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Eligible professionals do not have to 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 (PFS) 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. 2009 PQRI 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 and successfully submitted their user's quality data. 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. 2009 Testing of EHR-Based Reporting As described in the 2009 Medicare PFS 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 PFS final rule. For 2009, the testing process was similar to the testing process used for 2008 and EHR vendors were invited to self-nominate again through the process outlined below. The requirements an EHR vendor must meet for 2009 testing and possible qualification are listed in the 2009 EHR Self-Nomination Letter available in the "Downloads" section below. 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. In preparation for testing of EHR-based reporting during 2009, ten of the PQRI measures proposed for 2009 have been specified for EHR-based submission. The Measure Specifications for the 2009 EHR test measures are available on the QualityNet website by clicking on "PQRI" from the dropdown menu under the "Physician Offices" tab. The Data Submission Specifications based on the HL7 (Health Level Seven) QRDA (Quality Reporting Documentation Architecture) draft standard for trial use are also available on the same QualityNet web page. 2008 PQRI 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. Registry-Based Submission for 2008 Incentive 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. 2008 Testing of EHR-Based Reporting 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. The "2008 EHR Vendor Notification" document, the "2008 EHR Measure Specifications" document, and the "2008 EHR Technical Specifications" document for the five overlapping DOQ-IT and PQRI quality measures are posted in the "Downloads" section below. A link to the Quality Net website may be found under "Related Links Outside of CMS" below.
Page Last Modified: 04/01/2009 10:42:10 AM
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