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Avoid Penalties in 2015 – Still Time to Report PQRS Data this Year
Posted on: 3/1/2013
Individuals or groups failing to report Physician Quality and Reporting System (PQRS) data during the 2013 reporting periods will be subject to a negative 1.5 percent payment adjustment beginning in 2015.

However, there is still time to report PQRS data for 2013 and not only earn a 0.5 percent incentive payment, but avoid penalties down the road.

The Centers for Medicare andMedicaid Services (CMS) is moving away from traditional fee-for service and toward pay-for-performance and public reporting of quality data via its Value Based Modifier (VBM) and its Physician Compare website. This year, 2013, marks the beginning of that transition.

Under the VBM, physicians and physician groups may be paid differently based on the quality of care data as reported during the 2013 PQRS reporting period. Thus, it is important for physicians to understand the PQRS process, how to participate and how reporting quality or failure to report quality data will impact their fee schedule in 2015 and beyond.

CMS's final Medicare Physician Fee Schedule Rule for 2013 also outlines a temporary process called the "administrative claims-based reporting option."

This option will allow practices that have not reported or do not successfully report PQRS data in 2013 to avoid the PQRS negative 1.5 percent payment adjustment in 2015. Please note: Using this option will not pay incentives in 2013 or 2014, but should avoid imposition of penalties in 2015. If you wish to elect this process, physicians must notify CMS prior to Oct. 15, 2013. CMS has not yet outlined the penalty avoidance process details; once they become known, the information will be posted on www.isms.org.



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