Background.  The 2006 Tax Relief and Health Care Act (TRHCA) (P.L. 109-432) required the establishment of a physician quality reporting system, including an incentive payment for eligible professionals (EPs) who satisfactorily report data on quality measures for covered services furnished to Medicare beneficiaries during the second half of 2007 (the 2007 reporting period). CMS named this program the Physician Quality Reporting Initiative (PQRI).

2009 PQRI. The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) (Pub. L. 110-275) made the PQRI program permanent, but only authorized incentive payments through 2010. EPs who meet the criteria for satisfactory submission of quality measures data for services furnished during the reporting period, January 1, 2009 - December 31, 2009, will earn an incentive payment of 2.0 percent of their total allowed charges for Physician Fee Schedule (PFS) covered professional services furnished during that same period (the 2009 calendar year).

As required by the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA) (Pub. L. 110-173), CMS has established 2 alternative reporting periods for the reporting of measures groups and for the submission of data on PQRI quality measures through clinical data registries. The 2 alternative reporting periods are: January 1, 2009 - December 31, 2009 and July 1, 2009 - December 31, 2009. In total, there are 9 options for satisfactorily reporting quality measures data for the 2009 PQRI that differ based on the reporting period an EP chooses to report on, whether an EP chooses to report through claims or an approved clinical registry, and whether an EP chooses to report on individual measures or measures groups.

The 2009 PQRI consists of 153 quality measures and 7 measures groups.

Source: CMS

Additional Information

Registry Requirements for submission of PQRI
PQRI Implementation Guide
MAV Process Explanation
MAV Flowchart