Medicare Eyes EHR Data for PQRI

HDM Breaking News, July 13, 2009

The Centers for Medicare and Medicaid Services is considering expanding the Physician Quality Reporting Initiative to include data on quality measures submitted from electronic health records systems.

The PQRI program presently includes Medicare incentive payments to physicians for submission of claims-based data. CMS has been testing with physicians the submission of EHR data without including incentive payments.

In a proposed rule setting the Medicare physician fee schedule for calendar year 2010, the agency indicates that now may be the time to formally start the incentive program with EHR data.

"We will make the determination as to whether accepting data from EHRs on quality measures is practical and feasible for the 2010 PQRI prior to publication of the CY 2010 PFS final rule with comment period," according to the proposed rule published on July 13. "We will indicate in the CY 2010 PFS final rule with comment period whether we intend to finalize this proposal. If we finalize this proposal, then, unlike in previous years, an eligible professional would be able to earn a PQRI incentive payment through the EHR-based reporting mechanism in 2010."

The 307-page proposed rule does not appear to have any obvious hints at what federal officials may be thinking as work continues to develop a definition of "meaningful use" of EHRs under the stimulus law's forthcoming Medicare/Medicaid incentives. The term "meaningful use" does not appear in the proposed rule. The HIT Policy Committee will meet again on July 16 to continue deliberations on a definition.

Text of the Medicare physician fee schedule proposed rule is available at gpoaccess.gov/fr/index.html.

--Joseph Goedert

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