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Sept. 30, Oct. 3 key deadlines to avoid payment penalties

The Society reminds physicians and their health care teams that Sept. 30 and Oct. 3 are important dates in terms of the Physician Quality Reporting System (PQRS), Value-Based Payment Modifier (Value Modifier) and the Medicare EHR incentive program. Failure to meet these deadlines can have a significant impact on a practice’s bottom line.

PQRS/Value Modifier

In order to avoid a Medicare reimbursement penalty in 2016, all physicians in groups of 10 or more eligible professionals (EPs) must submit clinical quality data for 2014 to the Centers for Medicare and Medicaid Services (CMS). Failure to do so will result in a four percent payment adjustment: two percent for PQRS and two percent for the Value Modifier (VM).

EPs in group practices who would like to report as a group practice (Group Practice Reporting Option or GPRO) must register with CMS by Sept. 30. GPRO self-nomination and registration information can be accessed here. Group practice reporting is generally perceived as “less work” than when a group reports on each physician individually, but no registration is required for a group if the EPs in that group plan to report as individuals.

More information is available in this CMS fact sheet, and questions may be directed to the Value Modifier QualityNet Help Desk at 1.866.288.8912 or via e-mail at qnetsupport@hcqis.org.

Medicare EHR Incentive Program

The last day to begin a 2014 reporting period for first-year Medicare eligible professionals (EPs) is Oct. 3. Those EPs who start participation by Oct. 3 will have the opportunity to receive an incentive for 2014, and if they continue to achieve meaningful use (MU), they can earn incentive payments for 2015 and 2016 participation. EPs who do not participate or those who fail to achieve meaningful use will be subject to a negative payment adjustment beginning in 2015.

More information is available on this CMS fact sheet.

Although CMS has attempted to align or adopt similar reporting requirements across these programs, EPs are urged to review the respective quality program (e.g. PQRS, MU, VM) to ensure they satisfy the specific requirements of each program.

Back to September 25, 2014 Medigram