2016 PQRS GPRO Registration

2016 Physician Quality Reporting System (PQRS) Group Practice Reporting Option (GPRO) Registration is Open between April 1, 2016 and June 30, 2016

Register to Participate in the 2016 PQRS GPRO

Modify or Cancel a 2016 PQRS GPRO Registration

Groups that Do Not Have to Register for the 2016 PQRS GPRO

Obtain an EIDM Account to Access the Registration System

Resources

 

Groups can register to participate in the 2016 PQRS GPRO via the Physician Value-Physician Quality Reporting System (PV-PQRS) Registration System between April 1, 2016 and June 30, 2016 (11:59 pm EDT). The Registration System can be accessed at https://portal.cms.gov using a valid Enterprise Identity Management (EIDM) account. Please see the instructions provided below on how to obtain an EIDM account.

A “group” or “group practice” is defined as a single Medicare-billing Taxpayer Identification Number (TIN) with 2 or more individual eligible professionals (EPs) (as identified by their individual National Provider Identifier (NPI)) who have reassigned their billing rights to the TIN. EPs that choose to participate in the PQRS as a group will need to inform CMS of their election by registering to participate in the 2016 PQRS GPRO. This is an annual election and participation in the PQRS as a group in years prior is not carried forward.

Groups can participate in the 2016 PQRS GPRO by selecting one of the GPRO reporting mechanisms:

• Qualified PQRS Registry
• Electronic Health Record (EHR) [via Direct EHR using certified EHR technology (CEHRT) or CEHRT via Data Submission Vendor]
  • Note: Contact your EHR Vendor before selecting this option to confirm that your EHR meets the requirements for group reporting.
• Qualified Clinical Data Registry (QCDR)
  • Note: Contact your QCDR Vendor before selecting this option to confirm that your QCDR meets the requirements for group reporting.
• Web Interface (for groups with 25 or more EPs only)
  • Note: Some groups may have zero Medicare beneficiaries assigned for GPRO Web Interface as a result of patient attribution and sampling rules. If a group does not have any Medicare patients for any of the GPRO Web Interface measures, the group will not meet the criteria for satisfactory reporting using the Web Interface. CMS will notify groups that do not have enough beneficiaries assigned and request that the group select a different reporting mechanism.
• Consumer Assessment of Health Providers and Systems (CAHPS) for PQRS Survey via a CMS-certified Survey Vendor (as a supplement to another GPRO reporting mechanism)
  • Note: In 2016, the CAHPS for PQRS survey is required for groups with 100 or more EPs, but is optional for groups with 2-99 EPs. For all groups that have elected or are required to report the CAHPS for PQRS survey, for 2016, the group is responsible for selecting and paying a certified survey vendor to implement these surveys on the group’s behalf. Some groups may have insufficient sample sizes, as a result of patient attribution and sampling rules, to have valid and reliable CAHPS for PQRS survey results. CMS will notify groups that do not have enough beneficiaries assigned. Groups should make sure to report sufficient number of measures via their primary chosen reporting method (EHR, Registry, GPRO Web Interface, or QCDR) to meet program requirements.
  • For groups with 2 or more EPs that elect or are required to report the CAHPS for PQRS survey, they can decide whether to include the group’s performance on the 2016 CAHPS for PQRS survey in the calculation of the group’s 2018 Value Modifier.

Step-by-step instructions for registering to participate in the 2016 PQRS GPRO are provided in the “2016 PQRS GPRO Registration Guide” located in the “Downloads” section below.
For additional information about the PQRS program, the CAHPS for PQRS survey, and the Value Modifier program, please refer to the links in the “Resources” section below.

2018 Value Modifier: Physicians, nurse practitioners (NPs), physician assistants (PAs), clinical nurse specialists (CNSs), and certified registered nurse anesthetists (CRNAs) in groups of all sizes and those who are solo practitioners are subject to the Value Modifier in 2018, based on performance in 2016. Avoiding the 2018 PQRS payment adjustment by satisfactorily reporting via a PQRS GPRO is one of the ways groups can avoid the automatic downward payment adjustment (-2.0% or -4.0% depending on the size and composition of the group) and qualify for adjustments based on performance under the Value Modifier in 2018. Alternatively, groups can also avoid the automatic downward payment adjustment and qualify for adjustments based on performance in 2018, if the EPs in the group participate in the PQRS as individuals in 2016 and at least 50% of the EPs meet the criteria to avoid the 2018 PQRS payment adjustment. No registration is necessary if the EPs in a group participate in the PQRS as individuals.

• Groups that participate in the Medicare Shared Savings Program
• Groups that only provide care to Medicare beneficiaries who are enrolled in a Medicare Advantage plan.
• EPs that choose to participate in the PQRS as individuals in 2016 via claims, qualified PQRS registry, QCDR, or EHR.
  • Note: Groups with 2 or more EPs must ensure that at least 50% of the EPs in the group meet the criteria to avoid the 2018 PQRS payment adjustment as individuals in order for the group to avoid the automatic downward payment adjustment (-2.0% or -4.0% depending on the size and composition of the group) and qualify for adjustments based on performance under the Value Modifier in 2018.

The Registration System can be accessed at https://portal.cms.gov using an EIDM account with the correct role. One person from the group must first sign up for an EIDM account with the Security Official role. If additional persons are needed to register the group for the PQRS GPRO, then they can also request the Security Official role or the Group Representative role in EIDM.

A person from the group can sign up for a new EIDM account or modify an existing account at https://portal.cms.gov. This step should be completed NOW to avoid any last minute delays in obtaining an EIDM account. An EIDM account must be obtained in advance so that the group’s registration can be submitted before the registration period closes on June 30, 2016 (at 11:59 pm EDT).  To find out whether there is already someone who can register the group to participate in the PQRS GPRO, contact the QualityNet Help Desk at the number provided in the “Resources” section below and provide the group's TIN and the name of the group.

Once an EIDM account with the correct role is obtained, follow the step-by-step instructions provided in the “2016 PQRS GPRO Registration Guide” located in the “Downloads” section below, to register the group to participate in the 2016 PQRS GPRO.   

For questions about participating in the 2016 PQRS as a group or as an individual or obtaining an EIDM account, contact the QualityNet Help Desk.

• Monday – Friday: 8:00 am – 8:00 pm EST
• Phone: (866) 288-8912 (TTY 1-877-715-6222)
• Email: qnetsupport@hcqis.org

For questions about the Value Modifier, contact the Physician Value Help Desk.

• Monday – Friday: 8:00 am – 8:00 pm EST
• Phone: 1-888-734-6433 (select option 3)
• Email: pvhelpdesk@cms.hhs.gov