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PQRI Statutory Authority Tax Relief and Health Care Act of 2006 (TRHCA). On December 20, 2006, the President signed the TRHCA, which initially authorized the PQRI. The financial incentive for eligible professionals who satisfactorily report the designated set of quality measures for 2007 is 1.5 percent (subject to a cap) of total estimated allowed charges for covered professional services payable under the Medicare Part B Physician Fee Schedule (PFS) during the 2007 reporting period (that is, July 1, 2007 through December 31, 2007). To view the TRHCA legislative language, see the "Downloads" section below. Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA). The President signed the MMSEA on December 29, 2007, which authorized the continuation of the PQRI for 2008 and 2009. MMSEA permitted program flexibility for 2008 by authorizing CMS to establish alternative mechanisms to previously established claims-based reporting of PQRI quality data. MMSEA provisions require alternative reporting periods and alternative criteria for satisfactorily reporting quality measures data through medical registries and reporting measures groups. In 2008, eligible professionals may earn an incentive payment of 1.5 percent of their total estimated allowed charges for Medicare Part B PFS covered professional services furnished during the respective reporting periods. While TRHCA established a cap on incentive payments for 2007, based on an average per measure payment amount, MMSEA removed the cap on incentive payments. Medicare Improvements for Patients and Providers Act of 2008 (MIPPA). The MIPPA made the PQRI program permanent, but only authorized incentive payments through 2010. Eligible Professionals who meet the criteria for satisfactory submission of quality measures data for services furnished during the 2009 or 2010 reporting period will qualify to earn an incentive payment of 2.0 percent of their total estimated allowed charges for Medicare Part B PFS covered professional services furnished during that same period. 2010 PQRI Regulations CMS' proposals for the 2010 PQRI, including the proposed PQRI reporting mechanisms, the proposed criteria for satisfactory reporting, the proposed measures, and the proposed measures groups, can be found in section G2 of the 2010 Medicare Physician Fee Schedule (PFS) proposed rule (74 FR 33559 through 33589). The 2010 PFS proposed rule was published in the Federal Register on July 13, 2009. A Correction Notice to correct technical errors in the 2010 PFS proposed rule related to the PQRI was published in the Federal Register on August 5, 2009 (74 FR 39032) Comments on the proposed rule will be accepted until August 31, 2009. The entire 2010 PFS proposed rule, including instructions for submitting comments, and the August 5, 2009 Correction Notice is available in the "Downloads" section below. The 2010 PQRI program was finalized in the 2010 PFS final rule with comment period. The final regulation went on display at the Office of the Federal Register's Public Inspection Desk on October 30, 2009. To view the entire 2010 PFS final rule with comment period, see "2010 PFS Final Rule -- CMS-1413-FC" in the "Related Links Inside CMS" section below. Measure Suggestions Received in Response to CMS "Call for 2010 PQRI Measures" In February 2009, CMS publicized a "2010 PQRI Call for Measures" to solicit measure suggestions from stakeholders for potential inclusion in the 2010 PQRI program year. A downloadable document titled "Table of 2010 Measure Suggestions" listing measure suggestions CMS received from respondents for potential inclusion in the 2010 PQRI, is available in the "Downloads" section below. 2009 PQRI Regulations Detailed information about the 2009 PQRI, including the criteria for satisfactory reporting can be found in section O1 of the 2009 PFS final rule with comment period (73 FR 69817 through 69847), which was published in the Federal Register on November 19, 2008. To view the entire 2009 PFS final rule with comment period, click on the relevant link in the "Related Links Outside CMS" section below. PQRI regulations and other relevant program instructions for previous program years have been archived. To access PQRI regulations for a specific program year, click on the appropriate PQRI Program link at left.
Page Last Modified: 11/04/2009 3:29:10 PM
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