By Dennis Beck, MD, FACEP
ACEP is working with a leading registry vendor who currently provides PQRS registry reporting for more than 40 medical societies. The penalty for failure to satisfy the 2014 PQRS requirements equals up to 4% of Medicare payments, approximately $2,500 per provider.
As a member benefit, ACEP is providing ACEP, EMRA & SEMPA members with $100 off the $299 per provider fee. We have negotiated a deeper discount of 10% off ($179) for groups of 10 or more and 15% ($169) for groups of 20 or more. For more information on reporting requirement, go to www.acep.org/qualityregistry. And be sure to return in early September to take advantage of this member benefit.
In 2014 a group of 10 or more eligible professionals may avoid the 2% PQRS penalty as well as the 2% VBM penalty (both applied to 2016 payments) if at least 50% or more of the individual eligible professionals in the group satisfy PQRS reporting requirements in 2014. Even just one Medicare Fee-For-Service claim for the calendar year qualifies a provider (physician or midlevel) as an eligible professional in a group for purposes of the “50% threshold.” However, please note that those eligible professionals in the group, who do not submit PQRS measures, will still be subject to the PQRS payment adjustment of 2%. To avoid the VBM penalty, at least 50% of individual EPs in a group must meet the minimum PQRS reporting requirements (for more information on these requirements visit www.acep.org/quality. So the choice of whether to report as individuals or to report as a group is a decision that is up to your group.
If your group decides to participate in the 2014 PQRS group practice reporting option (GPRO), the group is required to register through the Physician Value-Physician Quality Reporting System (PV-PQRS) Registration System by September 30, 2014. This registration process can take up to two weeks, so start now! Groups will need an Individuals Authorized Access to the CMS Computer Services (IACS) account to access the PV-PQRS Registration System. Registration lets CMS know which groups want to be analyzed at the group level (or TIN-level analysis).
Complete information about IACS and 2014 PQRS GPRO registration is available on the CMS website. Click here for that information.
During registration, the group practice will need to indicate the size of their group at the time they register. For GPRO Group size is based on the number of eligible professionals including PAs and NPs billing under the TIN. Be sure that your group’s Medicare Provider Enrollment, Chain, and Ownership System (PECOS) information is updated for before you begin registration.
Whatever your decision, to report as a group via GPRO registry or to report as individuals, the ACEP PQRS Wizard registry option will be available for you. Although you can upload quality data codes from your practice management, coding, or billing software to the portal through February of 2015, if you want to participate via GPRO your group must complete the PV-PQRS registration process by September 30, 2014. If you plan to report as individuals you can sign up through Dec. 31, 2014.
Dr. Beck is President and CEO of Beacon Medical Services in Aurora, Colorado. He is past chair and current member of the ACEP Reimbursement, Quality and Performance Committees. Dr. Beck is also a member of the ACEP Coding and Nomenclature Committee and chair of the Colorado ACEP Finance Network.