BREAKING NEWS: CMS relaxes PQRS 2014 requirement to apply all SOP codes

Notice from GE Healthcare:

Dear Quality Submission Service Participant:

We have some important news about the PQRS 2014 SOP code program requirements that we believe will provide significant relief for customers who are still in the process of applying SOP codes. This news includes updated guidance from CMS in addition to the creation of a new CQM script.

RELAXED SOP CODE REQUIRMENTS FOR 2014

GE Healthcare has been working with CMS over the last months to clarify the application of SOP codes for health plans. In our recent communications with you (webinars on 1/22 & 2/3; email on 2/4), we outlined GE’s interpretation of the PQRS 2014 requirements. CMS confirmed our interpretation but also acknowledged that there has been confusion among vendors in the use of the detailed SOP codes for PQRS submissions.

Yesterday, CMS stated an important change to the PQRS guidelines that adds customer flexibility:

• It is now acceptable, at your discretion, to ONLY apply SOP codes to the Medicare FFS (Part B) plans for PQRS 2014 reporting and to categorize the remaining health plans in a single broad health plan “Category D – Other.”
• Our customers may leave the non-Medicare FFS plans uncoded and these will be mapped by CQR to broad health plan “Category D – Other” without any intervention on your part.
• Please see the attached document for details on applying this guidance.
Please note: Our guidance to report on at least 9 measures across 3 domains that each represent a significant Medicare FFS initial patient population remains unchanged.

CUSTOMERS WHO HAVE ALREADY FULLY COMPLETED THEIR SOP CODE MAPPINGS:

CMS advised us to inform our customers that the requirement to apply SOP codes for all payers will be reinstated for PQRS submissions for the 2015 reporting year. Therefore, if you have already fully completed your SOP code mappings, according to our previously issued workflow for the 2014 program year, rest assured that you do not need to un-map any previously assigned SOP codes with this CMS clarification. You are well positioned for the 2015 program year when the requirement goes into effect.

New “Reset CQM Subscription” Script 

In addition to the welcome news from CMS, we are pleased to announce the availability of the “Reset CQM Subscription” script, as discussed on our February 3rd. CPS and CEMR customers will be able to download the script from the service portal once it is posted later today. After applying SOP codes in Part 1 (a), you must reset the Clinical Quality Measures subscription to transmit the data to CQR, and this new script automates that subscription reset process.

We welcome yesterday’s response from CMS and hope this news helps you more easily meet the requirement to authorize your providers by February 13, 2015. If you have any questions, please contact Centricity Support at 888-436-8491 (Option 2, Option 3).  If you have specific questions on the SOP rules, you can also contact the Sage Growth Partners SOP Hotline at 667-217-3650. For expedited service, please request that the support representative record “PQRS” at the beginning of the description of the support ticket.

Sincerely,
Peter Kinhan
Vice President & General Manager,
Ambulatory Practice Solutions
GE Healthcare IT