decisionhealth Newsletters, Part B News - 2015 Issue 2 (February)
Show clinicians the MAV policy to demonstrate importance of PQRS compliance
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Article Overview
This article covers Medicare’s measures applicability validation (MAV) process in the context of PQRS claims-based quality reporting. It explains why providers should not assume prior reporting success guarantees protection from payment adjustments, and it outlines the broader reporting requirements, cluster review issues, and practice-management considerations that can affect whether a claim-based reporter is subject to review. It is useful for clinicians, coding staff, quality reporting teams, and compliance personnel who need a high-level understanding of PQRS reporting expectations and validation review concepts.
Why This Topic Matters
PQRS quality reporting could affect Medicare payment adjustments, and MAV review determines whether a provider may avoid a penalty after missing reporting requirements. Understanding the scope of the review matters for practices trying to manage reporting workflows, data capture, and compliance risk.
Article Sections
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Quality reporting
Introduces Medicare quality reporting and the validation review concept discussed in the article. Summarizes the broader reporting framework and why providers may be reviewed.
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Clusters could pose a hidden hurdle
Explains the article’s discussion of clinically related groupings of measures and how they affect validation review when fewer measures are reported.
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Quality domains MAV: another obstacle
Covers the separate validation review related to quality domains and how that review fits into the reporting process.
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4 more tips to avoid MAV
Provides general practice and workflow considerations for avoiding validation issues, including staff education, data entry, and reporting preparation.
What You Will Learn
- The role of Medicare validation in PQRS claims-based reporting
- How reporting requirements can trigger a review process
- Why clinically related groupings matter in quality reporting
- How quality domains factor into validation review
- Practice workflow issues that can affect reporting completeness
Who Should Read This
- Clinicians
- Medical coders
- Quality reporting staff
- Practice managers
- Compliance teams
Codes Discussed
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