Wound Care Articles and Insights
November 15, 2016

2016 CMS Incentive Program Updates

Melissa Bailey

In 2016 the CMS Incentive programs include:

PQRS – Physician Quality Reporting System

VM – Value-Based Modifier (tied to PQRS reporting)

MU – Meaningful Use

Following are updates and notifications from CMS regarding these programs:

  • CMS began distributing letters to eligible professionals (EPs) regarding 2015 Physician Quality Reporting System (PQRS) results. The letter indicates that the recipient did not satisfactorily report 2015 PQRS quality measures or satisfactorily participate in a qualified clinical data registry (QCDR) in order to avoid the 2017 PQRS negative payment adjustment.  As a result, all of their 2017 Medicare Part B Physician Fee Schedule (PFS) payments will be subject to a 2.0% reduction.  Value-Based Modifier may add an additional 2.0% penalty to the 2017 Medicare Part B Physician Fee Schedule payment.
  • Saturday, October 1, 2016 was the deadline for eligible professionals, hospitals and critical access hospitals new to the meaningful use program to submit their attestations.
  • Eligible Professionals new to the meaningful use program must submit attestations for a continuous 90-day reporting period to avoid a payment adjustment in 2018.
  • The period for returning providers to submit attestations is Jan. 3 through Feb. 28, 2017.

On November 1, 2016, CMS finalized the 90-day EHR reporting period.   In both 2016 and 2017, all returning EPs, eligible hospitals, and CAHs (critical access hospitals) that have 

  • previously demonstrated meaningful use in the Medicare and Medicaid EHR Incentive Programs will only need to report over a continuous 90-day period.  This CMS final rule replaces the full calendar year requirement.

Since we are quickly approaching CMS deadlines for returning participants, I encourage all EPs to perform an analysis of your MU and PQRS measures to determine compliance with the CMS incentive programs. 

Following is a list of Eligible Professionals required to participate in Meaningful Use for 2016:

  • Doctors of Medicine or Osteopathy
  • Doctors of Dental Surgery or Dental Medicine
  • Doctors of Podiatric Medicine
  • Doctors of Optometry
  • Chiropractors

Please click on the link below for a list of Eligible Professionals required to participate in the CMS PQRS/VM programs.




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