For 2016 PQRS eCQMs, the expectation is that eligible professionals (EPs) or group practices reporting via the group practice reporting option (GPRO), referred to as PQRS group practices, select 9 measures and 3 domains applicable to their practice, or report on as many measures and domains as they have available (up to 9 measures/3 domains) within their CEHRT EHR and with applicable Medicare patient data. If more than 9 measures are applicable, then EPs/PQRS group practices can select the 9 most appropriate for their practice (or can report on as many applicable measures over 9 as desired). EPs will be required to select and report the July 2015 version of the eCQMs for 2016 reporting.EPs/PQRS group practices can avoid the 2018 PQRS downward payment adjustment by meeting the following criteria for satisfactory reporting:
1. Using a direct EHR product that is Certified EHR Technology (CEHRT) or EHR data submission vendor that is CEHRT, report on at least 9 measures covering 3 National Quality Strategy (NQS) domains.
The 0% performance rate rule, where no patients in the denominator are in compliance and/or receive the correct quality action rule, does not apply to 2016 PQRS eCQMs. However, EPs should be aware that for the Value-based Payment Modifier, performance on eCQMs will be included when calculating the Value Modifier. An EP/PQRS group practice must report on at least 1 measure with Medicare patient data meeting the denominator criteria, but the one patient does not need to meet numerator criteria.Note: This rule is not applicable to PQRS group practices reporting via Web Interface. Those groups must report all 21 Web Interface measures to avoid the 2018 PQRS downward payment adjustment. If an EP/PQRS group practice has no applicable eCQMs with Medicare data, (s)he should choose a different reporting mechanism for 2016 PQRS.
- If the EP’s or group practice’s CEHRT does not contain patient data for at least 9 measures covering at least 3 domains, then they must report the measures for which there is Medicare patient data. An EP must report on all payers and at least 1 measure for which there is Medicare patient data to avoid the 2018 PQRS downward payment adjustment.
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