Medicare PQRI Deadline Approaches

As we approach the July 1, 2007 deadline, health care providers are increasingly asking about the details associated with Medicare’s Physician Quality Reporting Initiative (“PQRI”). My next few blogs will address some of the questions I have been asked by providers.

Many providers are simply asking “what is PQRI?” PQRI is an initiative created by Congress under Title I, Section 101 of the Tax Relief and Health Care Act of 2006, (P.L. 109-432). It marks the first tangible step taken by Medicare in the direction of paying participating doctors based upon the quality of their performance.

Implied in the ‘what’ question is the ‘why’ question: “why should I care about PQRI?” PQRI matters because your revenue matters. Under PQRI, if a physician chooses to report certain additional information in the context of its claim submissions, he or she will be entitled to a bonus equal to as much as 1.5% of his or her total Medicare payments between July 1 and December 31, 2007.

Clearly this is a modest beginning towards the goal of appropriately compensating physicians; nevertheless, it appears to be the trend of the future and forward-thinking providers should get ‘on board’ now and start realizing an increase in revenue.

We’ve considered the ‘what’ and ‘why’ of PQRI. My next blog will address PQRI’s ‘when’ and ‘how.’

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