Fee schedule rule affects EHR program


Proposed fee schedule rule affects the Medicare EHR Incentive ProgramPhoto used with permission from Shuttershock.com

A 605-page document released July 8 by the Centers for Medicare & Medicaid Services (CMS) explains proposed changes to physician quality programs for calendar year 2014. What's not immediately evident within the proposed rule, which will be published July 19 in the Federal Register, is that it contains additional options for eligible professionals (EPs) to report clinical quality measures (CQMs) under the Medicare EHR Incentive Program beginning in 2014.

[See also: CMS proposes complex care management payment]

The proposed options fall into the following three categories:

1) CQM reporting using qualified clinical data registries
Under the proposed rule, EPs would be permitted to use qualified clinical data registries (as defined for the Physician Quality Reporting System) for purposes of meeting the CQM reporting component of meaningful use beginning in 2014.  EPs would have to use certified EHR technology, as required under the Medicare EHR Incentive Program, and report on CQMs that were included in the EHR Incentive Program Stage 2 final rule.

2) Group reporting option under the Comprehensive Primary Care Initiative
The Affordable Care Act authorized the Comprehensive Primary Care Initiative (CPCI), a multi-payer initiative fostering collaboration between public and private healthcare payers to strengthen primary care, according to CMS. The CPCI uses a subset of the CQMs finalized in the Stage 2 final rule.

"In a continuing effort to align quality reporting programs and innovation initiatives, we are proposing to add a group reporting option to the Medicare EHR Incentive program beginning in calendar year 2014 for EPs who are part of a CPCI practice site that successfully submits at least 9 CQMs covering 3 domains," CMS explained in the proposed rule.  "We are proposing that each of the EPs in the CPCI practice site would satisfy the CQM reporting component of meaningful use if the practice site successfully submits and meets the reporting requirements of the CPCI."

3) Reporting of electronically specified CQMs
The electronic specifications for the CQMs that were finalized under the Medicare EHR Incentive Program for use by EPs beginning in calendar year 2014 are updated routinely to account for issues such as changes in billing and diagnosis codes and changes in medical practices, CMS explained. 

CMS proposes that EPs who seek to report CQMs electronically under the Medicare EHR Incentive Program must use the most recent version of the electronic specifications for the CQMs and have certified EHR technology that is tested and certified to the most recent version of the electronic specifications for the CQMs.

EPs who do not wish to report CQMs electronically using the most recent version of the electronic specifications would be allowed to report CQM data to CMS by attestation for the Medicare EHR Incentive Program.

Click here to view or download a copy of the complete proposed rule. The EHR Incentive Program information begins on page 430.

Photo used with permission from Shuttershock.com.