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Physician Quality Reporting System, Quality Resource Use Reports, and Value-Based Modifiers

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2014 Annual Quality and Resource Use Reports Available

The 2014 Annual Quality and Resource Use Reports (QRURs) are now available for every group practice and solo practitioner nationwide. Groups and solo practitioners are identified in the QRURs by their Taxpayer Identification Number (TIN). The QRURs are also available for groups and solo...

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2014 Sample Quality Resource and Use Report

The Centers for Medicare & Medicaid Services (CMS) provide this downloadable sample 2014 Quality and Resource Use Report with explanations as to its completion.

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2014 Supplemental Quality and Resource Use Reports Are Available

On September 28, 2015, the Centers for Medicare & Medicaid Services (CMS) made available the 2014 Supplemental Quality and Resource Use Reports (QRURs) to every medical group practice and solo practitioner nationwide. Medical group practices and solo practitioners are identified in the...

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2015 and 2016 Value Modifier Payment Adjustment Sheet

For an overview of the Value-Based Payment Modifier and its relationship to PQRS, this handy double-sided PDF sheet indicates the prospective adjustments for 2015 and 2016.

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2015-2017 PQRS VM Adjustment Sheet

To find out how the 2015 Physician Quality Reporting System (PQRS) participation will affect the value modifier in 2017, refer to this handy reference.

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2016 Medicare Quality Reporting Videos

The Medicare Learning Network (MLN) Connects has released a library of brief Medicare Quality Reporting Program videos on the following topics: Medicare Quality Reporting Programs: What Eligible Professionals Need to Know in 2016; Run time of 15 minutes Medicare Access and CHIP Reauthorization Act...

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2016 Physician Quality Reporting System Payment Adjustment Fact Sheet

Overview of the Program Physician Quality Reporting System (PQRS) is a quality reporting program that uses negative payment adjustments to promote reporting of quality information by individual eligible professionals (EPs), EPs providing services at a Critical Access Hospital (CAH) billing under...

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2016 Value-Based Payment Modifier Downward Payment Adjustment Avoidance Action for Groups with 10 or More Eligible Professionals

The Centers for Medicare & Medicaid Services (CMS) have issued a notification to physicians in groups with 10 or more eligible professionals (EPs) on how to avoid the automatic calendar year 2016 value-based payment modifier downward payment adjustment. EPs consist of physicians, practitioners, physical or occupational therapists, qualified speech-language pathologists, and qualified audiologists. A group of physicians is defined by its Medicare-enrolled Taxpayer Identification Number (TIN). The deadline for the actions specified in the CMS memo is September 30, 2014. Download this PDF for details.

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Additional Information on July 2015 Transition from IACS to EIDM

The Centers for Medicare & Medicaid Services (CMS) has issued a reminder to Physician Quality Reporting System (PQRS) participants and their staff of an important system update scheduled to be in place on Monday, July 13, 2015. The Individuals Authorized Access to CMS Computer Services (IACS) system will be retired, but current IACS user accounts will transition to an existing CMS system called Enterprise Identity Management (EIDM). The EIDM system provides a way for business partners to apply for, obtain approval of, and receive a single user ID for accessing multiple CMS applications. Please read the pdf document linked here for important information and tips to help make sure the transition runs smoothly.

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ASC Quality Reporting Measures Specifications Manual, version 4.0a

The Ambulatory Surgery Center Association's Quality Reporting Specifications Manual, version 4.0a, applies to the program requirements between now and September 30, 2015. Version 4.1 will be applicable between October 1 and December 31, 2015.

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CMS Enterprise Identity Management (EIDM) User Guide

The Centers for Medicare & Medicaid Services (CMS) created an EIDM User Guide in pdf format for download. The guide includes information on what IACS applications are now supported by EIDM, troubleshooting tips, and direction for approvers. In addition, CMS created the EIDM System Toolkit,...

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CMS Teleconferences and Events

The Centers for Medicare & Medicaid Services (CMS) will periodically host events such as national provider teleconferences, listening sessions and meetings on the Physician Feedback Program and the Value-Based Modifier. Registration is free and information for these events will be posted as it...

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Medicare Payment Adjustment Calculator

If you participate in any of the following incentive programs offered by the Centers for Medicare & Medicaid Services (CMS), use this Excel worksheet to calculate the various payment adjustments that affect your practice: Meaningful Use (MU); Physician Quality Reporting System (PQRS); Value-Based Payment Modifier (VBM). Last updated 9/16/15.

