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Medicare Learning Network (MLN) Spotlights (Update the information on the webpage with information below) Go to the Spotlight page for the latest MLN products and announcements! Check it often! (Scroll to the bottom of this page to the "Related Links Inside CMS" section and click on the What's New link) Physician Quality Reporting Initiative (PQRI) The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) (Pub. L. 110-275) made the PQRI program permanent, but only authorized incentive payments through 2010. EPs who meet the criteria for satisfactory submission of quality measures data for services furnished during the reporting period, January 1, 2009 - December 31, 2009, will earn an incentive payment of 2.0 percent of their total allowed charges for Physician Fee Schedule (PFS) covered professional services furnished during that same period (the 2009 calendar year). As required by the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA) (Pub. L. 110-173), CMS has established 2 alternative reporting periods for the reporting of measures groups and for the submission of data on PQRI quality measures through clinical data registries. The 2 alternative reporting periods are: January 1, 2009 – December 31, 2009 and July 1, 2009 – December 31, 2009. In total, there are 9 options for satisfactorily reporting quality measures data for the 2009 PQRI that differ based on the reporting period an EP chooses to report on, whether an EP chooses to report through claims or an approved clinical registry, and whether an EP chooses to report on individual measures or measures groups. The 2009 PQRI consists of 153 quality measures and 7 measures groups. For further information on the 2009 PQRI quality measures. For additional information on the Physician Quality Reporting Initiative, see the Related Links Inside CMS section below. Electronic Prescribing Incentive Program (E-Prescribing) Section 132 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) authorizes a new and separate incentive program for individual eligible professionals who are successful electronic prescribers (e-Prescribers) as defined by MIPPA. This new incentive is separate from and is in addition to the quality reporting incentive program authorized by Division B of the Tax Relief and Health Care Act of 2006 - Medicare Improvements and Extension Act of 2006 (MIEA-TRHCA) and known as the Physician Quality Reporting Initiative (PQRI For additional information on the Electronic Prescribing Incentive Program, see the Related Links Inside CMS section below. ICD-10 On January 16, 2009, the Department of Health and Human Services released the HIPAA Administrative Simplification: Modifications to Medical Data Code Set Standards to Adopt ICD-10-CM and ICD-10-PCS Final Rule (CMS-0013-F). The compliance date for implementation of the ICD-10-CM/PCS Coding System is October 1, 2013 for all covered entities. For additional information on ICD-10, see the Related Links Inside CMS section below. HIPPA 5010- D.O The Centers for Medicare and Medicaid Services (CMS) is underway with implementation activities to convert from Health Insurance Portability and Accountability Act (HIPAA) Accredited Standards Committee (ASC) X12 version 4010A1 to ASC X12 version 5010 and National Council for Prescription Drug Programs (NCPDP) version 5.1 to NCPDP version D.0. The Secretary of the Department of Health and Human Services (HHS) has adopted ASC X12 version 5010 and NCPDP version D.0 as the next HIPAA standard for HIPAA covered transactions. For additional information on HIPPA 5010-D.O, see the Related Links Inside CMS section below. DMEPOS Competitive Bidding (Update the information on the webpage with the information below) GET READY FOR COMPETITIVE BIDDING! The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), enacted on July 15, 2008, made limited changes to the Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program, including a requirement that competition to re-bid Round 1 occur in 2009. On January 16, 2009, the Centers for Medicare & Medicaid Services (CMS) issued an interim final rule with comment period that incorporates into regulations only those provisions of MIPPA related to the DMEPOS competitive bidding program that are self-implementing and necessary to conduct the Round 1 rebid competition in 2009. That rule became effective on April 18, 2009. For additional information on the DMEPOS Competitive Bidding Program, see the Related Links Inside CMS section below.
Page Last Modified: 07/06/2009 9:04:57 AM
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