty phase)  2014 incentive AND penalty (last year incentive is offered)  2015, 2016, 2017, 2018……penalty (beginning at 1.5% based on 2013 participation and increasing.5% based on 2014 participation for a total of 2%)

1.5% PAYMENT REDUCTION LETTER RECEIVED If you believe the letter was received in error you can appeal (The instructions for this are within the letter that you have received. STI has nothing to do with this appeal process. This is between your office and CMS.) It is not too late to participate for 2014 to avoid additional payment reductions * follow the instructions outlined in the CMS letter NOW WHAT?

GOOD NEWS THE 1.5% PENALTY WILL GO AWAY IF YOU “SUCCESSFULLY” PARTICIPATE IN 2014

BAD NEWS THE 1.5% PENALTY WILL GO TO 2% IF YOU DO NOT PARTICIPATE IN 2014

Several Options for Reporting PQRS We are only discussing 1option today; group reporting through a 3 rd party registry *Covisint is a registry that many offices have used *Providers who belong to a medical society can ask what PQRS registry they recommend

HOW DO YOU FIND A REGISTRY? (google PQRS group reporting) Below is Covisint home page as example

25 Measure Groups

Each Measure Group Lists the associated diagnosis and CPT codes that are applicable Diabetes Measure Group Example

Example: Diabetes Measure Group

CHECK THE STATUS OF PQRS DATA SUBMISSION ommunity/pqri_home/212 Log into the portal and view your providers confidential PQRS report.

Links to CMS documents from

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