2014 Physician Payment Rule Includes New Electronic Quality Measure Reporting Options

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By Kendra Casey Plank  

Dec. 3 --The Centers for Medicare & Medicaid Services has made final changes to how Medicare-participating doctors can report clinical quality measures for purposes of meeting meaningful use program requirements.

In the 2014 physician payment rule, which will be published in the Dec. 10 Federal Register, the CMS specified criteria for three CQM reporting options for the Medicare Electronic Health Record Incentive Program. The CQM reporting options aim to align reporting requirements for the meaningful use program with other Medicare initiatives, including the Physician Quality Reporting System (PQRS) program.

The CQM reporting options were part of a vast rule whose centerpiece is a 20.1 percent cut to Medicare physician payment rates in calendar year 2014.

Among the options is one that will allow doctors, starting in 2014, to report quality measures through qualified clinical data registries, meaning doctors can use existing reporting mechanisms for their specialties to also satisfy quality measure reporting requirements for the meaningful use program.

Clinical data registries used for meaningful use program reporting must meet the current proposed definition and requirements for clinical data registries under the PQRS program, the CMS said. In addition, the CMS said physicians who use clinical data registries for meaningful use reporting must meet additional criteria that include the use of certified EHR systems as specified in the meaningful use program.

The final physician payment rule also requires that clinical data registries used for meaningful use reporting be certified for the CQM criteria that will be reported. Registries also would be required to be certified to “capture and export” criteria if they perform those functions, the CMS said.

Physician groups had widely supported the addition of CQM reporting via clinical data registries, but some argued in public comments on the proposed rule that such certification should not be required (see previous article). EHRs used by doctors and hospitals in the meaningful use program must be certified as meeting certain criteria established by the Office of the National Coordinator for Health Information Technology.

Other Options

The final rule also included a new group reporting option that allows eligible professionals who successfully report CQMs as part of a Comprehensive Primary Care (CPC) initiative practice site to be considered meeting CQM reporting requirements for the meaningful use program as well.

The CMS noted that if a CPC site failed to successfully report CQMs, physicians at those practices would still have the option to report CQMs for the meaningful use program under criteria established for Stage 2 of the program.

A third reporting option allows physicians to electronically report CQMs under the meaningful use program using the most recent version of the electronic specifications for the CQMs and have an EHR system certified and tested to the most recent electronic specifications for CQMs.

The CMS said that physicians not wanting to report CQMs electronically using the most recent version of the CQM specifications would be allowed to report CQM data through the attestation process for the meaningful use program.

The physician rule is available at http://op.bna.com/hl.nsf/id/bbrk-9dutyu/$File/FeeSkedRuleNov272013.pdf.


To contact the reporter on this story: Kendra Casey Plank in Washington at kcasey@bna.com

To contact the editor responsible for this story: Patty Logan at plogan@bna.com