As a reminder, Medicare will start penalizing physicians in 2015 based on whether they successfully report quality measures in 2013 as part of the Physician Quality Reporting System (PQRS). To avoid the 1.5% penalty in 2015, physicians need only report one individual quality measure for at least one patient.  Individuals may use any of four available reporting methods: claims-based reporting through Medicare Part B claims; (2) a qualified PQRS registry; (3) a qualified electronic health record (EHR); or 4) a qualified PQRS data submission vendor.

Physicians who have not yet started PQRS reporting should review the list of quality measures for 2013 and identify at least one that applies to your Medicare patients.  Access the measure specification for the measure you have selected (the ACCMA can send members a copy by calling 510-654-5383) to learn about the measure and how to report it.  Report the quality measure in accordance with the measure specification for at least one eligible Medicare patient in 2013, and you will avoid the penalty in 2015.

Physicians can qualify for an incentive equal to 0.5 percent of their total estimated Medicare Part B allowed charges for 2013 by achieving a higher reporting threshold – for example, reporting on at least three individual measures for at least 50% of the Medicare patients for whom the measures apply.

PQRS is a reporting program that uses both incentives and penalties to encourage physicians and other professionals to report quality measures. Please note that PQRS includes many different options for participation and reporting, which are not covered in this article.  The ACCMA and CMA will be posting an updated PQRS Reporting Guide in the near future, but you may click here to access several of the resources created for members in 2012 that provide basic information and an orientation to PQRS reporting.