2010 PQRI Proposed Rule Changes

The Centers for Medicare & Medicaid Services (CMS) released, July 1, Physician Quality Reporting Initiative (PQRI) changes for the Calendar Year (CY) 2010. There are a number of proposed reporting options and reporting periods available. Some options require data submission by Dec. 31, 2010. Data reported through registries, however, is not due to CMS until 2011.

 The key changes in the proposed rule for CY 2010 include:

  • Adding 22 individual PQRI measures and six measures groups on which individual eligible professionals (EPs) may report;
  • Implementing provisions of the 2008 Medicare Improvement for Patients and Providers Act (MIPPA) enabling group practices to qualify for a 2010 PQRI incentive payment based on a determination at the group practice level, rather than at the individual EP level, that the group practice has satisfactorily reported data on PQRI quality measures;
  • Adding an electronic health record (EHR)-based reporting mechanism to adopt and to use EHRs and to provide both eligible professionals and CMS with experience on EHR-based quality reporting. Under the rule, CMS would begin accepting data from qualified EHR products on 10 proposed individual PQRI measures. New this year, EPs are able to count their submission of EHR-based measures towards their eligibility for a PQRI incentive payment. In 2010, CMS proposes EPs who satisfactorily report data on at least three of these 10 proposed EHR-based individual PQRI measures are eligible for an incentive payment.  In past years, EHR-based measure submission was voluntary, and was counted towards an EP’s eligibility for incentive payment.

Following the distribution of 2010 incentive payments, CMS will post on its Web site the names of EPs and group practices who satisfactorily report quality measures.

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