Key Elements of the 2012 proposed rule include: Modification of measure to allow EPs to use either a qualified e-prescribing system or certified HER system Criteria will parallel 2012 and 2013 i.e., 25 scripts per year using G8553 Same CPT code set for reporting with Rxs Significant hardship exemptions. Incentives and Adjustments: 2009 2 percent [...]

Methods of Participation: Currently, there are two ways an eligible professional may participate in the Physician Quality Reporting System: (1) Individual eligible professional or (2) Group practice reporting option (GPRO) – single tax ID with 2 or > eligible providers (EP). 2010 – a GPRO was 200+ EP 2011 a GPRO was 200+ and a [...]

The proposed rule adds a Health Risk Assessment (HRA) as a required element for the annualwellness visit (AWV) beginning in 2012. Regulations for Medicare coverage of the AWV are established at 42 CFR 410.15. The AWV maybe performed by a physician, nonphysician practitioner (physician assistant, nurse practitioner,or clinical nurse specialist), or a medical professional (including [...]

Medicare has a longstanding policy to reduce payment by 50 percent for the second andsubsequent surgical procedures furnished to the same patient by the same physician on thesame day. Effective January 1, 1995, the MPPR policy, with the same percentage reduction,was extended to nuclear medicine diagnostic procedures. Under the CY 2006 PFS, the MPPRpolicy was [...]