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Physician Quality Reporting Initiative Click on the "Spotlight" link to the left to view "What's New" (recently posted items) for PQRI Background. The 2006 Tax Relief and Health Care Act (TRHCA) (P.L. 109-432) required the establishment of a physician quality reporting system, including an incentive payment for eligible professionals (EPs) who satisfactorily report data on quality measures for covered services furnished to Medicare beneficiaries during the second half of 2007 (the 2007 reporting period). CMS named this program the Physician Quality Reporting Initiative (PQRI). For each program year, CMS implements PQRI through an annual rulemaking process published in the Federal Register. Information regarding the 2009 PQRI program and related legislative requirements can be viewed by clicking on the "Statutes/Regulations/Program Instructions" link at left. A "List of Eligible Professionals" who may participate in PQRI is available in the "Downloads" section below. 2009 PQRI. The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) (Pub. L. 110-275) made the PQRI program permanent, but only authorized incentive payments through 2010. EPs who meet the criteria for satisfactory submission of quality measures data for services furnished during the reporting period, January 1, 2009 - December 31, 2009, will earn an incentive payment of 2.0 percent of their total allowed charges for Physician Fee Schedule (PFS) covered professional services furnished during that same period (the 2009 calendar year). As required by the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA) (Pub. L. 110-173), CMS has established 2 alternative reporting periods for the reporting of measures groups and for the submission of data on PQRI quality measures through clinical data registries. The 2 alternative reporting periods are: January 1, 2009 – December 31, 2009 and July 1, 2009 – December 31, 2009. In total, there are 9 options for satisfactorily reporting quality measures data for the 2009 PQRI that differ based on the reporting period an EP chooses to report on, whether an EP chooses to report through claims or an approved clinical registry, and whether an EP chooses to report on individual measures or measures groups. The 2009 PQRI consists of 153 quality measures and 7 measures groups. Click on the "Measures/Codes" link to the left to access a measures list, measure specifications, and other related information to get started. EPs do not need to sign-up or pre-register in order to participate in the 2009 PQRI. Submission of quality data codes for the 2009 PQRI quality measures to CMS through claims or a qualified registry will indicate your intent to participate in the 2009 PQRI. Click on the "Educational Resources" link at left to access educational materials and resources on how to satisfactorily participate in PQRI. Updated tools are available to assist professionals in PQRI reporting. To access these tools, click on the "PQRI Tool Kit" link at left. NOTE: All PQRI information for program years prior to 2009 has been archived. Please click on the appropriate PQRI Program link at left to view information specific to a previous year's PQRI. 2007 PQRI Reporting Experience. A report on the 2007 PQRI reporting experience outlines the issues identified for 2007 and CMS plans for modifications to the analytics for the 2008 PQRI. This report is available in the "Downloads" section of the "2007 PQRI Program" link at left. Letter to Medicare Beneficiaries. CMS has posted a letter to Medicare beneficiaries with important information about the PQRI. The letter is from Medicare to the patient explaining what the program is, and the implications for the patient. Physicians may choose to provide a copy to their patients in support of their PQRI participation. To obtain a copy of the letter, see the "Related Links Inside CMS" section below.
Page Last Modified: 10/23/2009 1:32:32 PM
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