Notice: This CMS-approved document has been submitted - Philips ...

CMS-1403-FC
incentive payments for participation in PQRI for a
particular year much sooner than the middle of the
following year because of the way in which the incentive
payments are calculated. The incentive payments are
calculated based on the total estimated allowed charges for
the reporting period. As required by section
1848(m)(1)(A)(ii) of the Act, as redesignated and added by
the MIPPA, we must wait until 2 months after the end of the
reporting period to allow eligible professionals to submit
claims for covered professional services furnished during
the reporting period.
Comment: The MIPPA requires that by January 1, 2010,
the Secretary shall establish and have in place a process
under which eligible professionals in a group practice
shall be treated as satisfactorily submitting data on
quality measures for the PQRI. A few commenters welcomed
this option and offered to assist CMS in defining “group
practice.” Another commenter noted that it would be more
cost-effective for multi-specialty group practices to
participate under this new option.
Response: We welcome the commenters’ interest in our
plans for implementing future enhancements to the PQRI
based on the MIPPA. However, we note that the scope of
this section of the final rule is limited to the 2009 PQRI.
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