The Tax Relief and Health Care Act of 2006 created a bonus program, the Physician Quality Reporting Initiative (PQRI,) for physician practices that choose to report quality performance measures listed on the Centers for Medicare & Medicaid Services (CMS) Web site, which was recently updated to include 74 measures. http://www.cms.hhs.gov/PQRI/35_2008PQRIInformation.asp) In response to widespread member interest and misinformation on our listservs, MGMA will be hosting two PQRI Webcasts, one on March 22 and the other on March 29.
You have heard the rumors about the new Medicare quality-reporting program. Get information directly from government officials and MGMA members on how you can take advantage of the 1.5 percent bonus pool available to physicians who report quality measures in the second half of 2007.
The Tax Relief and Health Care Act of 2006 created a bonus program for physician practices that choose to report quality performance measures listed on the Centers for Medicare & Medicaid Services (CMS) Web site. The reporting period runs July 1-
Dec. 31, 2007
. Practices will have to report at least three measures at least 80 percent of the time that those measures were clinically applicable to the visit. Reporting will consist of adding the appropriate G-code or CPT II code (when available) to a Medicare service claim that also contains the relevant ICD-9 code.
The bonus a practice receives is the lesser of either:
- 1.5 percent of its entire Medicare allowable charges for that six-month period; or
- A cap formula that CMS will calculate in 2008.
The cap formula will take into account the average allowable charge on all claims that have performance standards reported on them. CMS will calculate this figure in 2008, after the program has ended. Bonuses will be paid out as lump sums to appropriate practices in 2008.
To offer the most complete information to our members, MGMA is hosting a two-part series on the PQRI. National MGMA members can register for this valuable educational series for package price of $229.
On March 22, Part I of the two-part series, “PQRI Program Overview,” will feature Susan Nedza, MD, CMS medical officer for Region 5, and Bill Rogers, MD, CMS director of the Physicians Regulatory Issues Team.
On March 29, Part II, the “PQRI Practice Administrators’ Panel” will present Marilyn Orr, MBA, CMPE, Dover (Ohio) Orthopaedic Center Inc.; Lisa Jollif, CPC, coding manager, Idaho Emergency Physicians, Boise; and Shunn Phillips, chief financial officer, Baton Rouge (La.) Clinic.
Remember that MGMA does not limit the number of people that may be on a call to receive continuing education credit. This is an excellent staff training opportunity!
Register on mgma.com until March 21 or call 877.ASK.MGMA (275-6462). Can’t make the live Webcast? Order a CD of the presentation with handouts by calling the toll-free number above.
Have questions? I’m here to help.
