If you plan to participate in Medicare's Physician Quality Reporting System (PQRS) and Value-Based Payment Modifier (VM) programs for the 2016 performance period, now is the time to submit your quality measures data. Depending on the reporting mechanism used, deadlines vary from February through March 2017.
According to the Centers for Medicare & Medicaid Services (CMS), all eligible professionals who get paid under the Medicare Part B Physician Fee Schedule (MPFS) must comply with quality reporting requirements annually. In 2018, Medicare payment under the MPFS will be based on 2016 quality and cost performance, assessed under the PQRS and VM programs. To fulfill the quality reporting requirement for both programs, you simply report data on quality measures to PQRS. Failure to report data will result in an automatic 2-percent pay cut under PQRS, plus another automatic 2-percent to 4-percent pay cut under the VM program. To see how much these penalties will affect your practice in 2018, visit the TMA PQRS and VM Resource Center to access the Medicare payment adjustment calculator. To avoid the penalties, choose a reporting mechanism that best fits your practice, and submit your 2016 data by the deadline.
2016 PQRS Reporting Period Submission Deadlines
Note: The PQRS, VM, and meaningful use programs are three separate programs. PQRS data submitted to fulfill the quality reporting requirements for PQRS and VM do not automatically satisfy the clinical quality measure component of the meaningful use program. To have your data count for all programs, you must follow a specific data submission process. For details, refer to this CMS guide, and visit the CMS website. Additionally, TMA no longer endorses any registry; all registries and QCDRs have their own deadline, which may be different than the ones listed above. For lists of CMS registries and QCDRs, view the 2016 PQRS Qualified Registries and 2016 PQRS Qualified Clinical Data Registries. Contact your registry or QCDR of choice to inquire about its data collection process and submission deadline. Read "No PQRS, VM Penalties for Physicians Affected by ICD-10 Update" for more information.
Changes to CMS Quality Programs
Calendar year 2016 is the last year you will have to report data on quality measures to Medicare's PQRS, VM, and meaningful use programs. Due to the Medicare Access and CHIP Reauthorization Act (MACRA), CMS has consolidated all three programs into one single program called the Merit-Based Incentive Payment System (MIPS) under the new Quality Payment Program. The first MIPS performance period started on Jan. 1, 2017, and will end Dec. 31, 2017. Submission deadlines for the 2017 MIPS performance period will be scheduled in the first quarter of 2018. Although many changes were made, you may report your data to MIPS in the same way you have reported data to PQRS. Read "MACRA: Review Your Options for Medicare's New Quality Payment Program" for more information.
Where to Find Help
For PQRS questions about the upcoming deadlines, contact the CMS QualityNet Help Desk, Monday through Friday, 7 am to 7 pm CT, by phone, (866) 288-8912, or email at Qnetsupport[at]hcqis[dot]org. For guidance on quality reporting, visit the TMA PQRS and VM Resource Center. For no-cost technical assistant and education on PQRS and VM program, create a free account and join the TMF Value-Based Improvement and Outcomes Network.
Action, Jan. 17, 2017