CMS changes PQRI to align with healthcare reform

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The Centers for Medicare & Medicaid Services (CMS) has renamed the Physician Quality Reporting Initiative (PQRI) as the Physician Quality Reporting System (PQRS), while also altering a variety of reporting guidelines and verbiage in accordance with the Patient Protection and Affordable Care Act of 2010 (PPACA).

CMS expressed its hopes that the changes, authorized under the PPACA, will support the permanency of the program. Some of the major changes include:

  • Eligible professionals need only report 50 percent of measures to CMS for claims-based reporting, reduced from 80 percent in previous years.
  • Under the PPACA, CMS is required to establish a review process for eligible professionals wishing to appeal CMS decisions that the professionals did not satisfactorily submit quality data under PQRS.
  • For radiology, a jointly developed American Medical Association (AMA) and American College of Radiology (ACR) reminder system for mammography screenings will record the percentage of women 40 years and over undergoing screenings and set target reminders for periodic screenings.
  • Several code updates and terminology changes have been made to some measures potentially affecting diagnostic radiologists, interventional radiologists and radiation oncologists.

For more information on changes to the PQRS, click here.