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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. Eligible professionals need not enroll or file an intent to participate in the PQRI. 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 professional-services claims. (Professionals participating in a registry that self-nominates and qualifies to submit data for the 2008 PQRI incentive should expect to receive more information from the registry on how to participate.) Registry-Based Submission For 2008 Incentive To qualify to submit data on behalf of eligible professionals seeking incentive payments in 2008 through registry reporting, a registry must submit a self-nomination letter to CMS. The registry must meet certain technical and other requirements specified by CMS. The document "2008 PQRI Registry Requirements for Submission Under New Options" (see "Downloads" section, below) describes the high-level requirements for a registry to qualify to submit under the registry-based reporting alternatives for 2008. This document also describes how a registry can self-nominate to qualify to submit on behalf of its participants for 2008. On or before August 31, 2008, CMS will announce the names of self-nominated registries that are determined by CMS to meet necessary technical and other requirements to submit under the new options applicable to registry-based submission for 2008. Testing of EHR-Based and Clinical Registry-Based Reporting As described in the MPFS 2008 Final Rule, CMS is testing two methods of data submission, in cooperation with registries and electronic health record vendors. These vendors were selected from those who self-nominated per a process described in the rule. This testing process is separate from the processes CMS will use to enable registry-based submission of data in pursuit of an incentive payment. The data submissions under the registry testing process will conclude September 1, 2008, and before CMS begins accepting data for payment. Any actual data submitted for the testing process will be removed from the data warehouse and will need to be resubmitted if it is applicable to a professional seeking to achieve satisfactory reporting through registry-based submission for 2008. There is no incentive payment available through EHR-based data submission in 2008.
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.
In preparation for testing of EHR-based reporting during 2008, five of the PQRI measures proposed for 2008 have been specified for EHR-based submission. These five measures are also included as measures used by the Doctor's Office Quality – Information Technology ("DOQ-IT") project launched nationally in 2005. The Vendor Notification and updated EHR Measure and Technical Specifications for these five overlapping DOQ-IT and PQRI quality measures are posted in the "Downloads" section below.
Page Last Modified: 05/09/2008 12:46:54 PM
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