PQRI to Add Elder Maltreatment Reporting, Boost Bonus Payments
by Government Relations Staff
November 20, 2008—Psychologists participating in the Medicare reporting program known as the Physician Quality Reporting Initiative (PQRI) will have another measure for possible utilization in 2009. The new measure is designed to reflect the percentage of patients age 65 and over who have documentation of a screen for maltreatment and, if positive, documentation of a follow-up plan.
Reporting of the "elder maltreatment screening and follow up plan" measure must be accompanied by a diagnostic interview, neurobehavioral status examination or health and behavior assessment.
Examples of elder maltreatment include physical abuse, psychological or emotional abuse, neglect, sexual abuse, abandonment, financial exploitation and unwanted control.
The elder maltreatment screening and follow-up plan measure was developed by an expert work group assembled to create new measures for psychologists to use in the PQRI. The group consisted of four members of the American Psychological Association (APA): Chairperson Merla Arnold, PhD; Jeanne Carter, PhD; Paula Hartman-Stein, PhD; and Practice Directorate Executive Director Katherine Nordal, PhD.
The measure will become part of the PQRI on January 1, 2009. A detailed worksheet explaining the measure's specifications will be posted at www.cms.hhs.gov/pqri no later than December 31, 2008. The reporting period for the 2009 PQRI runs from January 1 to December 31, 2009, with reporting due no later than February 28, 2010.
The PQRI was expanded in 2008 with new measures giving participating psychologists greater opportunity to earn bonus payments from Medicare.
The 2009 program will include seven measures that relate to psychological services: antidepressant medication assessment: screening for depression; performing a diagnostic evaluation; assessing suicide risk; the elder maltreatment screening and follow-up plan; assessing pain prior to initiating therapy; and verifying current medications.
Looking ahead, a set of measures for substance abuse treatment may be added by the Centers for Medicare and Medicaid Services (CMS) to the PQRI in 2010. The substance abuse measure set has already received the approval of a consensus building organization, the AQA Alliance, a step that is required by law for CMS to consider a measure for the PQRI.
Psychologists who successfully report on measures in 2009 will receive an additional 2.0 percent of their total allowed charges to Medicare. This amount reflects an increase from the 1.5 percent bonus paid under the PQRI for 2007 and 2008.
The American Psychological Association (APA) Council of Representatives adopted Criteria for the Evaluation of Quality Improvement Programs and the Use of Quality Improvement Data at the 2008 APA Convention. APA members who are considering participation in the PQRI are encouraged to review these criteria.
In October 2008, the American Medical Association (AMA) surveyed physicians about their experience with the PQRI and issued a press release highlighting the problems reported.
Members with questions about the PQRI can contact government relations staff for the APA Practice Organization at (202) 336-5889 or send an email to pracgov@apa.org.
See answers to Frequently Asked Questions about PQRI.
PQRItoAddElderMaltreatmentReportingBoostBonusPayments.pdf
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