Physician Quality Reporting in 2009

As part of the 2009 Medicare Physician Fee Schedule, the Center for Medicare and Medicaid Services (CMS) made proposals concerning the Physicians Quality Reporting Initiative (PQRI). CMS is required by law to use a rulemaking process to select quality measures for the 2009 PQRI, as well as establish for 2009 alternative reporting criteria and alternative reporting periods for reporting of measures groups and for registry-based reporting.

CMS proposes a total of 175 measures for reporting in 2009, an increase of 56 measures from 2008. Of these, 111 are current measures, and 64 are new measures either endorsed by the National Quality Forum (NQF), adopted by the AQA Alliance (AQA), or measures currently under consideration by the NQF or the AQA.

The agency also proposes to include measures that were reviewed but not selected for the 2009 PQRI in a 2009 New Measures Testing Process similar to 2008. No financial incentive payment would be associated with submission of these new test measures for either 2008 or 2009, or for reporting data on (non-test) quality measures under the proposed 2009 PQRI.

The proposed rule would allow claims-based reporting either for individual measures or for Measures Groups. CMS proposes to require reporting of three individual measures (or less than three if only one or two are applicable to eligible professionals) for 80 percent of applicable cases during the calendar year. For Measures Groups, CMS proposes to require professionals who report for the full calendar year to report measures for 30 consecutive patients for whom all measures of one Measures Group apply, or 80 percent of patients to whom all measures of one Measures Group apply with a minimum of 30 patients.

Other provisions to the PQRI proposal include accepting PQRI data via clinical registries and electronic health records systems.
Carol Monaco (

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