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PQRS GPRO Registration

2015 Physician Quality Reporting System (PQRS) Group Practice Reporting Option (GPRO) Registration is Open between April 1, 2015 and June 30, 2015 

Register to Participate in the 2015 PQRS GPRO

Modify or Cancel a 2015 PQRS GPRO Registration 

Groups that May Register for the 2015 PQRS GPRO

Groups that Do Not Have to Register for the 2015 PQRS GPRO

Obtain an IACS Account to Access the Registration System

Resources

 

Groups can register to participate in the 2015 PQRS GPRO via the Physician Value-Physician Quality Reporting System (PV-PQRS) Registration System between April 1, 2015 and June 30, 2015 (11:59 pm EDT).  The Registration System can be accessed at https://portal.cms.gov using a valid Individuals Authorized Access to the CMS Computer Services (IACS) account.  Please see the instructions provided below on how to obtain an IACS account

A “group” or “group practice” is defined as a single Medicare-billing Taxpayer Identification Number (TIN) with 2 or more individual eligible professionals (EPs) (as identified by their individual National Provider Identifier (NPI)) who have reassigned their billing rights to the TIN. 

Groups can participate in the 2015 PQRS GPRO by selecting one of the GPRO reporting mechanisms:

  • Qualified PQRS Registry
  • Electronic Health Record (EHR) [via Direct EHR using certified EHR technology (CEHRT) or CEHRT via Data Submission Vendor]
  • Web Interface (for groups with 25 or more EPs only)
  • Consumer Assessment of Health Providers and Systems (CAHPS) for PQRS Survey via a CMS-certified Survey Vendor (as a supplement to another GPRO reporting mechanism)

Note:

  • In 2015, the CAHPS for PQRS survey is mandatory for groups with 100 or more EPs and optional for groups with between 2 to 99 EPs.  Groups with 2 or more EPs can elect whether to include the results of their 2015 CAHPS for PQRS survey in the calculation of their 2017 Value-based Payment Modifier (Value Modifier). 
  • In 2015, for groups that elect or are required to report the CAHPS for PQRS survey, the group is responsible for selecting and paying a certified a survey vendor to implement the survey on behalf of the group.
  • Some groups may have insufficient sample sizes, as a result of patient attribution and sampling rules, to have valid and reliable CAHPS for PQRS survey results. CMS will notify groups that do not have enough beneficiaries assigned.  Groups should make sure to report sufficient number of measures via their primary chosen GPRO reporting mechanism (Registry, EHR, or Web Interface) to meet program requirements.

Physician groups of all sizes and physician solo practitioners are subject to the Value Modifier in 2017, based on performance in 2015.  Satisfactorily reporting via a PQRS GPRO is one of the ways groups can avoid automatic downward adjustments and qualify for adjustments based on their performance, under the Value Modifier. Additional information about the Value Modifier program can be found here.

Step-by-step instructions for registering to participate in the 2015 PQRS GPRO are provided in the “2015 PQRS GPRO Registration Guide” located in the “Downloads” section below.

For additional information about the PQRS program, the CAHPS for PQRS survey, and the Value Modifier program, please refer to the links in the “Resources” section below.

 

  • Groups that register for the 2015 PQRS GPRO may modify their registration information (e.g., change the chosen GPRO reporting mechanism) by logging into the Registration System at any time before the registration period closes on June 30, 2015 (at 11:59 pm EDT)
  • Groups that register for the 2015 PQRS GPRO, but wish to cancel their registration, can log in to the Registration System and cancel their registration OR contact the Physician Value Help Desk at the number provided in the “Resources” section below before the registration period closes on June 30, 2015 (at 11:59 pm EDT).  Groups will not be allowed to cancel their 2015 GPRO registration after this date.  Groups that want to re-register to participate in the 2015 PQRS GPRO must contact the Physician Value Help Desk before the registration period closes.       

