Physician Quality Reporting System

The Physician Quality Reporting Initiative (PQRI) was first implemented as a voluntary pilot program in 2007. The PPACA (Patient Protetion and Affordable Care Act) made a number of changes to the program and extended incentive payments for several years. The program has been made a permanent part of Medicare andCMS is now transitioning the name of the program from PQRI to the “Physician Quality Reporting System. (PQRS)” The program will continue to provide incentive payments to eligible physicians and other practitioners, who satisfactorily report data on quality measures for covered services furnished during a reporting period. In 2010, participating professionals reporting measures were eligible for an incentive payment equal to 2.0 percent of the estimated total allowed charges for all covered professional services furnished during the reporting period. In 2010, eligible professionals (EPs) could report individual measures or measure groups through one of three reporting mechanisms: claims-based reporting, registry-based reporting, and electronic health record (EHR)-based reporting. In addition to reporting individual measures, participants could also report a limited number of preselected measure groups.

In 2011, eligible professionals can earn a 1.0 percent incentive payment based on total Part B allowed charges for successfully reporting measures in the reporting period. Incentive payments will be 0.5 percent for 2012 – 2014. Penalties will begin in 2015 for those who do not satisfactorily submit quality data.

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