Deadline to Avoid 2015 Penalty for Individual EPs and GPRO Participants


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Topic Deadline to Avoid 2015 Penalty for Individual EPs and GPRO Participants
Background For practices not currently participating in the Medicare Physician Quality Reporting System (PQRS), another Medicare penalty is looming unless you take action now to sign up for a mechanism to prevent it.
Regulating Body CMS
Compliance Date 10/18/2013
Consequences Practices not participating in PQRS in 2013 will pay a 1.5-percent penalty on their Medicare claims in 2015. Additionally, The Affordable Care Act requires CMS to apply a Value-Based Modifier (VBM) to all physicians' Medicare payments by 2017 and to some physicians' payment starting in 2015. AMA says CMS intends to apply a 1-percent VBM penalty to the Medicare payments of physicians in groups of 100 or more that did not participate in the PQRS in 2013. This VBM penalty would be in addition to another 1.5-percent penalty that would apply to all physicians who did not participate in PQRS either as an individual or as part of a group.
Next Steps ​The Centers for Medicare & Medicaid Services (CMS) has created an option — for 2013 only and if you sign up by Oct. 18, 2013 — that allows practices to participate in PQRS and avoid the penalty just by signing up — no quality reporting required (and no eligibility for PQRS incentives, either).
Find out how TMA can help!