2016 Isn’t Over Yet for Medicare – Last Minute Tips for MU and PQRS Reporting

 In Articles, Meaningful Use, Medicare Quality Programs, PQRS, Provider Notes

Avoid reductions of up to 9% on your 2018 Medicare payments by following these critical steps to complete 2016 reporting for PQRS and Meaningful Use.

Important Deadlines

Program-Reporting Approach Submission Deadline
PQRS via Claims CMS must receive claims by 2/28/17
PQRS via Registry/QCDR Each has its own deadline, most between 1/15 and 3/15. Registries/QCDRs must submit to CMS by 3/31/17
PQRS via EHR Upload your QRDA electronic file at https://portal.cms.gov by 2/28/17 to report quality measures for both the PQRS and MU programs. You must have an EIDM login which can take 2-3 weeks.
MU Attestation Complete your attestation at https://ehrincentives.cms.gov by 2/28/17

PQRS Tips

(Possible penalty 2% from PQRS plus 2-4% from Value Based Modifiers)

  • PQRS applies to all providers who bill Medicare under their own NPI, including Mid-Levels and PTs, OTs, Clinical Social Workers. No exclusions based on specialty or small volumes.
  • If you see Medicare patients at two different practices (Tax IDs), you are required to report PQRS for each practice separately.
  • Remember that the performance rate on the quality measures you report to PQRS will be used in the VBM program and compared to national averages. Some will be publicly available on the Physician Compare website. Choose measures that have the highest performance rate.
  • If you registered to report as a group (GPRO) but find that you can’t report as expected, you are allowed to use a different mechanism or report as individual providers. However, if you didn’t register before 7/1/16 you can’t now choose to report as a group and must report as individual providers.
  • Haven’t started yet? Check out the Measure Group option that allows you to report on a sample of 20 patients.
  • You can report fewer than 9 measures and still be successful using the MAV process.

Meaningful Use Tips

(Possible penalty 3%)

  • Late year rule change allows for a 2016 reporting period of 90 consecutive days or longer. Make use of volume-based exclusions for many measures by reducing your reporting period to 90 days.
  • Review your registration information for accuracy, especially the listed email. Audit notices will be sent to the email listed.
  • For Measure 10 (Public Health Registries) you are required to report to 2 registries selected from an Immunization Registry, a Syndromic Surveillance Registry, and 1 or 2 Specialty Registries. If you meet an exclusion for one of these 3 options, you will need to report to the remaining option or meet an exclusion for all 3 types of registries. Early in the attestation process you’ll be asked to select which type of registry you will report on. If you plan to use an exclusion to cover any portion of this measure, you’ll need to select Immunization & Syndromic Surveillance & Specialty Registry (1) – 3 checkmarks. As you complete the attestation, when you reach measure 10, you will mark an exclusion or ‘yes’ to reporting for 10A (Immunization Registry), mark an exclusion or ‘yes’ to reporting for 10B (Syndromic Surveillance) and mark an exclusion or ‘yes’ to reporting for 10C (Specialty Registry 1).
  • After attesting to each of the MU measures, you will be asked whether you plan to report Clinical Quality Measures electronically or manually enter data as part of this attestation. If you plan to report electronically, your QRDA file must be uploaded at https://portal.cms.gov by 2/28/17.
  • Did you change EMRs in 2016? Significantly affected by Hurricane Matthew? If you can’t meet the MU requirements you may qualify for a Hardship Exemption. Requests for Hardship Exemptions are reviewed on a case-by-case basis. Watch cms.gov/ehrincentiveprograms for application details (likely deadline 6/30/2017).

Need Help with Medicare Quality Programs?

Contact Jeanne Chamberlin at j.chamberlin@msochealth.com or 919-442-2422.

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