I received a letter about a penalty for not participating in PQRS.  What does this mean?

The Physician Quality Reporting System (PQRS) has been in effect since 2007 providing incentive payments for eligible professionals, and will begin to impose payment adjustments in 2015. PQRS is NOT Meaningful Use. Participating in Meaningful Use does not meet the PQRS reporting requirement.

PQRS encourages eligible health care professionals (EPs) to report on specific quality measures.

If you are a facility or provider that bills using the physician fee schedule, then reporting to this program is mandatory or payment adjustments will be imposed beginning with calendar year 2015. To avoid further payment adjustments in 2016, you will need to report 2014 data.

If you are a Critical Access Hospital, and received a letter regarding PQRS payment adjustments for 2015, that letter could have been sent to you in error. 

"CMS misidentified eligible professionals (EPs) associated with critical access hospitals (CAHs) as receiving the 2015 payment adjustment.   These EPs associated with CAHs are not subject to the payment adjustment in 2015; CMS is in the process of correcting this.  There is no action required on the part of the CAH or EP." 

You may want to confirm this information and the status of your provider/facility with the Quality Net Helpdesk by emailing them at: mailto:qnetsupport@hcqis.org.  Need Help?  Check out HTS PQRS Services.

If I did not report PQRS in 2014 - what happens?

Even if you received a letter in error for 2015 payment adjustment - that only applied to this year. You are now eligible to report 2014 data, and need to in order to avoid a 2016 payment adjustment.

PQRS applies to the following professionals that you may be billing the Medicare Part B Physician Fee Schedule for - 

CMS announced possible changes for MU in 2015 - What should I do?

Read the CMS Blog for more details.

 

HTS recommends that until an official announcement is made by CMS that changes the meaningful use regulations for 2015, proceed with your MU efforts appropriate for your current year/stage of MU.  BE SURE YOUR EHR IS CONFIGURED and that you are tracking all necessary requirements for 2015 MU reporting.  Assume you will report as scheduled until/unless CMS officially changes the MU regulations for 2015. 

 

Read more information on preparing for 2015 meaningful use.

 

Contact HTS for more information.

 

Will Patient Portal challenges prevent me from meeting MU in

2015?

 

Many EHR vendors and their clients struggled to meet the 2014 Meaningful Use requirements for View, Download and Transmit.  There is no flexibility in 2015 in meeting this objective regardless of what MU Stage you are reporting.

 

It is critical to understand how your EHR and Portal will transmit patient information as well as how it is calculating the numerator and denominator for both measures.  Workflows should be clearly documented to make sure accurate information is available to the patient in the required timeframes as well as appropriate strategies in place to encourage patient engagement to access and utilize the patient portal functionality.  

 

Need help with MU - check out HTS MU Services.

 

Eligible Provider 2014 MU attestation deadlines - will I make it?

Medicare NLR Eligible Professional deadline for 2014 meaningful use attestation is February 28, 2015.

 

Medicaid SLR Eligible Professional deadline for 2014 meaningful use attestation, for both Montana and Wyoming, is March 31, 2015.

  

Need help with MU - check out HTS MU Services.