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 GPROII was 2-199 EPs
- 2012 CMS has decided that a group of 25 or more EPs is the magic number!
Claims, GPRO, Registry reporting of individual measures, and EHR-based reporting period is 12 months – Jan. to Dec
Registry reporting measures groups – 6 month or 12 month option
CMS does not anticipate making the list of qualified registries for the 2012 Physician Quality Reporting System available prior to the start of the 2012 program year.
For 2012 and beyond, CMS proposes that eligible professionals who choose to participate in the Physician Quality Reporting System via the EHR-based reporting mechanism have the option of submitting quality measure data obtained from their Physician Quality Reporting System qualified EHR to CMS either:
1) direct from his or her qualified EHR, in the CMS-specified manner, or
2) indirect from a qualified EHR data submission vendor (on the eligible professional’s behalf), in the CMS-specified manner.
CMS proposes that, in addition to meeting the appropriate criteria for satisfactory reporting of individual measures for the 2012 Physician Quality Reporting System EHR reporting option, eligible professionals who choose the EHR-based reporting mechanism for the 2012 Physician Quality Reporting System would be required to have a Physician Quality Reporting System qualified EHR product. “We understand that eligible professionals may have purchased Certified EHR Technology for purposes of reporting under the Medicare and Medicaid EHR Incentive Programs. Such Certified EHR Technology may or may not be qualified for purposes of the 2012 Physician Quality Reporting System. The certification process for EHR technology does not test the EHR product’s ability to output a file that meets the Physician Quality Reporting System measures file specifications.”
For direct EHR vendors wishing to qualify for participation in the 2012 Physician Quality Reporting System-Medicare Incentive Pilot for the Medicare EHR Incentive Program (discussed in section IV.H. of this proposed rule), is proposing a separate, accelerated vetting process for EHR vendors and their products.
Incentive Payments for the 2012 Physician Quality Reporting System
Incentive equal to 0.5 percent of the total estimated part B allowed charges for all covered professional services furnished by the eligible professional (or group).