PQRS: Last Day for Dual Participation in PQRS and the Medicare EHR Incentive Program (Meaningful Use)
The Physician Quality Reporting System (PQRS) is a quality reporting program by the Centers for Medicare & Medicaid Services (CMS) that uses negative payment adjustments to promote reporting of data on quality measures. The Value-Based Payment Modifier (VBM) program is a separate CMS program that assesses quality and cost performance. The VBM is based partially on participation in PQRS. Under the VBM program, physicians are subject to upward, neutral, or downward payment adjustments based on quality of care furnished compared with the cost of care during a performance period. To fulfill the quality reporting requirement for both programs, you simply report data on quality measures to PQRS.
All solo physicians and group practices who get paid under or based on the Medicare Physician Fee Schedule must comply with quality reporting requirements on an annual basis. Failure to report data on quality measures to Medicare for the 2016 PQRS program year will result in an automatic 2-percent pay cut under PQRS, plus another automatic 2-percent to 4-percent pay cut under the VBM program, all in 2018. To avoid the automatic penalty under each program, or “negative payment adjustment,” choose a reporting mechanism that best fits your practice, and submit your 2016 data by the deadline.
Note that PQRS, the VBM program, and the EHR Incentive Program (meaningful use) are three separate programs. PQRS data submitted to fulfill the quality reporting requirements for PQRS and VBM 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 described in the CMS document linked above. Click on the CMS link above for information on how to report your data for dual participation. Contact your EHR vendor for details and technical assistance to ensure your data on clinical quality measures are submitted accurately and successfully by the deadline.