July 1 Marks the Launch of CMS Physician Quality Reporting Initiative

 

June 26, 2007

June 26, 2007 - Physicians who report quality measures for care delivered to Medicare beneficiaries July 1–December 31, 2007 may receive an additional 1.5 percent incentive payment, subject to a bonus payment cap.

Voluntary participants must report a minimum of three quality measures on at least 80 percent of the cases for which that quality measure is reportable. If it is determined that reporting occurred less than 80 percent of the time for any one of the measures, the physician would be ineligible for the incentive payment.

Quality measures within the 2007 Physician Quality Reporting Initiative (PQRI) are adopted or endorsed by a consensus organization such as the AQA Alliance, the Physician Consortium, or National Quality Forum (NQF). HRS' Quality Improvement Task Force, Chaired by Stephen C. Hammill, M.D., and Sana Alkhatib, M.D., has been working on efforts to include reimbursement codes routinely used by HRS Membership into this initiative. 74 quality measures have been announced with specific reimbursement codes linked to each quality measure.

Members of the Heart Rhythm Society have the opportunity to report on:

* ACE or ARB therapy for heart failure patients with Left Ventricular Systolic Dysfunction (LVSD)

* Antiplatelet therapy prescribed for Coronary Artery Disease (CAD) patients

* Beta-blocker therapy prescribed for CAD patients with prior Myocardial Infarction (MI)

* Beta-blocker therapy prescribed for heart failure patients with LVSD

* Perioperative Care: Timing of Antibiotic Prophylaxis – Ordering Physician

* Perioperative Care: Discontinuation of Prophylactic Antibiotic

Reporting is claims-based. CPT Category II codes (or temporary G-codes where CPT Category II codes are not yet available) will be used for reporting quality data. Quality data codes, which supply the measure numerator, must be reported on the same claim as the payment codes, which supply the measure denominator. CMS will provide new information and educational opportunities in the near future.

For more information: www.hrsonline.org.