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Eligible professionals do not have to enroll or file an intent to participate in the eRx Incentive Program. Professionals who choose to participate by reporting the eRx measure through claims can simply report the G-code on service lines of Medicare Part B Physician Fee Schedule (PFS) professional-services claims. Beginning with the 2010 eRx Incentive program year, eligible professionals may also qualify to earn an eRx incentive by reporting the eRx measure to a qualified registry. Professionals participating in a registry that self-nominates and qualifies to submit data on behalf of eligible professionals for a particular program year should expect to receive more information from the registry on how to participate. Only registries qualified for the Physician Quality Reporting System are eligible to become qualified for purposes of submitting data on the eRx measure on behalf of eligible professionals. In addition to the claims-based reporting mechanism and the registry-based reporting mechanism, CMS tested electronic health record (EHR) data submission, in cooperation with EHR vendors. After successful completion of the 2009 Physician Quality Reporting System EHR Testing Program and a determination that there was at least one "qualified" EHR vendor, an eligible professional may potentially be able to earn an eRx incentive payment through the EHR-based reporting mechanism beginning with the 2010 eRx Incentive Program (if the eligible professional is using one of the EHR products that CMS "qualified" in its 2009 Physician Quality Reporting System EHR Testing Program). Only an EHR vendor that is qualified for the Physician Quality Reporting System is eligible to become qualified for purposes of an eligible professional being able to earn an eRx incentive through submission of eRx measure data extracted from a qualified EHR product. For more information on the 2009 Physician Quality Reporting System EHR Testing Program, click on the "2009 Physician Quality Reporting System EHR Testing Program" link under the "Related Links Inside CMS" section below. 2012 eRx Incentive Program EHR-Based Submission for 2012 Incentive In the 2012 Final PFS rule, CMS stated that the 2012 EHR measure specification for the eRx Incentive Program will be available for EHR-based reporting in 2012. The "2012 EHR Measure Specifications for eRx" and the corresponding "2012 EHR Measure Specifications for eRx - Release Notes" documents may be found in the "Downloads" section below in the "2012 EHR eRx Documents for Eligible Professionals" zip file. The specifications contain a detailed description of data element names and codes. Additionally, in this zip file, the "2012 EHR Downloadable Resource" and the corresponding "2012 EHR Downloadable Resource Table - Release Notes" may be found in the "Downloads" section below. Vendors should refer to the "EHR Documents for Vendors" in the "Downloads" section on the "Alternative Reporting Mechanism" page on the Physician Quality Reporting System website. To qualify to report the eRx measure for 2012, EHR vendors will need to be qualified to report 2012 Physician Quality Reporting System EHR measures. EHR vendors who wish to qualify to participate in the 2012 Physician Quality Reporting System EHR program must have submitted a self-nomination letter requesting inclusion in the 2012 Physician Quality Reporting System Testing Process in 2012 by no later than January 31, 2011. The 2012 Physician Quality Reporting System EHR vendor qualification process and requirements for the 2011 Physician Quality Reporting System EHR Testing Process are described in the "Requirements for EHR Vendors to Participate in the 2012 Physician Quality Reporting System EHR Program," which is available in the "Downloads" section below. Any EHR vendor that wants to report the eRx measure for the 2012 eRx Incentive Program also will need to have followed the requirements contained in this document. 2011 eRx Incentive Program 2011 Qualified Registries CMS is pleased to announce the registries that have become "qualified" to submit quality data to CMS on behalf of their eligible professionals for 2011 PQRS reporting. Each of these registries have gone through a thorough vetting process including checking their capability to provide the required PQRS data elements, reviewing a measure flow and algorithms, performance use case calculations (this checks to see whether the registry calculates the measure's reporting and performance rates correctly), and transmitting the required information in the requested file format (XML). Some registries are also capable of reporting the electronic prescribing measure to CMS. See the table and more information in the link titled "2011 Qualified Registries" in the "Downloads" section below. 2011 eRx Registry XML Specifications and System Edit Messages This document describes the high-level requirements for a registry to qualify to submit under the registry-based reporting alternatives for the 2011 Physician Quality Reporting System. This document also outlines how a registry can become qualified for 2011 Physician Quality Reporting System data submission. Any registry that wants to report the eRx measure for the 2011 eRx Incentive Program also will have to follow the requirements contained in this document. Additionally, the document "2011 eRx Registry XML Specifications and System Edit Messages" can be found under the "Downloads" section below. This document provides the data submission specifications as well as the edit messages for registry-based submissions. 2011 Registry Submission Requirements The document Registry Requirements for Submission of 2011 Physician Quality Reporting System Data on Behalf of Eligible Professionals "2011 Registry Submission Requirements" may be found in the "Related Links Inside CMS" section below. EHR-Based Submission for 2011 Incentive Qualified Electronic Health Record (EHR) Vendors for the Physician Quality Reporting System and Electronic Prescribing (eRx) Incentive Program A list of EHR vendors that have been qualified to submit quality data to CMS by eligible professionals for the 2011 Physician Quality Reporting System program year has been updated on October 4, 2011 and is now available in the "Downloads" section below by clicking on the link titled "2011 EHR Qualified Vendors for Physician Quality Reporting and eRx Incentive Program". The "2011 EHR Measure Specifications for eRx" and the corresponding "2011 EHR Measure Specifications for eRx - Release Notes" documents may be found in the "Downloads" section below by clicking on the link titled "2011 EHR eRx Documents for Eligible Professionals. The specifications contain a detailed description of data element names and codes. Additionally, the "2011 EHR Downloadable Resource" and the corresponding "2011 EHR Downloadable Resource Table - Release Notes" may be found in the "Downloads" section below. Vendors should refer to the "EHR