Note: The AOA's 2011 CAP for PQRS closed on Feb. 1, 2012
Some changes are in store for the 2011 CAP for PQRS program. First, the name of the program has changed from the Physician Quality Reporting Initiative (PQRI) to the Physician Quality Reporting System (PQRS). In addition, the bonus incentive for the 2011 program is 1% of allowable charges for the reporting year. The following changes will impact data abstraction and reporting in 2011:
You will need to abstract 30 unique Medicare Part B Fee-For-Service (FFS) patients who meet patient sample criteria for the measures group.
You will need to satisfy and report each measure within the measure group at least one time. CMS guidelines indicate that each measure you report must have a performance rate greater than 0%.
You no longer have to fax in your attestation. The process is now completed electronically.
CAP Participation
The AOA developed the CAP for PQRS to provide physicians with an opportunity to receive enhanced payment from CMS and understand how patients are doing using evidence-based process and outcome measures.
Eligible professionals can only choose to participate in one measure group per reporting year and there is only potential to receive one bonus incentive per reporting year. CMS has expanded the number of measure groups to 14, which greatly expands your opportunity to participate in the program. The AOA CAP for PQRS offers all 14. The new measure group this year is Asthma. Please note that there are changes and updates to some of the measure groups this year.
Fees
Due to rigorous data-checking programs, AOA CAP for PQRS has been highly successful in submitting data to CMS for the bonus payment. Over 90% of participants have successfully submitted data using CAP. We anticipate similar results for the CAP for PQRS program in 2011.
Bonus incentives for CAP for PQRS participants in 2010 were $3600 on average. Although the average may be lower in 2011 due to the 1% bonus incentive, we still anticipate a high rate of return.
In 2011, the AOA continues the fee structure that saves members $100 more than non-members. Member DOs receive discounted pricing of $199. Non-member medical professionals pay a fee of $299. This year we also have special pricing for Nurse Practitioners, Physician Assistants, Certified Nurse Specialists, and Registered Dieticians, as well as for group practices of 10 or more physicians. Please call Angi Beranek at (312) 202-8198 for details about pricing.
Requirements and Deadlines
CMS requires all registries to conduct audits of participant data.
Please make sure that you keep track of your 30 patient charts and match them with their computer generated Patient Identifier numbers. This number is approximately 8-digits that is automatically populated in the system when you add a new patient to the program.
We suggest you keep a list in an Excel file for easy access and also record this number in the patient chart. We have created a tracking sheet for you to use in the Tools section of this Web page.
All data during the reporting period for 2011 must be submitted by Feb. 1, 2012, to be eligible for the PQRS bonus payment.
CMS payments for PQRS 2011 will be made in the fall of 2012.
The AOA CAP for PQRS reserves the right to accept or decline any request for a refund. If you feel that a refund is due, please contact AOA CAP for PQRS at aberanek@osteopathic.org prior to Feb. 1, 2012, at 5 p.m. EST. Include the following information: your name, an email address you would like the confirmation sent to, and reason for refund. A confirmation email will be sent with information related to your refund, including whether such a refund has been approved. The amount to be refunded in the case where the refund has been approved will incur a $25 processing fee.