McKesson released the following letter on January 16, 2015:

This letter provides information regarding the current capability of Practice Partner® v11.0 as it relates to submission of the following reports:

• Physician Quality Reporting System (PQRS) 
• Electronic Clinical Quality Measures (eCQM) reports 
• Comprehensive Primary Care Initiative (CPCI) reports

McKesson certified Practice Partner v11.0 with the Office of the National Coordinator for HealthCare IT (ONC) is using a tool called Cypress. Cypress is one of the rigorous and repeatable testing tools used by ONC to certify Electronic Health Records (EHRs) and EHR modules in calculating performance metric reports and Clinical Quality Measures (CQMs) for Meaningful Use (MU) Stage 2.

The Centers for Medicare & Medicaid Services (CMS) recently indicated the Quality Reporting Document Architecture (QRDA) file format certified previously with Cypress is not the layout they accept. The QRDA format that CMS accepts is the combined format for CQM, CPCI and PQRS. Therefore, McKesson needs to make modifications to Practice Partner v11.0 to allow for the required format that CMS will accept for PQRS reporting.

McKesson is working diligently with CMS to understand the changes needed in Practice Partner v11.0 in order to provide our customers the ability to report on PQRS measures via CEHRT. To date, we have successfully registered for QualityNet and we are conducting focused testing and certification on the QRDA file format to help ensure that the changes made meet CMS requirements.

IMPORTANT NOTE: Until this testing is complete, customers will not be able to submit CQM data electronically.

There are 64 possible Clinical Quality Measure (CQM) reports required for Stage 2 certification. These same measures are valid for PQRS submission. Practice Partner currently provides 38 of these reports, with another five that will be released in January 2015, bringing the total number to 43. These 43 measures should cover the majority of primary care and specialty requirements. Additional measures will be considered in the future road map based on request, but currently there are no additional CQM reports slated to be added.

For practices participating in the CPCI program, please watch for future notification on how to attest manually for this incentive program.

We will continue to provide updates with our progress as it relates to the above information.

Sincerely,

Tom Reinecke
Director – Product Management
Business Performance Services

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What does this mean for Medisoft Clinical / LytecMD / Practice Partner Users?

Users that are participating in the EHR Incentive Program can meet the requirements for Meaningful Use by selecting to report CQM data through attestation. This will satisfy the requirements for Meaningful Use, however it will not satisfy the requirements for the PQRS program.

With this announcement it is imperative that Practices that have not already submitted PQRS data for 2014 make proper arrangements to do so.

Facts about PQRS:

• Providers can earn a Bonus payment of 0.5% of their total estimated Medicare Part B allowed charges by reporting PQRS data for 2014.
• There is a 2% payment adjustment/penalty that will be deducted from all Medicare Part B payments for services provided in 2016 if providers do not satisfactorily report PQRS for 2014.
• The deadline to submit PQRS data for 2014 is February 28, 2015.

There are several ways to report PQRS data for 2014 including:

1. Claims Based Reporting:
   Requires appropriate G codes for 9 individual measures to have been billed on Medicare Part B Claims for 50% of applicable patients for the entire calendar year of 2014
2. Qualified Registry Reporting: 
   Option A: Choose 1 Measure group to report 20 applicable patients
   – 12 Month OR 6 Month Reporting Period)
   – At least 11 patients must be Medicare patients
   Option B: Choose 9 Individual Measures aross 3 NQS Domains for at least 50% of Medicare patients to whom the individual measures apply.
   – 12 Month Reporting Period
   List of 2014 Qualified Registries
3. Direct EHR Reporting:
   Report on 9 Individual Measures across 3 NQS Domains for applicable patients for a 12 Month Reporting Period.
   – In 2014 CMS is allowing providers to single report quality measures to PQRS for the entire year (12 Month reporting period) and have it qualify for the CQM requirement under Meaningful Use. However, because the 2014 CEHRT versions of Medisoft Clinical/LytecMD/Practice Partner (v11) were not released until after the start of the year, and due to the fact that many of the measures require configuration or changes to documentation in order to capture the data in a manner that will produce numbers on the CQM reports, it is unlikely that any providers will have a full year’s worth of data in their CQM reports. In addition, the announcement cited above from McKesson confirms that direct EHR Reporting is not available at this time.
4. EHR Reporting via Data Submission Vendor:
   Report on 9 Individual Measures across 3 NQS Domains for applicable patients for a 12 Month Reporting Period.
   – McKesson is not currently partnered with any Data Submission Vendors, however, there may be Data Submission Vendors that are compatible with Medisoft Clinical/LytecMD/Practice Partner as a third party solution. Providers are responsible for working directly with third party vendors to report via this method.
   – Data Submission Vendors require the applicable data to be recorded in a structured manner for the entire 12 month reporting period in order for them to accurately export and report the data on the providers behalf.
5. Qualified Clinical Data Registry (QCDR):
   Report on 9 Individual Measures across 3 NQS Domains for applicable patients for a 12 Month Reporting Period.
   – McKesson is not currently partnered with any QCDRs, however there may be QCDRs that are compatible with Medisoft Clinical/Lytec MD/Practice Partner as a third party solution. Providers are responsible for working directly with third party vendors to report via this method. 2014 Certified QCDRs List

For practices that did not report PQRS data through claims in 2014 we are recommending Qualified Registry Reporting. While AZCOMP has no direct experience with any of the Registries, and therefore cannot endorse any specific registry, we have found sites such as MDInteractive.com that have made the process for reporting PQRS simple. For example, if providers qualify to report under a measure group then MDInteractive.com has a worksheet (usually 1-2 pages with 9 or fewer questions) that only need to be filled out for a total of 20 applicable patients (11 must be Medicare). We have heard that the entire process generally takes an office 4-6 hours to identify the patients, fill out the worksheets and enter the information into the registry. For specific questions regarding registry reporting please contact the registry of your choice directly as AZCOMP does not directly support registry reporting.

For Questions Regarding the PQRS program contact the QualityNet Help Desk

• Available Monday – Friday; 7:00 AM–7:00 PM CST
• General CMS Physician Quality Reporting System Incentive Program information
• Portal password issues
• Feedback report availability and access
• PQRI-IACS registration questions
• PQRI-IACS login issues

Phone: 1-866-288-8912

TTY: 1-877-715-6222

Email: Qnetsupport@hcqis.org

Disclaimer: AZCOMP Technologies, Inc, (AZCOMP) is providing this material as an informational reference for eligible professionals. Although every reasonable effort has been made to assure the accuracy of the information within these pages at the time of posting, the EHR Incentive program is constantly changing, and it is the responsibility of each provider to remain abreast of the EHR Incentive program requirements.