PQRS: PQRI and E-Prescribing Feature Several Changes This Year

Why This Topic Matters

Practices needed to understand shifting CMS reporting requirements, eligibility thresholds, and potential payment adjustments so they could avoid missed incentive opportunities or penalties.

Article Sections

1. PQRS program updates for the reporting year

   Overview of changes to the quality reporting program and the updated measure specifications discussed during the CMS call.

2. Reporting requirements for Medicare beneficiaries

   Discussion of the reporting population rules and how CMS described the Medicare patient count requirements for the year.

3. E-prescribing process and payment adjustment overview

   Summary of CMS guidance on the Medicare e-prescribing program, participation expectations, and the possibility of future payment adjustments.

4. Hardship exemption and other exemption considerations

   General discussion of CMS hardship review and other circumstances that could affect whether a payment adjustment applies.

5. Determine eligibility for the e-prescribing program

   Step-by-step eligibility review topics, including CMS resources, measure applicability, system qualifications, and charge-based thresholds.

6. Practice participation questions and refill scenarios

   Questions raised by callers about participation when prescribing volume is low and how refill-related situations were discussed.

7. Finding out why incentive payments were not received

   Explanation of how CMS feedback and help desk support were described for practices seeking reasons behind unpaid incentives.