On July 12, 2007, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule with respect to the Physician Quality Reporting Initiative (PQRI) for calendar year 2008. Under congressional authorization, the PQRI was implemented in a transitional phase on July 1, 2007 through notifications on the CMS website. Between July 1, 2007 and December 31, 2007, physicians, and in some instances, other practitioners, may be eligible for temporary bonus payments of up to 1.5% of certain allowed charges if they submit quality data reports for at least 80% of their claimed services that are subject to the PQRI reporting program. Click here for more information on the current program.
For 2008, the PQRI will be based upon rules established with public input. The July 12 proposed rule is the first step in soliciting input from interested parties who may be affected by the PQRI. The PQRI for 2008 may apply to any practitioner who furnishes services that can be reimbursed under the physicians' fee schedule, provided that the CMS rules created with public input specify quality measures and accompanying CPT codes for which a practitioner may bill and the selected reporting mechanism would allow a practitioner to submit quality data.
CMS announced in the proposed rule that it intends to link to the 2008 PQRI program the distribution of $1.35 billion in discretionary funds allocated to CMS under the Physician Assistance and Quality Initiative (PAQI) Fund. Congress has authorized the PAQI Fund for "physician payment and quality improvement initiatives" in calendar year 2008. CMS estimates that quality reporting bonuses of up to 2% may be available from the PAQI Fund to eligible professionals who file reports under the 2008 PQRI. You can view the proposed rule here (2 MB PDF). Comments on the proposed rule are due by 5 p.m. on August 31, 2007.
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