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The Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA) enacted on December 29, 2007, authorizes CMS to make PQRI incentive payments for satisfactory reporting of quality measures data in 2008 and to establish alternative reporting periods and criteria for the reporting of measure groups and for reporting PQRI quality measures through a clinical data registry. CMS has posted a document that establishes the new alternative reporting criteria and reporting periods: "2008 PQRI: Establishment of Alternative Reporting Periods and Reporting Criteria." This document is available as a downloadable file on the "Statute/Regulations/Program Instructions" page (click link at the left to access). These are options eligible professionals can choose to pursue instead of or in addition to the reporting period and the reporting criteria previously set forth in the 2008 Medicare Physician Fee Schedule (MPFS) final rule. The new options include alternative reporting periods and alternative criteria for satisfactorily reporting measures groups and alternative reporting periods and alternative criteria for satisfactorily reporting through registry-based reporting. Eligible professionals need not enroll or file an intent to participate in the PQRI program. Professionals who choose to participate by reporting quality measures data through claims can simply report the appropriate quality data codes on service lines of Part B Physician Fee Schedule professional-services claims. (Professionals participating in a registry that self-nominates and qualifies to submit data for the 2008 or 2009 PQRI incentive should expect to receive more information from the registry on how to participate.) Registry-Based Submission For 2009 Incentive. To qualify to submit data on behalf of eligible professionals seeking incentive payments for 2009, registries are required to go through a self-nomination and vetting process if they are new to PQRI registry reporting or to notify CMS of their desire to continue PQRI data submission in 2009 if they were qualified in 2008. Selected registries must meet certain technical and other requirements specified by CMS. The document " Registry Requirements for Submission of 2009 PQRI Data on Behalf of Eligible Professionals" may be found in the "Downloads" section below. This document describes the high-level requirements for a registry to qualify to submit under the registry-based reporting alternatives for 2009. This document also outlines how a registry can become qualified for 2009 data submission.
The "Qualified Registries for 2008 PQRI" document is available in the "Downloads" section below. This document lists the names and websites of the "qualified" registries that may submit quality data on behalf of their eligible professionals for a possible payment incentive in 2009 for the 2008 PQRI. Testing of EHR-Based Reporting As described in the MPFS 2009 Final Rule, CMS is testing EHR data submission, in cooperation with electronic health record vendors. These vendors were selected from those who self-nominated per a process described in the 2008 rule. This testing process will continue in 2009 and additional EHRs will be invited to self-nominate through a process to be outlined on this website no later than 12/31/09. EHRs that are successful with the 2009 testing process will be "qualified" for possible PQRI data submission via EHRs if this means of data submission is used in a future PQRI reporting year. There is no incentive payment available through EHR-based data submission for 2008 or 2009. On February 22, 2008, CMS announced the registries and the EHR vendors that have been selected to participate in the testing process. Both of these announcements are available in the "Downloads" section, below. In preparation for testing of EHR-based reporting during 2008, eleven of the PQRI measures proposed for 2008 have been specified for EHR-based submission. Five of these measures are also included as measures used by the Doctor's Office Quality ¡V Information Technology ("DOQ-IT") project launched nationally in 2005. The "2008 EHR Vendor Notification" document, the updated "2008 EHR Measure Specifications" document, and the "2008 EHR Technical Specifications" document for these five overlapping DOQ-IT and PQRI quality measures are posted in the "Downloads" section below. Additional electronic measure specifications are available on the Quality Net website by clicking on "PQRI" from the dropdown menu under the "Physician Offices" tab. A link to the Quality Net website may be found under "Related Links Outside of CMS" below.
Page Last Modified: 11/18/2008 9:35:05 AM
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