CMS Physician Quality Reporting Program
The Physician Quality Reporting Initiative (PQRI) was created by the Tax Relief and Health Care Act of 2006 (TRHCA) to help the Centers for Medicare and Medicaid Services (CMS) enhance the value of care provided to Medicare beneficiaries. The program is dependent on measures that are often developed by a physician specialty or adopted or endorsed by a consensus organization, such as AQA Alliance or the National Quality Forum.
AASLD, in collaboration with the AGA Institute, has been involved in the development of measures related to the management and treatment of hepatitis C that were adopted in the 2008 Medicare quality reporting program along with many other PQRI measures.
To further strengthen those measures developed by AASLD and the AGA Institute, individual reporting by physicians treating patients with hepatitis C is very important.
Your Participation
To participate in the PQRI, eligible professionals must have National Provider Identifier (NPI) individual levels – used to analyze whether an eligible professional has successfully reported and is performing at the individual eligible professional level – and must consistently use their individual NPIs to correctly identify their services, procedures, and quality-data codes for an accurate determination of satisfactory reporting.
Financial Incentive
Additionally, the TRHCA authorizes a financial incentive for eligible professionals who participate in the PQRI. The 2007 program provided a bonus payment of 1.5% to those eligible professionals who successfully reported on a threshold of quality measures at least 80% of time. The 2008 bonus payment has yet to be determined, but is estimated to also be 1.5 percent.
CMS will provide confidential feedback reports to participating eligible professionals near the time that the lump sum bonus payments are made, which will likely be around mid-2009. Bonus payment checks will be sent electronically to the Taxpayer Identification Number (TIN), not the NPI.
Additional Information
The detailed specifications for all final 2008 PQRI measures, along with other information on the PQRI program, can be found at http://www.cms.hhs.gov/pqri.
Information regarding practical tips for hepatologists choosing to participate in the 2008 PQRI is forthcoming and will be posted here at www.aasld.org.