PQRS Reporting Critical for Rheumatologists to Avoid Penalty, Earn Incentive Payment

By participating in Physician Quality Reporting System (PQRS) reporting for 2013, rheumatologists have the potential to avoid a penalty and earn an incentive payment. The Centers for Medicare and Medicaid Services (CMS) updated PQRS reporting requirements for this year, making it easier to report the group measure option through a registry than in previous years.

The ACR developed the Rheumatology Clinical Registry (RCR) as an easy-to-use tool for meeting PQRS reporting requirements. Currently, the RA Measures Group is available as a reporting option through the RCR. Please keep in mind that eligible professionals may only choose to participate in one measure group per reporting year, and there is only potential to receive one PQRS bonus incentive per reporting year.

2013 PQRS Changes

  • Report on 20 patient encounters from visit dates ranging from Jan. 1, 2013–Dec. 31, 2013.
  • 11 out of the 20 patient encounters must be visits with Medicare Part B patients. The other nine patient encounters may be with patients insured by any other payer.

Should You Participate in the RCR for PQRS?

Before signing up for the RCR for PQRS reporting, consider these questions:

  • Is your billing department already reporting PQRS data on your behalf? If you answered “Yes,” you do not need to sign up for the RCR for PQRS reporting. You’ve already fulfilled the PQRS reporting requirement, so there’s no need to submit your data a second time.
  • Have you adopted Certified Electronic Health Record (EHR) Technology for the Meaningful Use program?

If so, ask your EHR vendor if your system can submit PQRS data for you. If your EHR can submit the data and you decide to use this functionality, you don’t need to participate in the RCR for PQRS.

Are PQRS and the CMS EHR Incentive Program the Same?

No. PQRS is completely separate from the EHR Incentive Program, which evaluates whether you’re meeting criteria for meaningful use of EHRs. This means you can earn both the EHR Incentive Program payment and the PQRS incentive if you meet both programs’ criteria.

Requirements and Deadlines

All data must be submitted to the RCR by Jan. 31, 2014, at 5 PM EST, to be eligible for the 2013 PQRS bonus payment and to avoid the 2015 penalty. CMS will issue incentive payments for PQRS in the fall of 2014. Penalties will be assessed in the fall of 2015.

Questions? Ready to Get Started?

The ACR health information technology staff is available to answer all of your PQRS reporting questions, including the process for reporting through the RCR. Please contact HIT@rheumatology.org to request more information.

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