Part B Insider (Multispecialty) Coding Alert

Published on Wed Apr 04, 2007 PDF

Watch out: The quality data you provide to CMS for the Physician Quality Reporting Initiative (PQRI) could soon end up in the hands of beneficiaries.

Medicare patients could soon be using PQRI data to comparison-shop for doctors- offices based on quality, according to Michael Beebe, director of CPT editorial services for the American Medical Association. -Down the line, there's going to be interest on the part of CMS in providing this data to beneficiaries, as they did with hospitals,- Beebe told the American Association for Professional Coders conference April 17.

Starting next year, the Centers for Medicare & Medicaid Services (CMS) plans to make the PQRI a normal part of the physician fee schedule. CMS will issue a 2008 PQRI proposed rule by August 15, 2007, with a final rule by Nov. 15, 2007.

By law, CMS is required to include -structural measures,- such as electronic health records and e-prescriptions, in 2008. Also, next year, reporting will be -registry-based and electronic record-based,- Beebe warned.

The AMA is preparing its own user-friendly version of the PQRI measure specifications, which should be on the AMA web site by June, Beebe promised.