Wound Care Articles and Insights

2016 CMS Incentive Program Updates

In 2016 the CMS Incentive programs include:

  • PQRS – Physician Quality Reporting System
  • VM – Value-Based Modifier (tied to PQRS reporting)
  • MU – Meaningful Use

Following are updates and notifications from CMS regarding these programs:

  • CMS will soon begin distributing letters to Physician Quality Reporting System (PQRS) individual eligible professionals (EPs), EPs providing services at a Critical Access Hospital (CAH) billing under method II, and group practices regarding the 2017 PQRS negative payment adjustment. The letter indicates that the recipient did not satisfactorily report 2015 PQRS quality measures or satisfactorily participate in a qualified clinical data registry (QCDR) in order to avoid the 2017 PQRS negative payment adjustment and, therefore, all of their 2017 Medicare Part B Physician Fee Schedule (PFS) payments will be subject to a 2.0% reduction.
  • Saturday, October 1, 2016 is the deadline for eligible professionals, hospitals and critical access hospitals new to the meaningful use program to submit their attestations.
  • Eligible Professionals new to the meaningful use program must submit attestations for a continuous 90-day reporting period to avoid a payment adjustment in 2018.
  • CMS is currently requiring returning participants to report for a full calendar year. The period for returning providers to submit attestation is Jan. 3 through Feb. 28, 2017.
  • In July, CMS proposed a 90-day EHR reporting period in 2016 for all eligible professionals and hospitals to offer greater flexibility in the meaningful use of EHRs.  The reporting period would be any continuous 90-day period between Jan. 1, 2016, and Dec. 31, 2016.  The rule has not yet been finalized.

Since we are quickly approaching CMS deadlines, I encourage all EPs to perform an analysis of your measures to determine compliance with the CMS incentive programs.

~ Terrie A. Dittmeyer, RN, BSN, MBA