Washington Report — Updated June 20, 2007 (original publication April 9, 2007)

Dear Heart Rhythm Society Member:

On December 20, 2006, President Bush signed the Tax Relief and Health Care Act of 2006 (TRHCA) mandating establishment of a physician quality reporting initiative within the Centers for Medicare and Medicaid Services (CMS) and authorizing a payment incentive for voluntary participation. Physicians who report quality measures for care delivered to Medicare beneficiaries July 1–December 31, 2007 may receive an additional 1.5 percent incentive payment, subject to a bonus payment cap. Registration will not be necessary for physician-level reporting. 2007 PQRI is not linked to the ICD Registry™ effort at this time.

Quality measures within the 2007 Physician Quality Reporting Initiative (PQRI) are adopted or endorsed by a consensus organization such as the AQA Alliance, the Physician Consortium, or National Quality Forum (NQF). HRS' Quality Improvement Task Force, Chaired by Stephen C. Hammill, MD and Sana Alkhatib, MD, has been working on efforts to include reimbursement codes routinely used by HRS Membership into this initiative. 74 quality measures have been announced with specific reimbursement codes linked to each quality measure.

For 2007 only, HRS members have the opportunity to report on:

• Measure #5 Worksheet (Adobe PDF, 91K): ACE or ARB therapy for heart failure patients with Left Ventricular Systolic Dysfunction (LVSD)
• Measure #6 Worksheet (Adobe PDF, 82K): Antiplatelet therapy prescribed for Coronary Artery Disease (CAD) patients
• Measure #7 Worksheet (Adobe PDF, 85K): Beta-blocker therapy prescribed for CAD patients with prior Myocardial Infarction (MI)
• Measure #8 Worksheet (Adobe PDF, 89K): Beta-blocker therapy prescribed for heart failure patients with LVSD
• Measure #20 Worksheet (Adobe PDF, 99K): Perioperative Care: Timing of Antibiotic Prophylaxis – Ordering Physician
• Measure #22 Worksheet (Adobe PDF, 96K): Perioperative Care: Discontinuation of Prophylactic Antibiotic

Note (added January 2008): 2008 PQRI worksheets are available.

Voluntary participants must report a minimum of three quality measures on at least 80 percent of the cases for which that quality measure is reportable. If it is determined that reporting occurred less than 80 percent of the time for any one of the measures, the physician would be ineligible for the incentive payment.

Reporting is claims-based. CPT Category II codes (or temporary G-codes where CPT Category II codes are not yet available) will be used for reporting quality data. Quality data codes, which supply the measure numerator, must be reported on the same claim as the payment codes, which supply the measure denominator. CMS will provide new information and educational opportunities in the near future.

Confidential feedback reports will be available at or near the time of the bonus payments in mid-CY2008. Reports are expected to summarize reporting and performance rates. The exact format and content of the reports have yet been determined. 2007 PQRI data will NOT be publicly reported. There are no interim reports provided during the reporting period.

CMS provides both a Medlearn Matter (MM5558) and CMS Frequently Asked Questions (FAQ) to help participants understand 2007 PQRI. In addition, the Heart Rhythm Society's PQRI FAQ (Word doc., 120K, updated 6/20/07) offers a comprehensive source of information tailored to HRS membership to help you make the determination to participate in 2007 PQRI.

If you have any questions, Joel Harder, Manager of Quality Improvement and Outcomes at the Heart Rhythm Society, can be reached at (202) 464-3489 or jharder@HRSonline.org.