CMS Reporting

What You Need to Know, Now!

Oncologists who don't participate in the reporting programs of the Centers for Medicare and Medicaid Services (CMS)—specifically, the Physician Quality Reporting System (PQRS), the Electronic Prescribing (eRx) Incentive Program, and the Electronic Health Records (EHR) Incentive Program—run the risk of reductions in Medicare reimbursements on Part B physician fee schedule (PFS) services. See below for information on the phase-out of financial incentives and commencement of financial reductions to Medicare reimbursements.

A timeline of reporting deadlines for these 3 programs for 2013 is also available. Also see CMS' timelines and decision trees for all three programs.

CMS Reporting Program2013 ImplicationsDeadlines for 2013Deadlines for 2014
Physician Quality Reporting System
Provides incentives for reporting quality measures through 2014; negative payment adjustments start in 2015, based on 2013 PQRS reporting.

Non-Reporting:
1.5% payment reduction in 2015

Reporting:
0.5% PFS payment increase (only through 2014) and participation noted on CMS Physician Compare Site

Oct. 15, 2013: Deadline (1) to choose the Admin Claims option to avoid 2015 financial penalities; (2) for group practices to submit a self-nomination letter; (3) for groups of 100+ EPs to elect the quality-tiering option for VBM.

Dec. 31, 2013: End of reporting period.

Feb. 28, 2014: Claims-based reporting for 2013 must have arrived to CMS data warehouse.

March 2014: Registry reporting due (deadline is registry specific).

Electronic Prescribing Incentive Program
Provides incentive to practices that successfully e-prescribe. There are payment penalities for eligible professionals who are not successful electronic prescribers.

Non-Reporting:
2.0% payment reduction in 2015

Reporting:
0.5% PFS payment increase (only through 2014) and participation noted on CMS Physician Compare Site

June 30, 2013: End of 6 month reporting period to avoid 2014 financial penalities. Also last day to apply for an exemption to 2014 penalities. Successful 2012 participants can ignore, as they are automatically excluded from the 2014 penalities. 

Dec. 31, 2013: End of reporting period.

Feb. 28, 2014: Claims-based reporting for 2013 must have arrived to CMS data warehouse.

EHR Incentive Program
Provides incentives to providers that demonstrate "meaningful use" of EHR technology over three program stages. Payment reductions begin in 2015 for eligible professionals who do not participate.

Non-Reporting:
1.0% payment reduction in 2015

Reporting:
Incentive payments through Medicare or Medicaid (varies depending on program and year of initiation)

October 3, 2013: Last day to begin 90 day reporting period (for first year of MU only).

Dec. 31, 2013: End of reporting period.

Feb. 28, 2014: Last day to attest for EHR program.

Value Based Modifier Program
Assesses both quality of care furnished and the cost of that care under the Medicare Physician Fee Schedule.

Summer of 2014: Quality Resources and Use Reports (QRURs) will be available for all groups and solo practitioners