Recommends Changes to CQM Reporting in Stage 2 of the Medicare EHR Incentive Program
On July 8, 2013, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would update payment policies and payment rates for services furnished under the Medicare Physician Fee Schedule (MPFS) on or after Jan. 1, 2014. The proposed 2014 Medicare Physician Fee Schedule is schedule for publication in the Federal Register this Friday, July 19, 2013. In the proposed rule CMS recommends three changes to how EPs report clinical quality measures (CQM) in Stage 2 of the Medicare EHR Incentive Program. Here is a rundown of recommendations from the CMS Fact Sheet.
Reporting CQMs in Stage 2 EHR Incentive Program
Medicare EHR Incentive Program: In calendar year (CY) 2014 PFS proposed rule, we propose additional options for eligible professionals (EPs) to report clinical quality measures (CQMs) under the Medicare EHR Incentive Program beginning in 2014.
Medicare EHR Incentive Program CQM Reporting Using Qualified Clinical Data Registries: We are proposing an option for EPs to submit CQM information using qualified clinical data registries (as defined for PQRS) for purposes of meeting the CQM reporting component of meaningful use (MU) for the Medicare EHR Incentive Program beginning in 2014. EPs would have to use certified EHR technology, as required under the Medicare EHR Incentive Program, and report on CQMs that were included in the EHR Incentive Program Stage 2 final rule.
Comprehensive Primary Care Initiative – Proposed Additional Group Reporting Option
The Comprehensive Primary Care Initiative (CPCI), under the authority of Section 3021 of the Affordable Care Act, is a multi-payer initiative fostering collaboration between public and private health care payers to strengthen primary care. The CPCI uses a subset of the CQMs finalized in the Stage 2 final rule. In a continuing effort to align quality reporting programs and innovation initiatives, we are proposing to add a group reporting option to the Medicare EHR Incentive program beginning in CY 2014 for EPs who are part of a CPCI practice site that successfully submit at least 9 CQMs covering 3 domains. We are proposing that each of the EPs in the CPCI practice site would satisfy the CQM reporting component of meaningful use if the practice site successfully submits and meets the reporting requirements of the CPCI.
Reporting of Electronically Specified Clinical Quality Measures for the Medicare EHR Incentive Program
The electronic specifications for the clinical quality measures that were finalized under the Medicare EHR Incentive Program for use by EPs beginning in CY 2014 are updated routinely to account for issues such as changes in billing and diagnosis codes and changes in medical practices. We propose that EPs who seek to report clinical quality measures electronically under the Medicare EHR Incentive Program must use the most recent version of the electronic specifications for the clinical quality measures and have CEHRT that is tested and certified to the most recent version of the electronic specifications for the clinical quality measures. EPs who do not wish to report clinical quality measures electronically using the most recent version of the electronic specifications (for example, if their CEHRT has not been certified for that particular version) would be allowed to report clinical quality measure data to CMS by attestation for the Medicare EHR Incentive Program.
In addition to proposed changes to the Medicare EHR Incentive Program, CMS also looks to expand medicare payments for telehealth services. Of specific interest is the proposal to modifying the definition of a rural Health Professional Shortage Area, or HPSA, as determined by the Office of Rural Health Policy (ORHP). CMS states in the proposed change that redefining “rural” to include geographic areas within Metropolitan Statistical Areas (MSAs) would allow for “additional HPSAs as areas for telehealth originating sites”. Read a synopsis of proposed changes to telehealth services..
The proposed rule will be published in the Federal Register on July 19. Comments will be accepted until September 6, 2013 with the final rule expected November 1, 2013.