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2009 Physician Fee Schedule Notice of Proposed Rulemaking Section 1848(k)(2)(B)(ii) of the Social Security Act, as amended by the Medicare, Medicaid, and SCHIP Extension Act of 2007 (Pub. Law 110-173), requires the Secretary to publish a proposed set of quality measures that would be appropriate for eligible professionals to use to submit data in 2009 in the Federal Register by August 15, 2008. This proposed set of quality measures for the 2009 PQRI and the proposed 2009 PQRI reporting options were published in the Calendar Year 2009 Physician Fee Schedule Proposed Rule (73 FR 38558 through 38576) in the Federal Register on July 7, 2008 (please see link to Federal Register in the "Related Links Outside CMS" section below.) In the Proposed Rule, we identified and proposed a subset of the proposed 2009 PQRI measures as measures that we would accept reporting through electronic health records (EHRs) in 2009. Asterisks were used to signify such measures in Tables 11 and 13 of the Proposed Rule (73 FR 38568, 38571). Asterisks were inadvertently left off of two measures that we had intended to propose as measures that we would accept reporting through EHRs in 2009 ¨C Measures #110 (Preventive Care and Screening: Influenza Immunization for Patients ¡Ý 50 Years Old) and #111 (Preventive Care and Screening: Pneumonia Vaccination for Patients 65 years and Older) in Table 11 (73 FR 38569). We anticipate issuing a correction notice for the Proposed Rule that will include asterisks for Measures #110 and #111 so that the total number of measures proposed for EHR submission would be seventeen measures rather than fifteen measures. New Reporting Options CMS has recently announced new options making it easier than ever for professionals to participate in PQRI in 2008 -- whether they submit quality measures information through claims or registries. It is not too late for those who have not started reporting to begin participation. To learn more, please see "008 PQRI" below. Registry Requirements CMS has recently posted the requirements a registry must meet to qualify to submit quality measures information on behalf of their eligible professionals who seek to earn an incentive bonus payment using registries in 2008. The requirements are summarized in the document "2008 PQRI Registry Requirements for Submission Under New Options" To download this document, please click on the "Reporting" link to the left, then scroll to the "Downloads" section of that page. This document also describes how a registry can self-nominate to qualify to submit on behalf of its participants for 2008. Background The 2006 Tax Relief and Health Care Act (TRHCA) (P.L. 109-432) required the establishment of a physician quality reporting system, including an incentive payment for eligible professionals who satisfactorily report data on quality measures for covered services furnished to Medicare beneficiaries during the second half of 2007 (the 2007 reporting period). CMS named this program the Physician Quality Reporting Initiative (PQRI). For additional information about TRHCA PQRI requirements, click on the "Statute/Regulations/Program Instructions" link at left. 2008 PQRI: The Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA) was enacted on December 29, 2007 (Pub. Law 110-173). MMSEA authorizes CMS to make PQRI incentive payments for satisfactorily reporting quality measures data in 2008. For 2008, eligible professionals who meet the criteria for satisfactory submission of quality measures data for services furnished during the reporting period, January 1, 2008 ?20December 31, 2008, will earn an incentive payment of 1.5 percent of their total allowed charges for Physician Fee Schedule (PFS) covered professional services furnished during that same period (the 2008 calendar year). This reporting period was established in the 2008 PFS Rule, as authorized by TRHCA. MMSEA also provides professionals greater flexibility for participating in the PQRI for 2008, by authorizing CMS to establish alternative reporting criteria and alternative reporting periods for the reporting of measures groups and for the submission of data on PQRI quality measures through clinical data registries. CMS has posted a document that establishes the new alternative reporting criteria and periods: "2008 PQRI Establishment of Alternative Reporting Periods and Reporting Criteria." This document is available as a downloadable file on the "Statute/Regulations/ Program Instructions" link at left. Note that physicians and eligible professionals still have the opportunity to begin participating in the 2008 program, and should review the document for more information about the dates for which reporting can occur. Financial incentives earned for 2008 reporting will be paid in mid-2009 from the Federal Supplementary Medical Insurance (Part B) Trust Fund. The 1.5% financial incentive and its funding source for 2008 are the same as for 2007. 2008 PQRI consists of 119 quality measures, including 2 structural measures. One structural measure conveys whether a professional has and uses electronic health records and the other electronic prescribing. For further information on 2008 PQRI measures and detailed specifications, click on the "Measures/Codes" link in the left-hand column on this page. The Centers for Medicare & Medicaid Services has posted a letter to Medicare beneficiaries with important information about the Physician Quality Reporting Initiative (PQRI). The letter is from Medicare to the patient explaining what the program is, and the implications for the patient. Physicians may choose to provide a copy to their patients in support of their PQRI participation. To obtain a copy of the letter, see the "Related Links Inside CMS" section below. Updated tools are available to assist professionals in 2008 PQRI reporting. To access these tools, click on the "PQRI Tool Kit" link at left. 2007 PQRI 2007 PQRI concluded on December 31, 2007. The deadline for submission of 2007 PQRI quality data was February 29, 2008 on claims for dates of service July 1 through December 31, 2007. For further information about 2007 PQRI, click on the "2007 PQRI General Information" link at left.
Page Last Modified: 07/15/2008 9:48:51 AM
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