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How to earn the 2014 Physician Quality Reporting System incentive and avoid the 2016 PQRS payment adjustment

The Measure-Applicability Validation (“MAV”) is a process utilized by Centers for Medicare & Medicaid Services (“CMS”) to determine whether eligible professionals or group practices should have reported additional measures to CMS for a specified reporting period. Specifically, MAV determines whether eligible professionals or group practices have earned the 2014 Physician Quality Reporting System (“PQRS”) incentive and thereby avoided the 2016 PQRS payment adjustment.

As such, in the instance an eligible professional or group practice has satisfactorily reported nine or more measures across three or more domains, MAV would not apply and the eligible professional or group practice can earn the 2014 PQRS incentive and avoid the 2016 PQRS payment adjustment.

To avoid application of the MAV, Precision recommends the following:

1. Providers should report each measure for a minimum of 50% of their eligible patient population.
2. Providers should report at least nine or more measures. Be prepared to report one or more additional measures in case one of the nine measures does not report successfully.
3. Providers must cover at least three national quality strategy domains within each measure.
4. Providers who have face-to-face time with Medicare patients should report at least one cross-cutting measure.
5. Group practices should set up guidelines with their clinical staff on the proper reporting of the measures.
6. Data submission education and training is critical to ensuring all measures and related data are submitted properly.
7. Providers should try to avoid utilizing measure codes or modifiers which indicate they did not complete a particular measure.
If you have any questions relating to the MAV, or otherwise how to report measures successfully, please do not hesitate to contact Precision.