What is the Physician Quality Reporting System (PQRS)?
PQRS was a quality reporting program that used negative payment adjustments to promote reporting of quality information by individual EPs and group practices. 2016 was the last program year for PQRS. In 2017, PQRS transitioned to the Merit-based Incentive Payment System (MIPS) under the Quality Payment Program. The final data submission timeframe for reporting 2016 PQRS quality data to avoid the 2018 downward payment adjustment was January through March 2017. The first MIPS performance period is the 2017 calendar year.
Why is PQRS important?
Non-participation or failure to satisfactorily report or satisfactorily participate in the 2016 PQRS reporting period will subject you to a 2 percent payment adjustment on your covered professional services in 2018. Non-PQRS reporters will also experience an additional penalty under the Value-Based Payment Modifier (VM).
For PQRS, EPs were required to report nine (9) measures across three (3) National Quality Strategy (NQS) domains. Providers and practices participating in the claims-based or qualified registry reporting mechanisms who did report 9 measures across 3 NQS domains must have reported on all applicable measures and successfully passed the Measure-Applicability Validation (MAV) process in order to successfully participate in PQRS and avoid a downward payment adjustment. For payment adjustment considerations, the MAV process determines whether an EP, who submitted data on fewer than 9 PQRS measures across 3 NQS domains, should have submitted additional measures to PQRS. Eligible professionals who fail MAV are subject to the 2018 payment adjustment. Information on how the 2016 PQRS MAV is applied is found on the CMS Analysis and Payment webpage.
Please visit the CMS webpages listed below for additional resources on PQRS.
For information on PQRS reporting options and regulatory information, please contact the ASA Department of Quality and Regulatory Affairs at (202) 289-2222 or firstname.lastname@example.org.