PQRS Reporting and MAV (Measure-Applicability Validation) – Answers to PMI Questions

As 2017 begins, Revenue Cycle Management companies continue to navigate the Quality Payment Program. PMI recently contacted the QPP Service Center to ask the following questions:

  1. In the past we were able to submit quality data both by Claims and by Registry. The PQRS program used the reporting method that was most advantageous to the provider in determining quality scores. I understand that in 2017 this will no longer be the case. Please advise how a provider is to let the QPP know which method he/she is using. Will there be a specific declaration of intent, or does the submission by registry override any claims data that may have been submitted? It’s likely impossible to stop all claims quality codes from being submitted, even if the provider expects to report by registry.
  2. I understand there will be a process in place (similar to PQRS MAV), that will be used to ensure that all eligible measures have been submitted. Please advise when you expect the MAV clusters for both Claims and Registry to be published.

The QPP Service Center responded:

  1. You can still report Quality Category data by claims or registry. However if it were to happen where data was submitted by both mechanisms under a single category, CMS would score all mechanisms but use the high score for their final composite scoring. CMS prefers one submission method as they take the highest score out of however many mechanisms you have.
  2. There will be procedure just like MAV however there will be no clusters to implement this year.

As PMI provides support to its billing and registry clients for QPP, we are actively monitoring program updates, to include the release of a MAV replacement.