Note:

    • If a physician group with 2 or more EPs cancels its 2015 PQRS GPRO registration, then the group can still avoid the automatic 2017 Value Modifier downward payment adjustment (-2.0% or -4.0% depending on the group’s size), if the EPs in the group participate in the PQRS as individuals in 2015 and at least 50% of the EPs meet the satisfactory reporting criteria as individuals via claims, qualified PQRS registry, or EHR (or in lieu of satisfactory reporting, satisfactorily participate in a qualified clinical data registry) to avoid the 2017 PQRS payment adjustment.  No registration is necessary if the EPs in a group participate in the PQRS as individuals.
  • Step-by-step instructions for modifying or canceling a 2015 PQRS GPRO registration are provided in the “2015 PQRS GPRO Registration Guide” located in the “Downloads” section below.

Eligible Professionals that choose to participate in the PQRS as a group practice will need to inform CMS of their election by registering to participate in the 2015 PQRS GPRO.  This is an annual election and participation in the PQRS as a group in years prior is not carried forward. Specifically:

  • Groups with 2 or more EPs that want to avoid the 2017 PQRS negative payment adjustment and the automatic 2017 Value Modifier downward payment adjustment by reporting PQRS quality data at the group level
  • Groups with 2 or more EPs that want to report via the registry reporting mechanism
  • Groups with 2 or more EPs that want to report via Direct EHR using CEHRT or CEHRT via Data Submission Vendor
  • Groups with 25 or more EPs that want to select the Web Interface reporting mechanism
  • Groups with between 2 to 99 EPs that want to supplement their GPRO reporting mechanism with the CAHPS for PQRS survey

Please note that physician groups must meet the criteria to avoid the 2017 PQRS payment adjustment in order to also avoid the automatic 2017 Value Modifier downward payment adjustment (-2.0% or -4.0% depending on the group’s size) and qualify to earn Value Modifier adjustments based on performance. 

  • Groups that participate in the Medicare Shared Savings Program
  • Groups that only provide care to Medicare beneficiaries who are enrolled in a Medicare Advantage plan.
  • EPs that choose to participate in the PQRS as individuals in 2015 via claims, qualified PQRS registry, qualified clinical data registry, or EHR.

Note:

  • Physician groups with 2 or more EPs must ensure that at least 50% of the EPs in the group meet the criteria to avoid the 2017 PQRS payment adjustment as individuals in order for the group to avoid the automatic 2017 Value Modifier downward payment adjustment (-2.0% or -4.0% depending on the group’s size) and qualify to earn Value Modifier adjustments based on performance.

 

The Registration System can be accessed at https://portal.cms.gov using an IACS account with the correct role.  One person from the group must first sign up for an IACS account with the primary Group Security Official role (instructions provided here).  If additional persons are needed to register the group for the PQRS GPRO, then they can request the backup Group Security Official role (instructions provided here) or the Group Representative role (instructions provided here) in IACS.  If a person already has an IACS account, then he or she must modify the existing account to sign up for one of the group roles described above (instructions provided here).

To find out whether there is already someone who can register the group to participate in the PQRS GPRO, contact the QualityNet Help Desk at the number provided in the “Resources” section below and provide the group's TIN and the name of the group.  If the group registered for a PQRS GPRO during a previous year, then the same person can register the group again using his or her IACS User ID and password.

A person can sign up for a new IACS account or modify an existing account at https://applications.cms.hhs.gov.  This step should be completed NOW to avoid any last minute delays in obtaining an IACS account.  Also, note that it takes approximately 24 hours for CMS to process an IACS account request; therefore, an IACS account must be obtained in advance so that the group’s registration can be submitted before the registration period closes on June 30, 2015 (at 11:59 pm EDT).  Once an IACS account with the correct role is obtained, follow the step-by-step instructions provided in the “2015 PQRS GPRO Registration Guide” located in the “Downloads” section below, to register the group to participate in the 2015 PQRS GPRO.   

 

PQRS Program

PQRS Group Practice Reporting Option

PQRS Payment Adjustment Information 

Value Modifier

For questions about participating in the 2015 PQRS as a group or as an individual or obtaining an IACS account, contact the QualityNet Help Desk.

  • Monday – Friday: 8:00 am – 8:00 pm EST
  • Phone: (866) 288-8912 (TTY 1-877-715-6222)
  • Email: qnetsupport@hcqis.org

For questions about the Value Modifier, contact the Physician Value Help Desk.

  • Monday – Friday: 8:00 am – 8:00 pm EST
  • Phone: 1-888-734-6433 (select option 3)