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Electronic Health Record Reporting

Beginning with the 2010 Physician Quality Reporting System (PQRS) program year, eligible professionals may qualify to earn a PQRS incentive through the Electronic Health Record (EHR)-based reporting method.  Beginning in 2014, group practices may also qualify to earn a PQRS incentive through the EHR-based reporting method.

For 2014 and beyond, CMS will discontinue the PQRS qualification requirement for Data Submission vendors and Direct EHR vendors. To align with the EHR Incentive Programs, EHR systems will instead need to be considered certified EHR technology (CEHRT). The Office of the National Coordinator for Health Information Technology (ONC) certification process has established standards and other criteria for structured data that EHRs must use.  Also beginning in 2014, the eCQM specifications will be used for multiple programs, including the EHR-based reporting option for the PQRS as well as the Medicare EHR Incentive Program to reduce the burden on providers participating in multiple quality programs. EPs must select at least 9 measures covering a minimum of 3 National Quality Strategy domains.

Individual eligible professionals (EPs) and group practices have the following CEHRT-based reporting options:

1. Submit PQRS quality measure data directly from the CEHRT.  
2. Submit PQRS quality measure data extracted from their CEHRT to a qualified EHR Data Submission Vendor.

Direct CEHRT Reporting

To submit quality measure data directly from their own EHR system, EPs and groups need to verify that their Direct EHR vendor is using CEHRT.

EPs and groups must also register for an Individuals Authorized Access to CMS Computer Services account (IACS). More information on registering for an account can be found at the Physician and Other Health Care Professionals Quality Reporting Portal.

CEHRT Reporting Through a Data Submission Vendor

An EHR Data Submission Vendor is an entity that collects an individual EP’s or group practice’s clinical quality data directly from the EP’s or group practice’s CEHRT. Data Submission Vendors are responsible for submitting PQRS measures data from an EP or group practice’s CEHRT to CMS via a CMS specified format(s) on behalf of the EP or the group practice for the program year.

PQRS and the EHR Incentive Programs

EPs and group practices participating under the Group Practice Reporting Option (GPROs), who are also eligible for the Medicare EHR Incentive Program, have the opportunity to submit their electronic clinical quality measures (eCQMs) through the PQRS EHR reporting options to fulfill the eCQMs requirements for both PQRS and the Medicare EHR Incentive Program. EPs and group practices using GPRO may satisfactorily report 12 months of eCQM data to earn credit for both PQRS and the Medicare EHR Incentive Program. Or, EPs may satisfactorily report three months of eCQM data to earn credit for the Medicare EHR Incentive Program only (not applicable to group practices using GPRO). The eCQM reporting is only one component of the Medicare EHR Incentive Program, EPs and group practices using GPRO must still meet the additional components of the Medicare EHR Incentive Programs.  

Data submission vendors (DSVs), plus EPs and group practices participating via GPRO and utilizing the direct EHR submission option, are able to submit data electronically to CMS. Regardless of the reporting period, data submitted on behalf of EPs or group practices using GPRO must  be submitted via the Physician and Other Health Care Professionals Quality Reporting Portal (Portal) using an Individuals Authorized Access to CMS Computer Services (IACS) account. EPs and group practices using GPRO that report via an EHR-based reporting option must use the June 2013 eCQM measures specifications from the EHR Incentive Program’s eCQM library. Please note the exception for CMS140, which is to be reported using the December 2012 version (CMS140v1). To view more information, click on this direct link to the EHR Incentive Programs’  eCQM Library.

2014 PQRS

2014 GPRO EHR Reporting for Vendors

CMS has posted a fact sheet about 2014 GPRO EHR-based reporting for EHR vendors, which includes information about how EHR Direct and Data Submission Vendors should report 2014 PQRS for group practices participating in PQRS GPRO. EHR Vendors wishing to participate in the 2014 PQRS and submit data for groups participating in PQRS GPRO should review this document by clicking on the following link: 2014 GPRO EHR Reporting for Vendors.

Group practices participating in 2014 GPRO via EHR reporting will need to work directly with their EHR Direct or Data Submission Vendor.

2014: PQRS EHR Reporting Made Simple

This document outlines EHR-based reporting for 2014 PQRS and applies to individual EPs who wish to report via EHR and group practices that registered for EHR-based reporting under the Group Practice Reporting Option (GPRO).  To view click on the following link: 2014: PQRS EHR Reporting Made Simple.