Anesthesiologists Can Earn Additional 0.5% Medicare Bonus by Participating in MOC:PQRS
Anesthesiologists who satisfy the requirements for participation in the specialty Maintenance of Certification (MOCA) program are eligible for an additional 0.5% PQRS bonus for the years 2013 and 2014.
Under the PQRS program, board-certified physicians are eligible for the additional MOC:PQRS incentive payment if they (1) satisfactorily report quality measures for the 12-month reporting period, qualifying for the basic PQRS bonus and (2) participate in the applicable MOC program “more frequently than is required to qualify for or maintain board certification status” and successfully complete a qualified MOC program practice assessment for the 12-month period.
The American Board of Anesthesiology (ABA) has recently qualified as a MOC:PQRS entity. As a qualified entity, the ABA defines what constitutes “more frequent participation” than is required for board certification. Last week, the ABA notified its diplomates by e-mail of the availability of the MOCA and provided them with step-by-step instructions.
Step-By-Step Instructions
Time limited and non-time limited certificates. The ABA’s MOCA instructions differ slightly depending on whether the anesthesiologist holds a time limited or non-time limited certificate. Time limited certificates are those issued to anesthesiologists who have qualified beginning in 2000; these physicians must complete the cycle of MOCA activities within ten years. Anesthesiologists certified before 2000 hold non-time limited certificates. Since non-time limited certificate holders are not required to participate in MOCA at all (although voluntary participation is encouraged), participating in the regular MOCA program requirements is considered “more frequent” participation for them. The time-limited certificate holders are required to complete more CME units.
All activities must be completed and reported or attested to by the deadline of December 31, 2013.
1. Satisfactorily report PQRS quality measures for the 12-month period January 1-December 31, 2013. Most anesthesiologists submit PQRS quality measures using the claims-based method. Other acceptable methods are (a) reporting to CMS using a qualified electronic health record, (b) reporting to a qualified registry such as the Anesthesia Quality Institute (AQI) or the American Board of Medical Specialties’ MOC Matters tool, (c) providing the data to a qualified data submission vendor, or (d) using the group-practice reporting method for larger qualifying groups. For further information on the 2013 PQRS program, see ABC’s Alert “PQRS Refresher for Anesthesiologists, CRNAs and Pain Physicians” dated March 25, 2013.
2. Enroll in the MOCA program if the anesthesiologist is not already enrolled. The ABA website, www.theABA.org, allows diplomates to create individual portal accounts through which they can enroll in MOCA. The individual will need to provide his or her National Provider Identifier (NPI) and Board identification number upon registration and will select a personal password that should be controlled like any other confidential password.
3. Complete the Lifelong Learning and Self-Assessment (MOCA Part 2) activities. Anesthesiologists must report successful completion of their CME requirements through their ABA portal accounts. The requirements differ according to whether the anesthesiologist holds a time limited or non-time limited certificate, as noted above.
Time Limited Certificates Non-Time Limited Certificates
Category 1 CME Credits 30 25
ABA-Approved Patient Safety CME Credits 3 2
4. Complete one Practice Performance Assessment and Improvement (PPAI, MOCA Part 4). There are five different ways for anesthesiologists to satisfy the PPAI requirement:
Case evaluation. Diplomates submit to the ABA a summary of the four required steps (collect data; compare outcomes with clinical guidelines; implement plan to improve outcomes; evaluate).
ASA PPAI module. The ASA offers PPAI courses on a number of topics including the following: Obstructive Sleep Apnea, Perioperative Hyperglycemia, Mask Ventilation, Massive Transfusion Therapy and Prevention and Management of Local Anesthetic Systemic Toxicity.
Simulation course. There are multiple ASA-approved simulation centers around the country in which anesthesiologists can enhance their skills in managing critical events through simulation training.
Reciprocity with other specialty boards (Anesthesiology is one of the 24 American Board of Medical Specialties boards).
Quality Improvement Project through the Multi-Specialty Portfolio Program. The anesthesiologist’s own institution sponsors approved multi-disciplinary QI programs on the local level.
5. Participate in a patient experience of care survey. The survey can be administered by the individual’s hospital or department. Alternatively, diplomates can complete the optional module offered by MOC Matters. This module provides a patient experience of care survey including detailed instructions for administration, tracking of progress, and access to aggregate results. (The survey results are not shared with CMS; however, CMS may ask diplomates who attest to completing this module to provide information about the survey).
6. Attest to completion of the MOCA activities. Diplomates can attest to fulfillment of the MOCA requirements using the MOC:PQRS Attestation form available on the MOC Matters website, upon payment of a $30 fee. This is the only available means of attestation. The ABA will verify individual participation in the MOCA program in January 2014 and will notify CMS.
ADDITIONAL INFORMATION
How much is the MOC:PQRS bonus?
The bonus will amount to 0.5% of Medicare estimated allowed payments—thus doubling the maximum amount a physician can earn under the PQRS program.
When will the bonus be paid?
The MOC:PQRS bonus will be paid at the same time as the Physician Quality Reporting incentive payment for 2013 for those physicians that qualify. It will be a separately identifiable payment on the Physician Quality Reporting feedback report for 2013.
Can CRNAs earn the bonus?
No, only board-certified physicians are eligible.
For what years will the bonus be available?
For 2013 and 2014 only, unless PQRS extends the program.