PQRS for Mental / Behavioral Health and Substance Abuse
by Leigh-Ann Renz, 6.29.15
PQRS Group Reporting Deadline is Tomorrow!
Tomorrow, 6.30.15, at 11:59 PM EDT, is the deadline for practices to register for the PQRS Group Practice Reporting Option (GPRO). Although many agencies won't report PQRS until 1.1.16, CMS requires practices, that choose to report as a group, register now - especially in light of the replacement of the IACS registration with EIDM in the upcoming months.
PQRS is a once-voluntary, now-mandatory reporting program for Medicare providers. See our PQRS Resource Center for details, including how it applies to mental / behavioral health and substance usage providers. Your Medicare reimbursements might be docked for non-participation (click here for details), so if you see Medicare clients but aren't participating in this program, you may want to check it out.
GPRO is Group Practice Reporting Option, one of the ways that groups can report PQRS, if they have more than 2 Eligible Professionals (EPs). Groups must meet the satisfactory reporting criteria through the PQRS GPRO in order to avoid the -2.0% CY 2017 PQRS payment adjustment. This can be accomplished via:
- Web interface (for groups with 25 or more EPs only)
- "Consumer Assessment of Health Providers and Systems (CAHPS) for PQRS Survey via a CMS-certified Survey Vendor (as a supplement to another GPRO reporting mechanism). See CAHPS for PQRS Made Simple for complete details."
Why Report as a GPRO?
If you qualify for the GPRO, it can simplify the PQRS process by allowing you to report under one tax identification number (TIN) for mulitple providers / EPs. It also simplifies the IACS portal submission process (soon to be replaced with EIDM).
Avoiding the Penalties
"Physician groups with 2 or more EPs that choose not to register, must ensure that at least 50% of the EPs in the group meet the criteria to avoid the 2017 PQRS payment adjustment as individuals in order for the group to avoid the automatic 2017 Value Modifier downward payment adjustment (-2.0% or -4.0% depending on the group’s size).
The Registration System can be accessed using a valid Individuals Authorized Access to the CMS Computer Services (IACS) account. CMS strongly encourage groups to obtain an IACS account and register now, since registration will close on June 30, 2015. CMS will be transitioning to a new Enterprise Identity Management (EIDM) system in the upcoming months; therefore, all registrations must be received before the deadline. Stay tuned for more information and resources in the coming weeks and months about the EIDM. In the meantime, please ensure that your IACS account is active, current, and you’re able to log in. This will help ensure a smoother transition to EIDM. Instructions for obtaining an IACS account with the correct role are provided on the PQRS GPRO Registration web page." - CMS