Disclaimer: Presentation dated April 9, 2015. Please check CMS's website directly for updated information. Link to CMS resources: .
To download the PowerPoint slides, please visit NBHP's website here: .
Intended Audience: Behavioral health administrators, billing professionals, controllers, quality and outcomes professionals, and eligible clinicians (especially: psychologists and LCSWs) working in a setting that bills Medicare Part B under unique provider identifiers. Physician Quality Reporting System (PQRS) eligible professionals in behavioral health may include: Doctor of Medicine, Doctor of Osteopathy, Occupational Therapist, Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist, Clinical Social Worker, and Clinical Psychologist.
Topics: The presentation will cover (1) General overview of Physician Quality Reporting System (PQRS), (2) Reporting requirements, (3) Claims-based reporting, (4) Behavioral/mental health measures. Purpose: To support Greater Houston behavioral health providers in maximizing third party funding streams revenue—in particular, in this case, to spare eligible providers from a 2% Medicare reimbursement penalty in 2017 for failure to participate or accurately report on PQRS measures in 2015. To continue to inform area providers about emerging trends in behavioral health outcomes and reimbursement in the context of the Patient Protection and Affordable Care Act.
Presenter: Molly MacHarris is the Acting Deputy Division Director for the Division of Electronic and Clinician Quality within the Quality Measurement & Health Assessment Group in the Centers for Clinical Standards of Quality at CMS. She is the lead for the Physician Quality Reporting System and Electronic Prescribing (eRx) Incentive Program. In this capacity, Molly provides leadership and input to a variety of aspects of the programs, including operations, policy and alignment with other quality programs.
About BHACA: The Behavioral Health Affordable Care Act (BHACA) Initiative is a major collaborative endeavor of the Network of Behavioral Health Providers (NBHP) and Mental Health America of Greater Houston (MHA) designed to support Greater Houston area mental health and substance use providers in responding to the Patient Protection and Affordable Care Act and other recent healthcare reforms across four domains: (1) enhancing and increasing the delivery of integrated health care (IHC), (2) maximizing third party funding streams revenue, (3) adopting certified electronic health record (EHR) systems, and (4) developing outcome-based evaluations. The BHACA Initiative is generously funded by Houston Endowment Inc., The Meadows Foundation, the United Way of Greater Houston Community Response Fund and the Rockwell Fund.
