tci Medicare Compliance & Reimbursement - 2010 Issue 17
PQRI: CMS Proposes Making PQRI Reporting Easier in 2011
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Article Overview
This article covers proposed updates to CMS’s Physician Quality Reporting Initiative (PQRI) for 2011, including changes to claims-based, registry, and EHR reporting requirements, measures groups, and the e-prescribing incentive program. It also discusses CMS error-report findings from prior PQRI quarters and highlights the types of reporting mistakes providers are expected to avoid. The content is useful for physicians, group practices, quality reporting staff, and coding professionals who track CMS reporting policy and quality program compliance.
Why This Topic Matters
The article helps readers understand where PQRI reporting rules were expected to change and how CMS was evaluating reporting accuracy. That makes it relevant for practices trying to plan quality reporting workflows and monitor common submission problems.
Article Sections
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Proposed 2011 PQRI reporting changes
Discusses CMS’s proposed revisions to PQRI reporting for 2011 across claims-based, registry-based, and EHR-based options. It also notes related program updates announced through the Medicare Physician Fee Schedule proposed rule.
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Measures groups and reporting mechanisms
Covers proposed updates affecting measures groups and the available reporting mechanisms for the 2011 program year. The section also references the CMS list of qualified registries and EHR systems.
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E-prescribing incentive payment and reporting criteria
Addresses the separate incentive payment discussion for successful e-prescribing and the relationship to other CMS incentive programs. It also summarizes the reporting method requirements discussed on the CMS call.
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Diagnosis codes matter in PQRI
Explains CMS feedback on data accuracy and why diagnosis information linked to claims is part of PQRI validation. The section focuses on the role of error reports in understanding reporting quality.
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Common errors in PQRI reporting
Summarizes the types of reporting errors CMS highlighted in its review of previous PQRI submissions. It notes that CMS identified patterns tied to patient age and gender errors in selected measures.
What You Will Learn
- What CMS proposed for 2011 PQRI reporting requirements
- How PQRI reporting options differed by submission method
- How the e-prescribing incentive was positioned relative to other CMS incentive programs
- What CMS error reports showed about common reporting problems
- Why accurate diagnosis information mattered for PQRI claims-based reporting
Who Should Read This
- Physicians
- Eligible professionals
- Group practices
- Medical coders
- Quality reporting staff
- Practice managers
- Compliance teams
Codes Discussed
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