Documents for Vendors" in the "Downloads" section on the "Alternative Reporting Mechanism" page on the Physician Quality Reporting System website. To qualify to report the eRx measure for 2011, EHR vendors will need to be qualified to report 2011 Physician Quality Reporting System EHR measures. EHR vendors who wish to qualify to participate in the 2011 Physician Quality Reporting System EHR program must have submitted a self-nomination letter requesting inclusion in the 2011 Physician Quality Reporting System Testing Process in 2010 by no later than January 31, 2010. The 2011 Physician Quality Reporting System EHR vendor qualification process and requirements for the 2011 Physician Quality Reporting System EHR Testing Process are described in the "Requirements for EHR Vendors to Participate in the 2011 Physician Quality Reporting System EHR Program," which is available in the "Download" section below. Any EHR vendor that wants to report the eRx measure for the 2011 eRx Incentive Program also will need to have followed the requirements contained in this document. 2010 eRx Incentive Program As described in the 2010 Medicare PFS final rule (to view the rule, click on the "Statute/Regulations" link at left), CMS retains the claims-based reporting mechanism. In addition, CMS will accept eRx measure data submitted by a qualified registry on behalf of an eligible professional or eRx measure data extracted from a qualified EHR product. Since only EHR products that are qualified for the Physician Quality Reporting System are eligible to become qualified for the eRx Incentive Program, this was contingent upon the successful completion of our 2009 Physician Quality Reporting System EHR Testing Program, a determination that one or more EHR vendors participating in the 2009 Physician Quality Reporting System EHR Testing Program was "qualified," and one or more qualified Physician Quality Reporting System EHR vendors notified us of their desire to have one or more of their products qualified for purposes of the 2010 eRx Incentive Program. Registry-Based Submission for 2010 Incentive To qualify to submit eRx measure data on behalf of eligible professionals seeking eRx incentive payments for 2010, registries must be qualified to submit 2010 Physician Quality Reporting System data on behalf of eligible professionals. To become qualified to submit 2010 Physician Quality Reporting System data on behalf of eligible professionals, and thus, be eligible to become qualified to submit 2010 eRx measure data on behalf of eligible professionals, registries are required to go through a self-nomination and vetting process if they are new to Physician Quality Reporting System registry reporting, or to notify CMS of their desire to continue Physician Quality Reporting System data submission in 2010 if they were qualified in 2009 and successfully submitted their users' quality data. To become qualified, registries must meet certain technical and other requirements specified by CMS. The document "Registry Requirements for Submission of 2010 Physician Quality Reporting System 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 the 2010 Physician Quality Reporting System. This document also outlines how a registry can become qualified for 2010 Physician Quality Reporting System data submission. Any registry that wants to report the eRx measure for the 2010 eRx Incentive Program also will have to follow the requirements contained in this document. Additionally, the document "2010 eRx Registry XML Specifications" can be found under the "Downloads" section below. This document provides the data submission specifications for registry-based reporting to be utilized by the qualified registries. An updated list of registries that have become "qualified" to submit quality data to CMS on behalf of their eligible professionals for 2010 Physician Quality Reporting System and eRx reporting is now available by clicking on the "Downloads" section below. This list consists of qualified registries for the 2008 and 2009 Physician Quality Reporting System that have successfully submitted 2008 Physician Quality Reporting System data on behalf of eligible professionals to us and that have notified us of their desire to submit 2010 eRx measure data on behalf of eligible professionals. Additional registries were added to the list of qualified registries for the 2010 eRx Incentive Program upon completion of the 2010 registry self-nomination process. The self-nomination process to qualify additional registries for the 2010 eRx Incentive Program was completed during summer 2010. EHR-Based Submission for 2010 Incentive The "2010 EHR Measure Specifications for eRx" and the corresponding "2010 EHR Measure Specifications for eRx - Release Notes" documents may be found in the "Downloads" section below. The specifications contain a detailed description of data element names and codes. Additionally, the "2010 EHR Downloadable Resource" may be found in the "Downloads" section below. To qualify to submit eRx measure data on behalf of eligible professionals or group practices seeking eRx incentive payments for 2010, EHR vendors must be qualified to report 2010 Physician Quality Reporting System EHR measures. In early 2010, CMS finished vetting EHR vendors that self-nominated to participate in the 2009 EHR Testing Program. EHR vendors that successfully completed the 2009 EHR Testing Program are qualified to report 2010 Physician Quality Reporting System EHR measures and may potentially be qualified to report the 2010 eRx measure. A list of qualified EHR vendors for the 2010 eRx Incentive Program is posted here. Qualified Electronic Health Record (EHR) Vendors for 2010 Physician Quality Reporting System and Electronic Prescribing Incentive Programs An updated list of EHR vendors and their programs that have become "qualified" to submit quality data to CMS by eligible professionals 2010 Physician Quality Reporting System reporting is now available in the "Downloads" section below. Each of these EHR vendors has gone through a thorough vetting process for the product and version listed including checking their capability to provide the required Physician Quality Reporting System data elements for 10 Physician Quality Reporting System measures. Some EHRs are also capable of reporting the electronic prescribing measure. In addition to capturing the required data elements for the measure calculation, these "qualified" EHR products can also transmit the required information in the requested file format. While the listed EHR vendors and their EHR products have successfully completed the vetting process, CMS cannot guarantee that any other product or version of software from the listed vendors will be compatible for EHR based submission for Physician Quality Reporting System. Additional 2010 EHR products that passed "qualification" were posted by mid-January 2010.
Page Last Modified: 01/11/2012 8:23:35 AM
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