Eligible providers (EPs) who do not participate in the Physician Quality Reporting System (PQRS) in 2013 will incur a 1.5 percent Medicare payment adjustment (penalty) in 2015. For EPs who wish to avoid the payment adjustment but are not concerned with earning an incentive, participating in PQRS through Administrative Claims is an option. Through this option, the Centers for Medicare & Medicaid Services (CMS) will automatically analyze an EP’s Medicare claims on a pre-selected set of largely primary care-focused measures. The measures have little relevance to urology; so, one’s “score” will not be completely pertinent to a urology practice. However, an EP gets credit for PQRS participation and successfully avoids the payment adjustment. Those choosing Administrative Claims must register with CMS, and CMS has just extended the deadline until Friday, October 18.
Additionally, in the Affordable Care Act, Congress requires CMS to apply a Value-Based Modifier (VBM) to all physicians’ Medicare payments by 2017 and to some physicians’ payment starting in 2015. In response, CMS intends to apply a 1 percent VBM penalty to the Medicare payments of physicians in groups of 100 or more that do not engage in GROUP participation in PQRS in 2013. This VBM penalty will be in addition to another 1.5 percent penalty that will apply to all physicians who do not participate in PQRS either as an individual or as part of a group. To avoid these penalties, physicians in groups of 100 or more should ensure that their GROUP is registered for one of the PQRS group participation options. This deadline was also extended until Friday, October 18.
Click here to register either for Administrative Claims or group reporting (GPRO) prior to Friday, October 18. Use of the system requires an Individuals Authorized Access to the CMS Computer Services (IACS) number, which can be acquired here. Please note that acquiring an IACS account or updating an existing account which has become dormant because it has not been used for several months can be an lengthy and involved process; so, participants are strongly encouraged to begin the IACS process well in advance of the Friday, October 18, deadline. Additional information regarding registration and obtaining or modifying an IACS account is available at the Self Nomination/Registration web page.
Please note that due to the government shutdown, CMS is unable to update the October 15 date listed on their website. Additionally, please note the help desk phone number listed in error messages on the PQRS registration portal is incorrect. Users should call the PV-PQRS Help Desk at 1-888-734-6433 Option 3 for questions about registration. They can also contact CMS’ QualityNet help desk at (866) 288-8912 or firstname.lastname@example.org.