Report: Physician Quality Reporting Penalties Will Cost Providers More than $1 Billion

Are you one of the majority of physicians who has held off submitting data to the Physician Quality Reporting System (PQRS)? Like many, did you find the reporting tools too cumbersome or time consuming, and decided it wasn’t worth it?

Since 2010 the Centers for Medicare and Medicaid Services (CMS) has offered a financial carrot to encourage medical professionals to submit their data through the PQRS. Now here comes the stick.

Physicians who fail to fully participate as of Jan. 1 of this year will be penalized 1.5 percent of Medicare reimbursements in 2015. That percentage increases to 2 percent in 2016.

You can download PQRS final rules and regulation here (PDF, registration required):  (You must be logged in to download this file. Don't have an account? Register for free and you'll be returned to this page.)

The American Medical Association has published an excellent summary of the upcoming penalties and their impact on physician, based on a study by The American College of Radiology’s Harvey L. Neiman Health Policy Institute published late last year. The Neiman Institute estimated CMS will cut Medicare reimbursements to physicians nationwide by $1 billion in 2015.

CMS disputes those figures, according to the AMA article. “About 30 percent of eligible professionals submitted at least some PQRS data in 2011, according to preliminary data, and CMS has continued to make changes to the reporting system by offering easier reporting options and aligning requirements with other quality improvement programs,” according to the AMA article. CMS estimates that 50 percent of physicians will participate this year, which means that 50 percent will be penalized in 2015.

For those qualifying physicians with questions about the PQRS program or who may wish to seek a hardship exemption, contact the PQRS Help Desk at (866) 288-8912.