2014 reporting to avoid penalties in 2016 pqrs presented by: marcy le
TRANSCRIPT
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
2007-2012 incentive 2013 incentive AND penalty
(1st 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 3rd 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
https://www.qualitynet.org/portal/server.pt/community/pqri_home/212
Log into the portal and view your providers confidential PQRS report.
QualityNet Help Desk is where all questions should be directed
1-866-288-8912 7:00 a.m. – 7:00 p.m. Monday-Friday
(CST)[email protected]
NOTE: This document is provided for informational and educational purposes only. It is not intended nor should it be relied upon to provide regulatory or legal advice. Please review all regulatory requirements in regards to this document and consult the appropriate counsel.