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Medicare Payment Adjustment Worksheet

If you participate in any of the following incentive programs offered by the Centers for Medicare & Medicaid Services (CMS), use this PDF worksheet to calculate the various payment adjustments that affect your practice: Meaningful Use (MU); Physician Quality Reporting System (PQRS); Value-Based Payment Modifier (VBM). Last updated 1/12/15.

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New QRURs Releasing on November 16, 2015

The Centers for Medicare & Medicaid Services (CMS) identified issues that impacted the 2014 Annual Quality and Resource Use Reports (QRURs) released on September 8, 2015. There were issues with data submitted via electronic health record (EHR) and Qualified Clinical Data Registry (QCDR), as...

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Physician Quality Reporting System (PQRS) Listserv Subscription Form

Sign up for notices from the new Centers for Medicare & Medicaid Services PQRS Listserv at this link.

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Physician Quality Reporting System (PQRS) Timeline 2014-2016

The PQRS Timeline (PDF format) lists all the major milestone dates during the reporting period.

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PQRS Assistance Flyer

For providers looking for assistance regarding their electronic health record reporting for the Physician Quality Reporting System (PQRS), look no further than Health Services Advisory Group (HSAG) for the consulting you need. From guidance with harnessing your EHR system to best practices in using electrojic data for patient health outcomes, HSAG has the expertise and resources to help.

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PQRS Claims and Measure Specification Search Page

The Centers for Medicare & Medicaid Services has created a search page for individual claims and registry-based measure specifications based on search criteria provided.

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PQRS Guidance for RHCs, FQHCs, and CAHs

This downloadable pdf flyer is intended for Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs), and Critical Access Hospitals (CAHs) seeking answers to frequently asked questions regarding cliams diected to the Centers for Medicare & Medicaid Services.

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PQRS Payment Adjustments and Providers Who Rendered Services at IDTFs

The Physician Quality Reporting System (PQRS) is a program that promotes the reporting of quality information by eligible professionals (EPs) and group practices. Participation in PQRS is at the individual National Provider Identifier (NPI) level within a Tax Identification Number (TIN). EPs who...

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PQRS Web-Based Measure Search Tool

The Centers for Medicare & Medicaid Services (CMS) has announced the availability of the new Physician Quality Reporting System (PQRS) Web-Based Measure Search Tool. This tool will assist eligible professionals (EPs) and PQRS group practices with easily identifying claims and registry measures...

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PQRS/Value-Based Payment Modifier: What Medicare Professionals Need to Know in 2015 (video)

A video recording of the "Physician Quality Reporting System (PQRS)/Value-Based Provider Modifier: What Medicare Professionals Need to Know in 2015" presentation has been posted to the Centers for Medicare & Medicaid Services MLN Connects® page on YouTube. This presentation is the same as the...

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Quality Measurement 101

The Centers for Medicare & Medicaid Services developed a new beginner’s module (PDF format) to learn the basics on the Physician Quality Reporting System (PQRS).

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Questions and Answers about the 2014 Quality and Resource Use Reports and the 2016 Value Modifier

The Centers for Medicare & Medicaid Services (CMS) provide this downloadable FAQ on the Annual and the Mid-Year Quality and Resource Use Reports (QRURs) for 2014.

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Revised Medicare Accountable Care Organization Program

On June 4, the Centers for Medicare & Medicaid Services (CMS) released the final rule for the Medicare Shared Savings Program, one of CMS' accountable care organization initiatives. This article reviews the primary elements of the rule in the context of several major themes.

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The Payment Calculator Webinar

In this web recording, Health Services Advisory Group (HSAG) Vice President for Medical Affairs and Chief Medical Officer, Howard Pitluk, MD, MPH, FACS, provides an overview of an online tool HSAG has created to assist providers in understanding how various Medicare incentive programs may lead to a...

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Timeline to Phase in Value-Based Payment Modifier

The Centers for Medicare & Medicaid Services (CMS) provides a visual timeline on what to expect now through 2018 on Value-Based Payment Modifier (VBM), accompanied by brief narrative description.

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Understanding Your QRUR

The Centers for Medicare & Medicaid Services have published Understanding Your QRUR (September 2015), designed to help providers comprehend their Quality and Resource Use Report, along with supplementary exhibits.

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Value-Based Modifier Policies for 2015, 2016, and 2017

For an overview of Value-Based Modifier policies, refer to this double-sided PDF sheet featuring essential value-modifier components.

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