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Eligible professionals (EPs) do not have to enroll or file an intent to participate in the PQRI program. Professionals who choose to participate by reporting quality measures data through claims can simply report the appropriate quality data codes on service lines of Medicare Part B Physician Fee Schedule (PFS) professional-services claims. Beginning with the 2008 PQRI program year, EPs may also qualify to earn a PQRI incentive by reporting quality measures data to a qualified registry. Professionals participating in a registry that self-nominates and qualifies to submit data on behalf of eligible professionals for a particular program year should expect to receive more information from the registry on how to participate. In addition to the claims-based reporting mechanism and the registry-based reporting mechanism, CMS is testing electronic health record (EHR) data submission, in cooperation with EHR vendors. Pending successful completion of the 2009 EHR Testing Program and a determination that there is at least one "qualified" EHR vendor, then an EP would be able to earn a PQRI incentive payment through the EHR-based reporting mechanism beginning with the 2010 PQRI (if the EP is using one of the EHR products that CMS is "qualifying in its 2009 EHR Testing Program). 2010 PQRI As described in the 2010 Medicare PFS final rule (to view the rule, click on the "Statute/Regulations/Program Instructions" link at left), CMS is retaining the claims-based and registry-based reporting mechanism. In addition, CMS will accept PQRI quality measures data extracted from a qualified EHR product for a limited subset of proposed 2010 PQRI quality measures. This is contingent upon the successful completion of our 2009 EHR Testing Program and a determination that one or more EHR vendors participating in the 2009 EHR Testing Program is "qualified." Registry-Based Submission For 2010 Incentive To qualify to submit data on behalf of EPs seeking incentive payments for 2010, registries are required to go through a self-nomination and vetting process if they are new to PQRI registry reporting or to notify CMS of their desire to continue PQRI data submission in 2010 if they were qualified in 2009 and successfully submitted their users' quality data. To become qualified, registries must meet certain technical and other requirements specified by CMS. The document "Registry Requirements for Submission of 2010 PQRI Data on Behalf of Eligible Professionals" may be found in the "Downloads" section below. This document describes the high-level requirements for a registry to qualify to submit under the registry-based reporting alternatives for 2010. This document also outlines how a registry can become qualified for 2010 data submission. Qualified Registries for 2010 PQRI Reporting. A list of registries that have become "qualified" to submit quality data to CMS on behalf of their eligible professionals for 2010 PQRI reporting is now available in the "Downloads" section below. Each of these registries has gone through a thorough vetting process including checking their capability to provide the required PQRI data elements, reviewing a measure flow (this checks to see whether the registry calculates the measure's reporting and performance rates correctly), and transmitting the required information in the requested file format (XML). While the listed registries successfully completed the vetting process, CMS cannot guarantee that any or all of the listed registries will be successful in providing the required information on behalf of their eligible professionals for the possible payment incentive. This list, however, represents those registries who successfully submitted data for 2008 PQRI in early 2009 on behalf of their eligible professional clients. Additional 2009 "qualified" registries (who have completed the vetting process) will be submitting 2009 PQRI data in early 2010 and will be added to this list if their data submission is successful (list update anticipated Spring 2010). Finally, there is a new self-nomination process currently underway which will allow other registries to become "qualified" for 2010 PQRI participation. We expect to complete the vetting process and post the names of the new registries by the summer of 2010. Final Documents for 2010 EHR-Based Reporting In the 2010 PFS final rule, CMS stated that ten measures are available for EHR-based reporting in 2010. The following documents for the electronic submission of these ten measures by EPs using a "qualified" EHR is available in the "Downloads" section below: • 2010 PQRI EHR Measure Specifications - The detailed description of data element names and codes related to each of the ten 2010 PQRI quality measures available for electronic submission. • 2010 PQRI EHR Measure Specifications – Release Notes – The corresponding release notes for the 2010 EHR Measure Specifications. The "Final 2010 EHR-Based Reporting Documents" ZIP file in the "Downloads" section below contain the following documents: • Data Submission Specifications Utilizing HL7 QRDA Implementation Guide Based on HL7 CDA Release 2.0 • Updated EHR Data Submission Specifications Utilizing QRDA – Release Notes – Release notes for Data Submission Specifications Utilizing HL7 Quality Reporting Document Architecture Based on HL7 CDA Release 2.0 • Updated 2010 EHR Downloadable Resource Table • Updated EHR Data Submission Specifications Utilizing QRDA Header Errors and Edits • Updated EHR Data Submission Specifications Utilizing QRDA Body Errors and Edits NOTE: The posting of any documents for the electronic transmission of any particular measure prior to publication of the 2010 PFS final rule does not signify that the measure will necessarily be selected for the 2010 PQRI measure set, nor that EHR-based reporting will be accepted for that measure even if it may otherwise be included in the 2010 PQRI. Qualified Electronic Health Record (EHR) Vendors for 2010 PQRI and Electronic Prescribing Incentive Programs An updated list of EHR vendors and their programs that have become "qualified" to submit quality data to CMS by eligible professionals 2010 PQRI reporting is now available in the "Downloads" section below. Each of these EHR vendors has gone through a thorough vetting process for the product and version listed including checking their capability to provide the required PQRI data elements for 10 PQRI measures. Some EHRs are also capable of reporting the electronic prescribing measure. In addition to capturing the required data elements for the measure calculation, these "qualified" EHR products can also transmit the required information in the requested file format. While the listed EHR vendors and their EHR products have successfully completed the vetting process, CMS cannot guarantee that any other product or version of software from the listed vendors will be compatible for EHR based submission for PQRI. Additional 2010 EHR products, if any, that pass "qualification" will be posted in mid-January 2010. 2011 PQRI Requirements for EHR Vendors to Participate in the 2011 PQRI EHR Program. EHR vendors who wish to qualify to participate in the 2011 PQRI EHR program must submit a self-nomination letter requesting inclusion in the 2011 PQRI Testing Process in 2010 by no later than January 31, 2010. The 2011 PQRI EHR vendor qualification process and requirements for the 2011 PQRI EHR Testing Process are described in the "Requirements for EHR Vendors to Participate in the 2011 PQRI EHR Program," which is available in the "Downloads" section below.
Page Last Modified: 02/17/2010 12:57:33 PM
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