CMS PQRI 2007 payments and reports to physicians / CMS issues report on Medicare RAC demonstration

[CAL/AAEM News Service]

CMS PQRI 2007 payments and reports to physicians

Source: The American Medical Association ( http://www.ama-assn.org )
Date: July 24, 2008


The Centers for Medicare & Medicaid Services (CMS) recently announced the distribution of 2007 Medicare Physician Quality Reporting Initiative (PQRI) incentive payments for eligible physicians, physician group practices and other professionals who satisfactorily reported. Payments will be distributed electronically to the related Tax ID Number and should be received by August. Registration is not needed to receive incentive payments.

According to CMS, more than $36 million in bonus payments will be made to more than 56,700 eligible PQRI participants who satisfactorily reported quality information to Medicare under the 2007 PQRI. The average incentive amount for individual professionals is over $600, while the average incentive payment for a physician group practice is over $4,700. The largest payment to a physician group practice totals over $205,700. 

Feedback reports for all eligible professionals who participated (regardless of success) are available; registration is required to access these reports. Visit the CMS Web site to register or to access your feedback report. Call (866) 484-8049 or (866) 523-4759 with questions on how to register, access or change your Individuals Authorized Access to CMS Computer Services (IACS) account. 

Contact the QualityNet Help Desk by calling (866) 288-8912 or e-mailing with questions on the 2007 PQRI reports related to the quality measures listed or any discrepancies with reports.

http://www.cms.hhs.gov/MMAHelp/07_IACS.asp

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CMS issues report on Medicare RAC demonstration 

Source: The American Hospital Association ( http://www.aha.org )
Date: July 11, 2008

 
After months of delay, the Centers for Medicare & Medicaid Services today released a new report on the Medicare Recovery Audit Contractor three-year demonstration program. According to the report, RACs recouped $992.7 million in overpayments to providers, while $37.8 million in underpayments were repaid to providers as of March 27. Of the overpayments, 85% were collected from inpatient hospital providers, 6% from inpatient rehabilitation facilities and 4% from outpatient hospital providers. After expenses, appeals and underpayments repaid to providers, the program returned $693.6 million to the Medicare Trust Fund; however, CMS notes that this amount is subject to change depending on the outcome of pending appeals. The report also outlined lessons learned during the demonstration and improvements CMS will make to the permanent program scheduled to roll-out later this summer. AHA Vice President for Policy Don May said, "We've worked hard to identify RAC
 problems and the report highlights several improvements CMS is implementing to make the permanent program fairer and less burdensome to hospitals. We appreciate these changes but more changes are needed." The AHA-backed Medicare Recovery Audit Contractor Program Moratorium Act (H.R. 4105), introduced by Reps. Lois Capps (D-CA) and Devin Nunes (R-CA), would place a one-year moratorium on the RAC program. RACs identify Medicare overpayments and underpayments, and receive a percentage of the overpayments they collect from providers.

Abid Mogannam &
Brian Potts MD, MBA
Managing Editors, CAL/AAEM News Service
University of California, Irvine

The CAL/AAEM Archives are available at: http://maillists.uci.edu/mailman/public/calaaem/

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