Eli's Rehab Report

Published on Thu Dec 26, 2013 PDF

Don’t miss: More measures now needed to qualify for your 0.5% bonus.

Along with therapy cap and SGR updates, the 2014 Medicare Physician Fee Schedule final rule finalized new standards for the Physician Quality Reporting System. In summary:

1. Careful: Nonparticipation penalty for 2016 increases. Starting in 2013, non-participation in PQRS resulted in a -1.5 percent penalty to be applied to your 2015 payments. Now, non-participation in 2014 will increase your penalty to -2.0 percent for 2016. (To avoid the penalty, providers muse report at least 3 individual measures for at least 50 percent of their eligible Medicare patients in 2014.)

2. Work even harder to earn that bonus. Reporting three measures will only keep you out of the red when it comes to PQRS. Now, to get a 0.5 percent bonus payment for 2014, you must report nine measures — and they must cross at least three National Quality Strategy domains.

3. SLPs: Prepare to lose a big chunk of reportable measures. CMS retired eight Functional Communication Measures (FCMs) used by ASHA’s National Outcomes measurement System (NOMS).

“The retirement of the FCMs for PQRS use leaves SLPs with two general measures to report on the claim form: the documentation of medication in the medical record, and standardized pain assessment,” says Lisa Satterfield, MS, CCC/A, director of health care regulatory advocacy for the American Speech-Language-Hearing Association.

The Centers for Medicare & Medicaid Services (CMS) also finalized requirements for a new data registry system, under which it is “significantly more difficult to qualify for approval,” Satterfield says. “ASHA is looking into all options, but it looks like for 2014, SLPs will need to report via the claim form whether they document medication in order to avoid the 2016 penalties.”

4. OTs: Keep fighting for Measure 182. The American Occupational Therapy Association requested that CMS add more OT-relevant measures and allow OTs to report on PQRS Measure 182 (Functional Outcome Assessment), reports Jennifer Hitchon, JD, MHA, counsel & director of regulatory affairs for the American Occupational Therapy Association. CMS did not respond to these requests, but AOTA policy staff continue to work on allowing occupational therapists to report on this measure, Hitchon says.