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The Five Things You Need to Know Now About PQRS 2014

Last Wednesday, just before we all headed home to gorge ourselves on turkey and pumpkin pie, Medicare released the Final Rule—all 1,369 pages of it. While it wasn’t exactly light reading, our fearless leader (and speed reader) Heidi Jannenga pored over this hefty document with a mission of finding all the Physician Quality Reporting System (PQRS) information that’s most important to you right now. Below is a breakdown of what you need to know about PQRS 2014.

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The Scoop on PQRS

The Centers for Medicare and Medicaid Services (CMS) developed Physician Quality Reporting System (PQRS), which mandates that eligible professionals meet standards for satisfactory reporting. If you are not PQRS-compliant in 2014, CMS will assess penalties. However, we do not yet know what the penalty amount is or how CMS will assess it.

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Founder Letter: PQRS 2014

Well, it’s November already, and that means two things: Thanksgiving and Physician Quality Reporting System (PQRS). Sure, PQRS doesn’t involve mouthwatering roasted turkey, savory stuffing, or creamy mashed potatoes, but it has become quite the November tradition for us here at WebPT. You see, this is the time of year that the Centers for Medicare & Medicaid Services (CMS) typically confirms the details of next year’s reporting requirements, thus allowing us to update our PQRS solution (claims- and registry-based reporting) and start our month-long blog and webinar theme of “everything you need to know to be PQRS compliant.”

Unfortunately, this year is shaping up a little differently. As a result of the government shutdown, CMS delayed its November 1 meeting to discuss the 2014 Physician Fee Schedule Proposed Rule—which includes potential PQRS changes—until at least the middle of this month. And until they meet, we won’t know much about what PQRS 2014 will truly entail in terms of reporting requirements, measures, penalties, and incentives—let alone when the government will actually finalize the Proposed Rule. This means that as of today, no one knows for sure:

  • which measures therapists must report
  • how many measures therapists must report
  • whether there will be compliance incentives
  • what penalties will be associated with noncompliance
  • what percentage of patients for whom therapists must complete PQRS reporting

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What PQRS Could Look Like in 2014

On July 19, 2013, the Centers for Medicare & Medicaid Services (CMS) published the 2014 Medicare Physician Fee Schedule (MPFS) Notice of Proposed Rulemaking (NPRM) in the Federal Register. According to this summary, most of the policies were open for comment until September 6, 2013 and, pending final decisions (which hopefully will occur this month), will take effect on January 1, 2014.

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