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PQRS for MEDITECH
  • PQRS Performance by Provider

PQRS Reporting and Electronic Delivery


Within the Physician Quality Package is the ability to participate in the PQRS submission program. For more information on the OneView Application and its features, click here. Group Practices (GPRO) and/or Individual EP's who need to report to avoid PQRS payment adjustments now have the option with OneView to use the EHR-based reporting method or the EHR Data Submission Vendor method . In order to be used for PQRS reporting, a product must be ONC-ACB Certified for Ambulatory Reporting.  You can visit our Eligible Professional page for details about our certification.  OneView includes the ability to report for Eligible Professionals that provide Medicare Part B services in a Hospital or acute care setting.  For a list of professionals eligible to participate in PQRS, click here.

PQRS Background

The Physician Quality Reporting System (PQRS) is a reporting program that uses a combination of incentive payments and payment adjustments to promote reporting of quality information by eligible professionals (EPs). The program provides an incentive payment to practices with eligible professionals (identified on claims by their individual National Provider Identifier [NPI] and Tax Identification Number [TIN]), or group practices participating in the group practice reporting option (GPRO) who satisfactorily report data on quality measures for covered Physician Fee Schedule (PFS) services furnished to Medicare Part B Fee-for-Service (FFS) beneficiaries (including Railroad Retirement Board and Medicare Secondary Payer). Additionally, EPs and group practices that do not satisfactorily report or satisfactorily participate in the 2014 PQRS program year will be subject to a payment adjustment in 2016.

EHR-Based Reporting Method

For 2014 and beyond, CMS will discontinue the PQRS qualification requirement for Data Submission vendors and Direct EHR vendors. The criteria for satisfactory reporting via EHR for PQRS are aligned with the CQM component of the Medicare EHR Incentive Program, which requires EPs and group practices to submit clinical quality measures using CEHRT. For purposes of PQRS, the EPs or group practices using a direct EHR product or EHR Data Submission Vendor must be certified to the specified eCQM versions.

Direct EHR Vendor (also known as EHR Direct):

Direct EHR vendors are those vendors who are certifying an EHR product and version for EPs or group practices to utilize to directly submit their PQRS measures data to CMS in the CMS-specified format(s) on their own behalf.

EHR Data Submission Vendor (DSV):

An EHR Data Submission Vendor is an entity that collects an individual EPs or group practices clinical quality data directly from the EP’s or group practice’s EHR. DSVs will be responsible for submitting PQRS measures data from an EP or group practice’s certified EHR to CMS via a CMS specified format(s) on behalf of the EP or the group practice for the program year.

2015 PQRS EHR Reporting

http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Electronic-Health-Record-Reporting.html

https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Downloads/2015_PQRS_EHR_Made_Simple.pdf

2015 PQRS Measures

eCQM Library

Penalties

Upcoming CMS penalties for non-participation in quality programs:

Year

eRx

EMR

PQRS

Total Penalty

2014

-2.0%

No penalty

No penalty

-2.0%

2015

No penalty

-1.0%

-1.5%

-2.5%

2016

No penalty

-2.0%

-2.0%

-4.0%

2017

No penalty

-3.0%

-2.0%

-5.0%

 

EPs who do not satisfactorily report data on quality measures for covered professional services during the 2014 PQRS program year will be subject to a 2 percent payment adjustment to their Medicare PFS amount for services provided in 2016.

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