Submit PQRI Data Through NCQA Recognition Programs

NCQA Diabetes and Back Pain Recognition Programs Approved by Medicare Physician Quality Reporting Initiative for 2009
The Centers for Medicare & Medicaid Services (CMS) accepted two popular NCQA Recognition Programs for measures group reporting for the purposes of the Physician Quality Reporting Initiative (PQRI). Physicians, chiropractors and nurse practitioners who have earned Recognition from NCQA through the Diabetes (DRP) and Back Pain Recognition (BPRP) Programs now have the opportunity to enjoy an extra benefit: they may opt to have NCQA submit their clinical quality data to Medicare for use in the PQRI.

Providers participating in Medicare's PQRI program receive financial rewards for collecting and reporting practice data about the quality of their care. In 2008, that reward was equal to 1.5 percent of each Medicare FFS Part B claim; in 2009 it rose to 2 percent.

Data for the 2009 PQRI registry can be submitted to NCQA through January 31, 2010. All of the received data will be submitted to CMS by NCQA in March of 2010.

Participation through NCQA's PQRI registry is open to all interested providers. Ways to join:
1. For DRP & BPRP Recognized providers: Clinicians, who are already recognized by NCQA, would have to submit their qualifying data from the 2009 reporting period to receive PQRI incentive payments. In addition, each clinician must provide NCQA with a written authorization that his/her data can be shared with CMS. 30 patients rather than the 25 necessary for Recognition are required in the submittal, and data must be submitted on at least 2 Medicare Fee for Service patients. The submission fee is $150 (per clinician) for resubmitting data for PQRI.

2. For providers currently applying for or considering applying for NCQA's DRP or BPRP program: Eligible providers should submit to NCQA their Recognition Program application along with a written authorization from each clinician that his/her data can be shared with CMS. 30 patients rather than the 25 necessary for Recognition are required in the submittal, and data must be submitted on at least 2 Medicare Fee for Service patients. NCQA is providing clinicians with this opportunity to qualify for the 2009 PQRI registry as an added feature to the Recognition process.

"Physicians and others who participate in PQRI through NCQA Recognition enjoy the two-fold benefit of being recognized for superb care, as well as being rewarded by Medicare for reporting clinical data," said NCQA President Margaret E. O'Kane.

For more information, including instructions and frequently asked questions, visit NCQA Web site at www.ncqa.org/Recognition.



About NCQA
National Committee for Quality Assurance (NCQA) is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations and recognizes physicians in key clinical areas. NCQA's HEDIS is the most widely used performance measurement tool in health care. NCQA is committed to providing health care quality information through the Web, media and data licensing agreements in order to help consumers, employers and others make more informed health care choices. For more information, visit http://www.ncqa.org.

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