CMS extends PQRS sign-up deadline

Medical groups with 100 physicians or more were given an extra three days to register for the CMS Physician Quality Reporting System, formerly known as the Physician Quality Reporting Initiative. If these groups fail to sign up by Friday, they will be subject to a 1% cut in Medicare fee-for-service payments in 2015 under the value-based payment modifier program mandated by Section 3007 of the Patient Protection and Affordable Care Act.

The extension also applies to groups seeking an “administrative” exemption to PQRS reporting requirements. Groups choosing this option would not do their own quality-measure reporting but instead will have the CMS collect their practice data via an “administrative claims-based reporting mechanism.” According to the California Medical Association, groups that go this route will be automatically evaluated from claims data on 19 quality measures and can avoid an additional 1.5% PQRS-associated penalty by doing so.

While the CMS website describes the value-based modifier program as supporting “the transformation of Medicare from a passive payer to an active purchaser of higher quality, more efficient health care through the value-based purchasing (VBP) initiative,” the American Medical Association has described it as “a flawed concept that cannot be equitably applied across the board to all physicians.”

While large groups are subject to the value-based modifier first, the VBM is scheduled to be phased in to apply to all physicians by 2017. It will increase or decrease Medicare payments using a formula that includes quality measures and “comparisons of patterns of resource use/cost among physicians and medical groups,” according to the description of the program on the CMS website.

“The AMA is continuing to advocate for a longer extension, but it may not happen due to the government shutdown,” an AMA bulletin on the extension said. “We therefore suggest that state societies take whatever steps they can to get the following information out to your members.”

It was noted that despite the extension, the CMS website continued to state that the deadline was Oct. 15 because the agency's website staffers were not working because of the government shutdown. The AMA bulletin said data from the CMS suggests that several hundred group practices that must register have not done so.

The Medical Group Management Association, California Medical Association and other state medical associations have posted guides for physicians and groups seeking to avoid the 1% VBM-related penalty and the 1.5% PQRS-related penalty.

Follow Andis Robeznieks on Twitter: @MHARobeznieks