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CMS Releases Payment, Penalty Data for PQRS, e-Rx Program



CMS released incentive payment and participation data for its quality reporting and electronic prescribing incentive programs.

Almost 40% of health care providers who participate in Medicare will see their reimbursements cut by 1.5% this year because they failed to meet CMS’ deadlines to submit quality data.

To avoid payment reductions under CMS’ Physician Quality Reporting System (PQRS) this year, providers in 2013 had to submit quality data on at least one of more than 100 possible measures. Physicians this year will need to report on at least nine of the measures in order to avoid future payment reductions.

According to CMS, more than 460,000 of the 1.25 million eligible Medicare providers did not meet deadlines to submit data for PQRS in 2013. The agency noted that about 70% of those who did not meet the deadlines see fewer than 100 Medicare patients annually.

Meanwhile, nearly 642,000 of eligible Medicare providers did comply with the quality reporting deadlines in 2013 and will receive a 0.5% reimbursement increase this year.

Overall, CMS said that provider participation in the program increased from 15% of eligible providers in 2007 to 51% in 2013. According to the report, psychiatrists and general practitioners make up the largest percentage of providers failing to participate or meet PQRS requirements.

Source: iHealthBeat, April 27, 2015



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