Statute Regulations Program Instructions

2013 Medicare Physician Fee Schedule Proposed Rule CMS-1590-P

CMS' proposals for the 2013 Physician Quality Reporting System and Electronic Prescribing Incentive Program can be found in the 2013 Medicare Physician Fee Schedule (PFS) proposed rule. The 2013 Medicare PFS proposed rule was displayed in the Federal Register on July 6, 2012 and was  published on July 30, 2012.  CMS will accept comments on the proposed rule until September 4, 2012 and will respond to the comments in a final rule with comment period to be issued by November 1, 2012. To view the entire 2013 Medicare PFS proposed rule, click on the "2013 Medicare Physician Fee Schedule Proposed Rule" link in the "Related Links" section below.

2012 Physician Quality Reporting System Regulations

On November 1, 2011, CMS issued a final rule with comment period that updates payment policies and rates for physicians and nonphysician practitioners (NPPs) for services paid under the Medicare Physician Fee Schedule (MPFS) in calendar year (CY) 2012. This rule includes updates to the 2012 Physician Quality Reporting System as well as provisions for the 2012, 2013, and 2014 Electronic Prescribing (eRx) Incentive Program. The final rule was published on November 28, 2011 in the Federal Register. CMS will accept comments through January 3, 2012. To view this final rule, click on the link titled "2012 Medicare PFS Final Rule - CMS-1524-FC" in the "Downloads" section below.

On July 1, 2011, CMS issued a proposed rule that would update payment policies and payment rates for services furnished under the Medicare Physician Fee Schedule (MPFS) on or after January 1, 2012. The proposed rule also contained proposals for changes to the three incentive programs that are associated with MPFS payments – electronic prescribing (eRx), electronic health records (EHRs), and the Physician Quality Reporting System – as well as changes to the Physician Compare tool on the Medicare.gov web site. The Medicare Physician Fee Schedule NPRM rule was published in the July 19, 2011 edition of the Federal Register. To view the 2012 PFS proposed rule, click on the "2012 Medicare PFS Proposed Rule - CMS-1524-P" in the "Related Links" section below.

2011 Physician Quality Reporting System Regulations

The 2011 Physician Quality Reporting System was finalized in the 2011 PFS final rule with comments. The final regulation was published on November 29, 2010 and is on display at the Federal Register. To view the entire 2011 PFS final rule with comments, see "2011 PFS Final Rule -- CMS-1503-FC" in the "Related Links" section below.

CMS' proposals for the 2011 Physician Quality Reporting System, including the proposed Physician Quality Reporting System reporting mechanisms, the proposed criteria for satisfactory reporting, the proposed measures, and the proposed measures groups, can be found in the 2011 Medicare Physician Fee Schedule (PFS) proposed rule. The 2011 PFS proposed rule was published in the Federal Register on July 13, 2010. To view the entire 2011 PFS proposed rule, click on the "2011 PFS Proposed Rule -- CMS-1503-P" in the "Related Links Inside CMS" section below. In addition, a correction to the proposed rule was published in the Federal Register on August 26, 2010. To view this correction notice, click on the "2011 PFS Proposed Rule Correction Notice – CMS-1503-CN" in the "Downloads" section below.

Physician Quality Reporting Systems Statutory Authority

Affordable Care Act.  The Affordable Care Act makes a number of changes to the Physician Quality Reporting System, including authorizing incentive payments through 2014 and requiring a penalty, beginning in 2015, for eligible professionals who do not satisfactorily report. The Affordable Care Act also authorizes an additional 0.5 percent incentive for 2011 through 2014 for eligible professionals who satisfactorily report and more frequently than is required to qualify for or maintain board certification status participates in a Maintenance of Certification Program for a year and successfully completes a qualified Maintenance of Certification Program practice assessment for such year.

Medicare Improvements for Patients and Providers Act of 2008 (MIPPA).  The MIPPA made the Physician Quality Reporting System permanent, but only authorized incentive payments through 2010. To view the MIPPA legislative language, see the "Related Links" section below.

Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA).  The President signed the MMSEA on December 29, 2007, which authorized the continuation of the Physician Quality Reporting System for 2008 and 2009.

Tax Relief and Health Care Act of 2006 (TRHCA).  On December 20, 2006, the President signed the TRHCA, which initially authorized the Physician Quality Reporting System. 
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Location of Previous Program Year Documents

All previous program year documents will be moved from this page to the specific program year section page at left.