The Centers for Medicare and Medicaid Services’ (CMS) Physician Quality Reporting Initiative (PQRI) will continue in 2009. Beginning January 1, 2009, eligible providers who report certain quality measures may be eligible for a 2% payment increase, to be paid in the second quarter of 2010. To assist nephrologists who may elect to participate in this program, RPA has compiled useful information developed by the RPA, the American Medical Association (AMA), as well as CMS to identify measures relevant to their practice and facilitate the data collection required to successfully report clinical performance data.
As it was in 2007 and 2008, participation in the 2009 program is entirely voluntary. Further, RPA members considering participation in the program should bear in mind that there remain unresolved issues concerning the program. is possible that the bonus payment will not cover the expenses associated with participating in the program.
For 2009, RPA has identified eight PQRI measures most applicable to nephrology practices, five specific to CKD and three specific to ESRD care (please note: only one ESRD measure is available for reporting through claims-based reporting). These measures were developed by the RPA in conjunction with the AMA-convened Physician Consortium for Performance Improvement. A complete list of all 153 quality measures can be found at www.cms.hhs.gov/pqri.
2009 Resources available
RPA has compiled useful information and links to assist nephrology practices in successfully participating in Medicare’s PQRI program. The following information is available to guide nephrology practices through the PQRI process including measure specific information about eligibility, coding, reporting frequency, reporting options and helpful hints for successful reporting including:
2009 ESRD, CKD and Diabetes Quality Measures - A table of ESRD, CKD, and Diabetes Mellitus quality measures that may be most appropriate for use by nephrologists. The table contains information about the requirements for eligibility, coding, reporting frequency, and helpful hints by PQRI measure as well as links to a series of worksheets intended for use by nephrology practice staff that will assist in the tracking of the measure information for reporting purposes. THESE PARTICIPATION TOOLS ARE INTENDED FOR CLAIMS-BASED REPORTING OF INDIVIDUAL MEASURES.
- Measure Description – This document contains additional descriptive information regarding the measure and should help users determine if it is a measure on which they would like to report. In particular, the document describes what type of information is required to report on the measure and how frequently reporting is required.
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2009 RPA PQRI RESOURCES
2009 RPA PQRI Office Tool
This PQRI “cheat sheet” is a resource that can be modified by the user and put into patients’ records to help PQRI users navigate the necessary information for claims submission.
2009 ESRD
CKD and Diabetes Quality Measures
Includes measure specific information about eligibility, coding, reporting frequency, reporting options and helpful hints for successful reporting
2009 Reporting Options
Includes information about claims based, measures group and registry reporting requirements for 2009 as well as links to CMS resources
2008 Aggregate PQRI Error Report
contains aggregate-level information about the quality data codes submitted between January 1, 2008 through September 30, 2008, by measure.
2008 PQRI Information
CMS PQRI RESOURCES
New 2009 PQRI and E-Prescribing Incentive Programs Resources from CMS
1. New Medicare Learning Network Education Product
2. New and Revised MLN Articles on the Physician Quality Reporting Initiative
3. Three Physician Quality Reporting Initiative Help Desk Resources
CMS establishes new PQRI helpline
The Centers for Medicare and Medicaid Services (CMS) will establish a new help line for participants in the Physicians Quality Reporting Initiative (PQRI) to answer questions regarding participation procedures, feedback reports, and bonus payments. The telephone number is 866-288-8912, and will be in operation between 7:00am and 7:00pm Central Time. CMS will also create a new email address for inquiries. Additional information about the help line and the email inquiry address will soon be posted on the Spotlight page of PQRI website, found at www.cms.hhs.gov/PQRI.
2009 PQRI Implementation Guide
2009 PQRI Quality Measure Specifications Manual
2009 PQRI Measures Group Specifications Manual
2007 PQRI Reporting Experience
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